穿刺侧骨水泥/椎体体积比与椎体成形骨水泥椎旁静脉渗漏的相关性  

Correlation between puncture-side bone cement/vertebral body volume ratio and bone cement paravertebral vein leakage in vertebroplasty

作　　者：高涛 李涛[1] 胡海刚[1] 袁德超 吴凡[1] 曾俊[1] 吴超[1] 林旭[1] Gao Tao;Li Tao;Hu Haigang;Yuan Dechao;Wu Fan;Zeng Jun;Wu Chao;Lin Xu(First Department of Orthopedics,Zigong Fourth People’s Hospital,Zigong 643000,Sichuan Province,China)

机构地区：[1]自贡市第四人民医院骨一科,四川省自贡市643000

出　　处：《中国组织工程研究》2021年第34期5478-5483,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前国内外骨水泥椎旁静脉渗漏的研究主要集中在穿刺部位、椎体血管分布及骨水泥/椎体体积比等,而穿刺侧骨水泥/椎体体积比对椎旁静脉渗漏的影响国内外尚未见相关报道。目的:探究椎体成形治疗骨质疏松压缩性骨折过程中骨水泥椎旁静脉渗漏的影响因素,验证穿刺侧骨水泥/椎体体积比与骨水泥椎旁静脉渗漏的相关关系。方法:回顾性分析自贡市第四人民医院2018年8月至2020年4月采用椎体成形治疗骨质疏松椎体压缩性骨折患者357例(425个椎体)的病历资料,观察术后X射线片及CT资料判断椎体是否出现椎旁静脉渗漏。采用Mimics软件将患者术后CT资料导入软件,使用3D重建功能计算出骨水泥/椎体体积比、穿刺侧骨水泥/椎体体积比。比较渗漏组与未渗漏组性别、年龄、体质量指数、骨密度、骨水泥体积、穿刺侧骨水泥体积、椎体体积、骨水泥/椎体体积比、穿刺侧骨水泥/椎体体积比之间的差异,采用Logistic回归分析比较两组间差异有显著性意义的因素与椎旁静脉渗漏之间的相关关系,绘制ROC曲线,选取有诊断意义的因素。结果与结论:①出现椎旁静脉渗漏42例(43个椎体),未出现椎旁静脉渗漏患者315例(382个椎体);②单因素分析显示,渗漏组与未渗漏组患者的性别、骨密度、穿刺侧骨水泥体积、穿刺侧骨水泥/椎体体积比相比,差异有显著性意义(P<0.05);③Logistic回归分析显示性别、穿刺侧骨水泥体积、穿刺侧骨水泥/椎体体积比与椎旁静脉渗漏存在相关关系(P<0.05);④受试者工作特征曲线图显示穿刺侧骨水泥/椎体体积比诊断椎旁静脉渗漏的受试者工作特征曲线面积>0.6,且P<0.05,具有一定诊断价值;穿刺侧骨水泥/椎体体积比诊断椎旁静脉渗漏的最佳截断点为13.33%,敏感度81.4%,特异度为26.2%;⑤提示性别、骨密度、穿刺侧骨水泥体积、穿刺侧骨水泥/椎体体积比是�BACKGROUND:The current research on bone cement leakage in the paravertebral vein mainly focuses on the puncture site,vertebral body blood vessel distribution and bone cement/vertebral body volume ratio.However,there have been no relevant reports about the effect of puncture-side bone cement/vertebral body volume ratio on cement leakage in the paravertebral vein in and outside China.OBJECTIVE:To explore the influencing factors of bone cement paravertebral vein leakage in the treatment of osteoporotic compression fractures by vertebroplasty,and to verify the correlation between puncture-side bone cement/vertebral body volume ratio and bone cement paravertebral vein leakage.METHODS:Data of 357 patients(425 vertebral bodies)with osteoporotic vertebral compression fractures treated from August 2018 to April 2020 in Zigong Fourth People’s Hospital were retrospectively analyzed.Postoperative X-ray and CT data were observed to determine whether the vertebral body has paravertebral vein leakage.Mimics software was used to import the patient’s postoperative CT data into the software.The 3D reconstruction function was applied to calculate the bone cement/vertebral body volume ratio,puncture-side bone cement/vertebral body volume ratio.The sex,age,body mass index,bone density,bone cement volume,bone cement volume of the puncture side,vertebral volume,bone cement/vertebral volume ratio,puncture-side bone cement/vertebral volume ratio were compared between the leaked group and the non-leaked group.Logistic regression analysis was used to compare the correlation between the factors with statistical significance between the two groups and the leakage of paravertebral veins.A ROC curve was drawn for the diagnosis of paravertebral vein leakage with statistically significant factors.RESULTS AND CONCLUSION:(1)There were 42 cases of paravertebral vein leakage(43 vertebral bodies).There were 315 patients(382 vertebral bodies)without paravertebral vein leakage.(2)Univariate analysis showed that the differences in sex,bone density,b

关 键 词：椎体成形 骨水泥椎旁静脉渗漏 穿刺侧 骨水泥体积 椎体体积 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]