老年骨质疏松性胸腰椎骨折经皮微创术后近期疗效的影响因素研究  

Study on the factors influencing the short-term efficacy of percutaneous minimally invasive surgeries for osteoporotic thoracolumbar fractures in the elderly

作　　者：蒋海涛 戴健[1] 张铖 孙海浪[1] 唐晓明[1] JIANG Haitao;DAI Jian;ZHANG Cheng;SUN Hailang;TANG Xiaoming(Department of Orthopedics,Huai'an First Hospital,Nanjing Medical University,Huai'an 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院骨科,江苏淮安223300

出　　处：《长春中医药大学学报》2022年第11期1266-1269,共4页Journal of Changchun University of Chinese Medicine

基　　金：江苏省自然科学基金(BK20170369)。

摘　　要：目的 探究老年骨质疏松性胸腰椎骨折(OVCF)经皮微创术后近期疗效的影响因素。方法 选择老年骨质疏松性胸腰椎骨折患者80例,根据椎体功能[Oswestry功能障碍指数(ODI)]恢复情况,分为PVP术后近期疗效优良组和不良组,对患者一般资料及术后骨水泥渗漏方式进行比较,并进行Logistic多因素分析,对患者PVP术后近期疗效的影响因素进行分析。结果 老年骨质疏松性胸腰椎骨折患者80例,PVP术后1个月ODI评分为(17.39±4.43)分,ODI≤20分术后近期疗效优良者57例,ODI>20分不良者23例;优良组与不良组患者的性别、BMI、手术部位、骨水泥注入量比较,差异均无统计学意义(P>0.05),近期疗效优良组骨密度值处于1~2.5 SD、骨水泥分离分布及椎旁型、椎管型渗漏的患者占比高于不良组(P<0.05);多因素Logistic回归分析结果显示骨密度、骨水泥分布方式及骨水泥渗漏类型是PVP术后近期疗效的独立危险因素(OR=3.504、95%CI=1.540~7.972;OR=3.618、95%CI=1.591~8.231;OR=3.766、95%CI=1.656~8.567)(P<0.05)。结论 骨密度、骨水泥分布方式及骨水泥渗漏类型是影响PVP术后近期疗效的因素,可根据影响因素提前采取干预措施,提高近期疗效。Objective To investigate the factors influencing the short-term efficacy of percutaneous minimally invasive surgeries for osteoporotic vertebral compression fractures (OVCF) in the elderly.Methods A total of 80 elderly OVCF patients who were admitted to our hospital from January 2018 to January 2020 were selected and divided into groups with an excellent and a poor short-term e?cacy after PVP according to the recovery of their vertebral function[Oswestry Dysfunction Index (ODI)].Their general data and the types of bone cement leakage after PVP were compared,and a Logistic multifactor analysis was performed to analyze the factors influencing the short-term efficacy of patients after PVP.Results In the 80 elderly patients with osteoporotic thoracolumbar fracture,the average ODI score was (17.39±4.43) one month after PVP,among whom 57 patients (ODI≤20) had an excellent short-term postoperative curative effect,while 23 patients (ODI>20) had a poor effect.There were no statistically significant differences in gender,BMI,surgical site,bone cement injection volume between the two groups (P>0.05).The proportion of patients in the excellent short-term curative e?ect group with bone mineral density values ranging from 1 to 2.5,bone cement separation and distribution,and paravertebral and spinal canal leakage was higher than that in the poor group (P<0.05).Incorporating it into a multivariate Logistic regression analysis,the results showed that the bone mineral density,types of bone cement distribution and bone cement leakage were the independent risk factors for the short-term e?cacy of PVP surgeries (OR=3.504,95%CI=1.540-7.972;OR=3.618,95%CI=1.591-8.231;OR=3.766,95%CI=1.656-8.567) (P<0.05).Conclusion The bone mineral density,types of bone cement distribution and bone cement leakage are the factors that a?ect the short-term e?cacy of PVP surgeries.Intervention measures can be taken in advance according to various in?uencing factors,which will help improve the short-term e?cacy of PVP surgeries.

关 键 词：骨质疏松 胸腰椎骨折 经皮椎体成形术 骨水泥渗漏 近期疗效 

分 类 号：R683.1[医药卫生—骨科学]