胸腰椎骨折后路钉棒固定联合人工骨植骨术后“空壳”现象Losgistic回归分析  

Logistic regression analysis of influencing factors for'shell phenomenon'after the treatment of posterior pedicle screw reduction and fixation combined with artificial bone graftin patients with thoracolumbar vertebrafracture

作　　者：叶永胜 屈锡亮 黄雄飞 邓方跃 庄沙斌 吴文仁 YE Yong-sheng(The fourth ward of department of orthopaedics,the Traditional Chinese hospital of Dongguan city,Dongguan,Guangdong,523000,China)

机构地区：[1]东莞市中医院骨四科,广东东莞523000

出　　处：《齐齐哈尔医学院学报》2020年第20期2516-2519,共4页Journal of Qiqihar Medical University

基　　金：东莞市社会科技发展一般项目(2018507150021353)。

摘　　要：目的探讨胸腰椎骨折后路钉棒固定植骨术后椎体“空壳”现象的相关因素。方法回顾性分析2017年7月—2019年7月本院收治的行后路钉棒复位内固定联合人工骨植骨术治疗的60例胸腰椎单节段骨折患者的临床资料。记录患者的性别、年龄、受伤至手术时间、骨折类型、伤椎前缘压缩程度、矢状面Cobb角,骨密度值,术前是否伴终板塌陷、复位程度等相关因素,观察患者术后椎体“空壳”现象的发生情况,应用单因素及多因素Logistic回归分析研究各因素与椎体“空壳”现象发生的相互关系。结果60例患者中有28例出现术后椎体“空壳”,发生率46.7%。单因素分析显示:年龄、骨密度、术前椎体压缩程度、术前伴终板塌陷为出现“空壳”现象的相关因素(P<0.05),术前Cobb角、椎体复位程度为非相关因素(P>0.05)。多因素Logistic回归分析显示,骨密度、术前椎体压缩程度,均是术后发生椎体“空壳”现象的独立危险因素(P<0.05)。结论胸腰椎骨折后路钉棒固定植骨术后出现椎体“空壳”现象受多种因素影响,其中骨密度和椎体压缩程度可能是造成“空壳”的主要因素。Objective To investigate the influencing factors for the'shell phenomenon'after the treatment of posterior pedicle screw reduction and fixation combined with artificial bone graft in patients suffered with thoracolumbar fracture.Methods A retrospective analysis was conducted in 60 patients with single segment thoracolumbar fracture who received posterior pedicle screw reduction and fixation combined with artificial bone graft in our hospital from July 2017 to July 2019.Their detailed information was recorded,including gender,age,time from injury to operation,type of fracture,compression of preoperative anterior column of spinal,preoperative sagittal Cobb angle,bone density,whether collapse of the end-plate in fracture segment or not,degree of fracture reduction.The incidence of the shell phenomenon was observed.Single factor analysis and multiple factor logistic regression analysis were used to study the correlation between these factors and the incidence of the shell phenomenon.Results The shell phenomenon in vertebra occurred in 28 ofthe 60 patients,with an incidence of 46.7%.Single factor analysis showed that the shell phenomenon was significantly correlated with age,bone density,preoperative vertebral compression,preoperative end-plate collapse(P<0.05),but not related to preoperative Cobb angle and vertebral reduction degree(P>0.05).Multiple factor Logistic regression analysis showed that bone density and degree of preoperative spinal compression were major independent risk factors for shell phenomenon.Conclusions The shell phenomenon after the treatment of posterior reduction and fixation combined with artificial bone graft in patients with thoracolumbar fracture is influenced by many factors,bone density and the preoperative vertebral compression rate may be the major risk factors of the problem.

关 键 词：胸腰段骨折 植骨 空壳现象 LOGISTIC 

分 类 号：R683.2[医药卫生—骨科学]