骨质疏松椎体压缩骨折椎体成形术后变形相关因素分析  

The analysis of related factors of deformation after vertebroplasty for osteoporotic vertebral compression fractures

作　　者：周辉[1] 彭亮[1] 乐军[1] 董刚[1] 项东[1] 方宜宥[1] Zhou Hui

机构地区：[1]杭州市中医院,310017

出　　处：《浙江临床医学》2020年第9期1251-1253,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省基础公益研究计划项目(LGF19H270008);杭州市科技发展计划项目(20160533B65)。

摘　　要：目的探讨骨质疏松椎体压缩骨折(OVCFs)患者经皮椎体成形术(PVP)与经皮椎体后凸成形术(PKP)后椎体变形的相关危险因素,并应用数字医学方法模拟术后椎体应力变化情况,并分析结果.方法回顾性分析154例OVCFs患者行PVP、PKP治疗的临床资料,采用χ2检验及多因素Logistic分析术椎变形的危险因素,通过计算机模拟分析2ml、4ml、6ml骨水泥注入状态下椎体所承受的力学变化情况.结果术后随访术椎变形29例,发生率18.83%.多因素Logistic分析显示骨质疏松程度、椎体高度恢复率、骨水泥弥散状态、手术方式选择均是术椎变形的相关因素.计算机模拟分析结果显示,椎体植入骨水泥量越大,椎体刚度增加越大,邻椎应力随之增大.结论PVP、PKP后椎体变形的发生率较高,受多因素影响.严格根据患者病情选择合适的注射方式和注射剂量,并重视骨质疏松的长期治疗,可有效降低术椎变形的发生率,同时骨水泥注入量增加椎体刚度的同时也加大邻椎骨折的危险.Objective To explore the risk factors of vetebral deformation afer percutaneous vertebroplasty,and to simulate the sress changes of vertebral body by digital medicine,and to get the analysis results.Methods The 154 cases of osteoporotic vertebral compression fracture treated by percutaneous vertebroplasty were analyzed retrospectively.To explore the risk factors that may cause the deformation of operation vertebrae,x^2 test and multi factor Logistic analysis were used for statistical analysis,and the mechanical changes of vertebrae under the condition of 2ml,4ml and 6ml bone cement injection were analyzed by computer simulation.Results The 29 cases were followed up,the incidence rate was 1883%.Multivariate logistic analysis showed that the degree of osteoporosis,the recovery rate of vertbral body height,the difusion state of bone cement and the choice of operation mode were all related factors of operative vertebral deformation.The results of computer simulation analysis showed that the greater the amount of bone cement implanted into the vertebral body,the greater the siffiness of the vertebral body,and the greater the stress of the adjacent vertebral body.Conclusion The incidence of vertebral deformation afer percutaneous vertebroplasty is high,which is afected by many factors.According to the patient's condition,choosing the appropriate injection method and dosage,and paying attention to the long-term treatment of osteoporosis can ffctively reduce the incidence of vertebral deformation.At the same time,too much bone cement injection can increase the sifiness of vertebral body and increase the risk factors of adjacent vertebral fracture.

关 键 词：骨质疏松 椎体成形术 脊柱骨折 危险因素 

分 类 号：R68[医药卫生—骨科学]