脊柱-骨盆矢状位平衡对PKP术后继发骨折的影响  

Effect of spinal pelvic sagittal balance on secondary fractures after PKP

作　　者：孙青[1] 卞敏凯[1] 金永[1] 张亮[1] 戴荣峰[2] 黄泽宇[3] 徐扬 SUN Qing;BIAN Min-kai;JIN Yong;ZHANG Liang;DAI Rong-feng;HUANG Ze-yu;XU Yang(Department of Orthopedics,the Third People's Hospital of Changzhou;Department of Endocrinology,the Third People's Hospital of Changzhou;Department of Education,the Third People's Hospital of Changzhou;Department of Orthopedics,Wujin People's Hospital,Changzhou,Jiangsu,213000,China)

机构地区：[1]常州市第三人民医院骨科 [2]常州市第三人民医院内分泌科 [3]常州市第三人民医院科教科 [4]武进人民医院骨科,江苏常州213000

出　　处：《颈腰痛杂志》2021年第5期614-616,共3页The Journal of Cervicodynia and Lumbodynia

基　　金：江苏省卫生健康委员会项目(编号:H2018025)。

摘　　要：目的探讨脊柱-骨盆矢状位平衡对经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)术后继发骨折的影响。方法纳入2014年6月~2019年6月本院收治的90例骨质疏松性椎体压缩骨折(OVCF)患者,其中男34例,女56例;年龄56~78岁,平均(64.11±4.87)岁。根据PKP术后是否继发骨折分为骨折组和未骨折组,在侧位X线片上进行脊柱-骨盆矢状位平衡参数测量,并进行组间分析比较。结果PKP术后继发骨折17例,发生率18.88%;脊柱-骨盆矢状位平衡参数中,两组胸椎后凸角(thoracic kyphosis,TK)、胸腰联合角(thoracolumbar joint,TLJ)、矢状面偏移(sagittal vertical axis,SVA)、骨盆入射角(pelvic incidence,PI)、骶骨倾斜角(sacral slope,SS)差异具有统计学意义(P<0.05),组间腰椎前凸角(lumbar lordosis,LL)、局部后凸角(local kyphosis,LK)、骨盆倾斜角(pelvic tilt,PT)差异无统计学意义(P>0.05);Logistic回归分析显示,TK、TLJ、SVA、PI、SS是PKP术后继发骨折的危险因素。结论OVCF患者PKP术后继发骨折的概率较高,受到TK、TLJ、SVA、PI、SS等脊柱-骨盆矢状位平衡参数的影响,术中可考虑降低相关参数值,矫正矢状面过度正平衡以减少继发骨折的发生。Objective To explore the effect of sagittal balance of the spine and pelvis on the secondary fractures after percutaneous kyphoplasty(PKP).Methods A total of 90 cases with osteoporotic vertebral compression fractures(OVCF)in our hospital from June 2014 to June 2019 were included into this study,including 34 males and 56 females.They were 56-78 years old,with an average age of(64.11±4.87)years.According to whether had the secondary fracture after PKP,they were divided into the fracture group and the non-fracture group.The sagittal balance parameters of the spine and pelvis were measured on the lateral X-ray film,and were analyzed and compared between two groups.Results Among the 90 OVCF patients,17 cases had secondary fractures after PKP operation,with an incidence rate of 18.88%.Among the parameters of sagittal balance of the spine and pelvis,thoracic kyphosis angle(TK),thoracolumbar joint angle(TLJ),sagittal vertical axis(SVA),pelvic incidence(PI)and sacral slope(SS)had statistically significant differences(P<0.05),and there were no statistically significant differences in lumbar lordosis(LL),local kyphosis(LK)and pelvic tilt(PT)between the two groups(P>0.05).Logistic regression analysis showed that TK,TLJ,SVA,PI and SS were risk factors for secondary fractures after PKP.Conclusion OVCF patients have a high rate of secondary fractures after PKP surgery,which is affected by spinal pelvic sagittal balance parameters,such as TK,TLJ,SVA,PI,SS,etc.During the operation,it may be considered to reduce the relevant parameter values and correct the excessive positive balance of the sagittal plane to reduce the occurrence of secondary fractures.

关 键 词：骨质疏松压缩性骨折 脊柱-骨盆矢状位平衡 经皮椎体后凸成形术 继发骨折 

分 类 号：R683.2[医药卫生—骨科学]