Denis B型胸腰椎爆裂骨折术后Cobb角度丢失的危险因素分析  

Analysis of risk factors for loss of Cobb angle in the last follow-up of Denis B thoracolumbar burst fracture

作　　者：卢微波[1] 白绍元[1] 王毅 LU Wei-bo;BAI Shao-yuan;WANG Yi(Department of Orthopaedics,Sanmenxia Central Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]三门峡市中心医院骨科,河南三门峡472000

出　　处：《颈腰痛杂志》2020年第3期332-334,共3页The Journal of Cervicodynia and Lumbodynia

基　　金：宁夏回族自治区自然科学基金(编号:NZ16212)。

摘　　要：目的探讨Denis B型胸腰椎爆裂骨折术后Cobb角度丢失的危险因素。方法纳入2013年1月~2017年1月本院收治的154例Denis B型胸腰椎爆裂骨折患者,均采用后路椎弓根钉内固定治疗,随访27~60个月,将Cobb角度丢失≥4°以及<4°者分别设为观察组与对照组。调查两组患者性别、年龄、固定方式等病历资料,并经单因素分析以及Logistic回归分析调查Cobb角度丢失的危险因素。结果术后Cobb角度丢失53例,发生率34.42%,丢失角度1~9°,平均(6.05±1.23)°;两组患者的伤椎置钉、功能锻炼情况、伤椎植骨、术前椎体压缩率、术前Cobb角、年龄、伤椎前缘高度比、体质量指数等差异有统计学意义(P<0.05);Logistic回归分析显示,伤椎未植骨(OR=3.031)、椎体压缩率>50%(OR=2.875)、功能锻炼不合理(OR=2.733)、术前Cobb角>30°(OR=2.723)、伤椎未置钉(OR=3.012)是Denis B型胸腰椎爆裂骨折术后Cobb角度丢失的独立危险因素。结论Denis B型胸腰椎爆裂骨折术易发生Cobb角丢失,受伤椎植骨、椎体压缩率、功能锻炼、术前Cobb角以及伤椎置钉等多种因素影响。Objective To study the risk factors of the loss of Cobb angle in the last follow-up of Denis B thoracolumbar burst fracture.Methods A total of 154 patients with Denis B thoracolumbar burst fractures treated with posterior pedicle screw internal fixation system from January 2013 to January 2017 were included in this study.The patients were followed up for 27-60 months.The Cobb angle loss≥4°and<4°were set as the observation group and the control group,respectively.The medical records of the two groups were investigated for gender,age,and fixed methods,and the risk factors for Cobb angle loss were investigated by single factor analysis and logistic regression analysis.Results Postoperative Cobb angle loss was observed in 53 patients,with an incidence rate of 34.42%,and the loss angle was 1°~9°,with an average of(6.05±1.23)°.The injured vertebra place nail,functional exercise,and injured vertebrae were observed in the observation group and the control group.The differences of bone,preoperative vertebral compression rate,preoperative Cobb angle,age,height of injured vertebrae,and body mass index were statistically significant between the two groups(P<0.05).Logistic regression analysis showed that the injured bone without implantation(OR=3.031),the vertebral compression rate>50%(OR=2.875),unreasonable functional exercise(OR=2.733),preoperative Cobb angle>30°(OR=2.723),and injured vertebra place nail(OR=3.012)were independent risk factors for the loss of Cobb angle in the last follow-up of Denis B thoracolumbar burst fracture.Conclusions Denis B thoracolumbar burst fracture is susceptible to various factors such as Cobb angle loss,injured vertebrae bone graft,vertebral compression rate,functional exercise,preoperative Cobb angle and injured vertebra place nail.

关 键 词：Denis B型胸腰椎爆裂骨折 Cobb角度丢失 危险因素分析 

分 类 号：R683.2[医药卫生—骨科学]