经皮椎体成形术术后新发椎体骨折特点及危险因素分析  

Analyses on the features and risk factors of new vertebral fractures after percutaneous vertebroplasty

作　　者：罗伟斌 林勇 孙春喜 潘敏成 邹其声 孙欣 LUO Weibin;LIN Yong;SUN Chunxi;PAN Mincheng;ZOU Qisheng;SUN Xin(Department of Orthopedics,the Third Affiliated Hospital of Guangdong Medical University(Longjiang Hospital in Shunde District of Foshan City),Guangdong,Foshan 528318,China;Orthopedic Center,Affiliated Hospital of Guangdong Medical University,Guangdong,Zhanjiang 524001,China)

机构地区：[1]广东医科大学附属第三医院(佛山顺德龙江医院)骨科,广东佛山528318 [2]广东医科大学附属医院骨科中心,广东湛江524001

出　　处：《中国医药科学》2021年第10期210-212,224,共4页China Medicine And Pharmacy

基　　金：广东省科技计划项目(2017ZC0311);广东省湛江市科技发展专项资金竞争性分配项目(2020A01042)。

摘　　要：目的探讨经皮椎体成形术(PVP)术后新发椎体骨折特点及危险因素。方法回顾性分析2016年2月至2019年11月在广东医科大学附属第三医院行PVP的200例患者临床资料。统计PVP术后新发椎体骨折的发生率,骨折位置及骨折发生时间的构成比。采用单因素分析和多因素Logistic回归分析PVP术后新发椎体骨折的危险因素。结果PVP术后新发椎体骨折的发生率为25.5%(51例),其中骨折位置为胸段、腰胸段、腰段的构成比分别为17.6%(9例)、54.9%(28例)、27.5%(14例),而骨折时间≤PVP后3个月、PVP后3个月<骨折时间≤PVP后6个月、PVP后6个月<骨折时间≤PVP后12个月的构成比分别为74.5%(38例)、15.7%(8例)和9.8%(5例)。单因素分析和多因素Logistic回归分析均显示,危险因素骨密度<-4.5 SD、年龄≥70岁、骨水泥渗漏、骨水泥用量>5.0 ml、伤椎数目>2、术前Cobb角>30°的P值均<0.05。结论PVP术后新发椎体骨折的发生率较高,以腰胸段骨折和术后3个月内骨折最为常见。危险因素骨密度<-4.5SD、年龄≥70岁、骨水泥渗漏、骨水泥用量>5.0 ml、伤椎数目>2、术前Cobb角>30°是PVP术后新发椎体骨折的独立危险因素。Objective To investigate the features and risk factors of new vertebral fractures after percutaneous vertebroplasty(PVP).Methods The clinical data of 200 patients undergoing PVP in the Third Affiliated Hospital of Guangdong Medical University from February 2016 to November 2019 were analyzed retrospectively.The incidence of new vertebral fractures after PVP and the constituent ratio of the fracture location and the fracture occurrence time were counted.Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of new vertebral fractures after PVP.Results The incidence of new vertebral fractures after PVP was 25.5%(51 cases),among which the constituent ratio of the fracture locations were thoracic segment,lumbar thoracic segment and lumbar segment,accounted for 17.6%(9 cases),54.9%(28 cases)and 27.5%(14 cases),respectively.Meanwhile,the constituent ratios of fracture time≤3 months after PVP,3 months after PVP<fracture time≤6 months after PVP,6 months after PVP<fracture time≤12 months after PVP accounted for 74.5%(38 cases),15.7%(8 cases)and 9.8%(5 cases),respectively.Univariate analysis and multivariate logistic regression analysis proved that the P values of risk factors such as bone mineral density<-4.5 SD,age≥70 years old,bone cement leakage,bone cement dosage>5.0 ml,number of injured vertebrae>2 and Cobb angle before operation>30°were all<0.05.Conclusion The incidence of new vertebral fractures after PVP is relatively high,and the most common are fractures of lumbar thoracic segment and those within 3 months after PVP.Risk factors such as bone mineral density<-4.5 SD,age≥70 years old,bone cement leakage,bone cement dosage>5.0 ml,number of injured vertebrae>2 and Cobb angle before operation>30°are independent risk factors of new vertebral fractures after PVP.

关 键 词：经皮椎体成形术 新发椎体骨折 术后 危险因素 

分 类 号：R687.3[医药卫生—骨科学]