中老年胸腰段骨折继发后凸畸形的柔韧性影像学评估(Logistic回归分析)  

Imaging evaluation of flexibility of kyphosis secondary to thoracolumbar fracture in middle-aged and elderly patients(Logistic regression analysis)

作　　者：盛明 于海洋[2,3] 张伟 张旭[2] 郑国辉 SHENG Ming;YU Hai-yang;ZHANG Wei;ZHANG Xu;ZHENG Guo-hui(People’s Hospital of Fuyang Affiliated to Anhui Medical University,Fuyang,Anhui 236000,China;Department of Spinal Surgery,People’s Hospital of Fuyang,Fuyang,Anhui 236000,China;Spinal Deformity Clinical Research Center of Anhui Province,Fuyang,Anhui 236000,China)

机构地区：[1]安徽医科大学附属阜阳人民医院(阜阳市人民医院) [2]阜阳市人民医院脊柱外科 [3]安徽省脊柱畸形临床医学研究中心,安徽阜阳236000

出　　处：《颈腰痛杂志》2022年第3期315-318,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：2021年度安徽省卫生健康委科研项目立项项目(编号:AHWJ2021b111)。

摘　　要：目的以Logistic回归模型分析影响中老年胸腰段骨折继发后凸畸形柔韧性(FLEXIBILITY OF KYPHOSIS SECONDARY TO THORACOLUMBAR FRACTURE IN MIDDLE-AGED AND ELDERLY)的相关因素。方法回顾分析66例中老年胸腰段骨折继发后凸畸形患者的临床资料,采用俯卧位加压CT定位像及站立位脊柱全长侧位X线测量局部后凸LKCA角(local kyphosis cobb angle,LKCA)、计算中老年胸腰段骨折继发后凸畸形的柔韧性。统计分析患者年龄、性别、骨折位置、病程、椎体高度丢失程度、是否合并KUMMELL病、骨折椎体楔形变侧椎间盘退变程度、腰椎前凸角(lumbar lordosis,LL)、胸椎后凸角(thoracic kyphosis,TK)和矢状面垂直轴(sagittal vertical axis,SVA)等数据,连续性数据采用单因素相关性分析,非连续性数据采用方差分析,将与柔韧性相关的指标进行多元线性回归分析,进一步明确各因素与柔韧性相关程度。结果相关性分析及方差分析显示,中老年胸腰段骨折继发后凸畸形柔韧性与俯卧位加压CT定位像后凸LKCA角呈负相关,与SVA、是否合并Kummell病呈正相关,与其他观察因素无关;多元线性回归显示,俯卧位加压CT定位像后凸LKCA角是影响中老年胸腰段骨折继发后凸畸形柔韧性的最显著相关因素。结论中老年胸腰段骨折继发后凸畸形柔韧性与俯卧位加压CT定位像后凸LKCA角、SVA、是否合并Kummell病有关,术前测量这些指标可以预测患者后凸柔韧性,对手术方案的制定有一定指导意义,可达到更好的治疗效果。Objective To investigate the factors affecting the flexibility of kyphosis secondary to thoracolumbar fracture in middle-aged and elderly patients by Logistic regression model.Methods The clinical data of 66 middle-aged and elderly patients with kyphosis secondary to thoracolumbar fracture were retrospectively analyzed.Local kyphosis cobb angle(LKCA)was measured,and the flexibility of kyphosis secondary to thoracolumbar fracture in middle-aged and elderly patients was calculated by using prone compression CT positioning image and standing X-ray.Age,gender,location of fracture,duration of disease,degree of vertebral height loss,Kummell’s disease,degree of intervertebral disc degeneration on wedge side of fractured vertebral,lumbar lordosis(LL),thoracic kyphosis(TK),sagittal vertical axis(SVA)and other data were analyzed.Single factor correlation analysis was used for continuous data,while variance analysis was used for non-continuous data.Multiple linear regression analysis was conducted for indicators related to flexibility to further clarify the correlation degree between various factors and flexibility.Results Correlation analysis and variance analysis showed that flexibility of kyphosis secondary to thoracolumbar fracture in middle-aged and elderly patients was negatively correlated with the kyphosis LKCA angle of the prone compression CT positioning image,and positively correlated with the formation of SVA and Kummell’s disease,but had no correlation with other observation factors.Multiple linear regression analysis showed that the kyphosis LKCA angle was the most significant factor affecting flexibility of kyphosis secondary to thoracolumbar fracture in middle-aged and elderly patients.Conclusion Flexibility of kyphosis secondary to thoracolumbar fracture in middle-aged and elderly patients is related to the formation of the kyphosis LKCA angle,SVA and Kummell’s disease,preoperative measurement of these indicators can predict the kyphotic flexibility of patients,which has a certain guiding significance

关 键 词：中老年胸腰段骨折 骨质疏松 后凸畸形 柔韧性 相关因素 

分 类 号：R682.13[医药卫生—骨科学]