多因素变量分析经皮椎体成形术后患者疗效不佳的影响因素  

Multivariate analysis of influencing factors of poor curative effect in patients after percutaneous vertebroplasty

作　　者：陈瑞 杨棋[2] 郭振鹏[2] 赵晓林 张洋 沈天宇 向治成 祝昊 尚晖[2] CHEN Rui;YANG Qi;GUO Zhenpeng;ZHAO Xiaolin;ZHANG Yang;SHEN Tianyu;XIANG Zhicheng;ZHU Hao;SHANG Hui(Jinzhou Medical University,Jinzhou,LianNing 121000,China;Department of Spinal Surgery,Taihe Hospital of Shiyan City,Affiliated Hospital of Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]锦州医科大学,辽宁锦州121000 [2]十堰市太和医院(湖北医院学院附属医院)脊柱外科,湖北十堰442000

出　　处：《中国医学工程》2023年第2期22-29,共8页China Medical Engineering

摘　　要：目的 探讨多因素分析经皮椎体成形(PVP)术后早期胸腰背部疼痛缓解不满意的可能影响因素。方法 收集十堰市太和医院2019年7月至2021年12月收治的958例老年性骨质疏松性椎体压缩性骨折(OVCF)患者的基本资料,以分析PVP术后患者疗效不佳的相关影响因素。采用单因素和多因素Logistic回归分析PVP术后胸腰背部疼痛症状缓解不满意的影响因素。结果 68例患者术后1月内随访主诉胸腰背部疼痛缓解不满意,总的发生率为7.1%(68/958)。单因素变量分析及多因素Logistic回归分析表明,术前骨密度(BMD)、手术时机、骨折椎体压缩程度、骨折椎体数量、骨水泥弥散情况、骨水泥注入量、胸腰背部筋膜损伤、抑郁症、脊柱退变性疾病、脊柱矢状面平衡状态与PVP术后胸腰背部疼痛改善不佳相关。结论 术前低BMD值、丧失最佳手术时机、骨折椎体压缩程度高、合并胸腰背部筋膜损伤、多节段椎体骨折、骨水泥注入量不足、骨水泥弥散不满意、合并抑郁症、合并脊柱退变性疾病、脊柱矢状面失衡状态是OVCF患者PVP术后疗效不佳的高危因素。【Objective】To analyze the possible influencing factors of unsatisfactory relief of early thoracolumbar back pain after percutaneous vertebroplasty(PVP) by multivariate analysis. 【Methods】The basic data of 958 patients with senile osteoporotic vertebral compression fracture(OVCF) admitted in our hospital from July 2019 to December 2021 were collected to analyze related influencing factors for the dissatisfaction of thoracolumbar back pain relief after PVP. Univariate and multivariate logistic regression analysis was used to analyze the influencing factors of unsatisfactory relief of thoracolumbar back pain symptoms after PVP. 【Results】Sixty-eight patients were followed up within 1 month after the operation and complained of unsatisfactory relief of thoracolumbar back pain, with a total incidence rate of 7.1%. Univariate analysis and multivariate logistic regression showed that preoperative bone mineral density(BMD), timing of surgery, degree of compression of fractured vertebral body, number of fractured vertebral bodies, distribution of bone cement, amount of bone cement injected, thoracolumbar back fascia injury,depression, spinal degeneration, degenerative disease and sagittal spine balance were associated with poor improvement in low back pain after PVP. 【Conclusion】Low preoperative BMD value, loss of optimal operation timing, high degree of compression of fractured vertebral body, combined thoracolumbar back fascia injury, multi-segmental vertebral fracture, insufficient bone cement injection, unsatisfactory bone cement distribution, combined depression, concomitant spinal degenerative diseases and sagittal imbalance of the spine are high risk factors for poor outcomes after PVP in patients with OVCF.

关 键 词：骨质疏松症 椎体压缩性骨折 椎体成形术 腰背痛 影响因素 

分 类 号：R683.2[医药卫生—骨科学]