急性骨质疏松性椎体压缩骨折患者腰背肌筋膜炎的发生率和危险因素分析  

The incidence and risk factors of lumbodorsal fasciitis in osteoporotic vertebral compression fractures

作　　者：王锋[1] 孙瑞 吴小涛[1] 张绍东[1] Wang Feng;Sun Rui;Wu Xiaotao;Zhang Shaodong(Department of Spinal Surgery,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院脊柱外科中心,南京210009

出　　处：《中华骨科杂志》2023年第7期438-444,共7页Chinese Journal of Orthopaedics

基　　金：江苏省卫生健康委面上项目课题(M2022084)。

摘　　要：目的探讨急性骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)患者腰背肌筋膜炎的发生率和危险因素。方法回顾性分析2016年6月至2020年10月东南大学附属中大医院脊柱外科收治的1182例急性OVCF的患者资料,男219例、女963例,年龄(72.19±9.39)岁(范围45~98岁)。总结腰背肌筋膜炎的发生率,比较合并与不合并腰背肌筋膜炎OVCF患者的性别、年龄、脊柱外伤类型、椎体骨折数量、胸腰背痛时间、合并疾病类型和数量,采用二元logistic回归分析OVCF合并腰背肌筋膜炎的危险因素。结果1182例中OVCF合并腰背肌筋膜炎患者532例,发生率为45.01%。OVCF合并腰背肌筋膜炎患者的年龄为(74.57±9.21)岁、男性占23.5%(125/532),不合并腰背肌筋膜炎患者分别为(70.24±9.60)岁、14.5%(94/650),差异均有统计学意义(t=7.85,P<0.001;χ^(2)=15.82,P<0.001)。OVCF合并腰背肌筋膜炎患者中年龄≥80岁者占比最高(36.1%,192/532),不合并腰背肌筋膜炎患者中60~70岁者占比最高(34.6%,225/650),两组年龄分布的差异有统计学意义(χ^(2)=56.27,P<0.001)。OVCF合并腰背肌筋膜炎患者中脊柱无明显外伤者占37.0%(197/532)、椎体骨折数量≥3个者占10.5%(56/532),不合并腰背肌筋膜炎分别占26.3%(171/650)和3.2%(21/650),差异均有统计学意义(χ^(2)=17.67,P<0.001;χ^(2)=40.63,P<0.001)。OVCF合并腰背肌筋膜炎患者中胸腰背痛时间>4周者占20.7%(110/532),不合并腰背肌筋膜炎占7.4%(48/650),差异有统计学意义(χ^(2)=62.46,P<0.001)。OVCF合并腰背肌筋膜炎患者中患高血压病者占52.8%(281/532)、冠心病占14.7%(78/532)、脑梗死占24.8%(132/532),均高于不合并腰背肌筋膜炎患者[(42.8%(278/650)、9.9%(64/650)、17.9%(116/650)],差异均有统计学意义(χ^(2)=11.85,P<0.001;χ^(2)=6.42,P=0.011;χ^(2)=8.56,P=0.003)。OVCF合并腰背肌筋膜炎患者中合并两种疾病者占23.7%(126/532),高于不合并腰背肌筋膜炎患者的16.1%(105/650Objective To identify the incidence and risk factors related to lumbodorsal fasciitis in acute osteoporotic vertebral compression fractures(OVCF).Methods The clinical data of 1182 acute OVCF hospitalized in Zhongda Hospital Southeast University between June 2016 and October 2020 were retrospectively analyzed,including 219 males and 963 females,aged 72.19±9.39 years(range,45-98 years).The demographics,comorbidity profile,spine trauma,back pain duration,and vertebral fracture number of the OVCF with or without lumbodorsal fasciitis were summarized and compared.The independent risk factors of lumbodorsal fasciitis were identified by binary logistic regression analysis.Results There were 532 cases of OVCF complicated with lumbodorsal fasciitis among 1,182 patients,and the incidence was 45.01%.The OVCF with fasciitis had higher ratio of males(23.5%,125/532)than the OVCF without(14.5%,94/650)fasciitis(χ^(2)=15.82,P<0.001).The OVCF with fasciitis were aged 74.57±9.21 years and significantly older than the OVCF(aged 70.24±9.60 years)without fasciitis(t=7.85,P<0.001).The highest proportion of patients with OVCF combined with fasciitis was≥80 years old(36.1%,192/532),while most(34.6%,225/650)of the OVCF without fasciitis were aged 60-70 years(χ^(2)=56.27,P<0.001).The OVCF with fasciitis had higher ratio of no evident spine trauma(37.0%,197/532)and multiple vertebral fractures involving≥3 vertebra(10.5%,56/532)than the OVCF without fasciitis[26.3%(171/650),3.2%(21/650);χ^(2)=17.67,P<0.001;χ^(2)=40.63,P<0.001].The ratio of pre-hospital back pain>4 weeks was higher in the OVCF with(20.7%,110/532)than without(7.4%,48/650)fasciitis(χ^(2)=62.46,P<0.001).The OVCF with fasciitis had higher comorbidity of hypertension(52.8%,281/532),coronary heart disease(14.7%,78/532),and cerebral infarction(24.8%,132/532)than the OVCF without fasciitis[42.8%(278/650),9.9%(64/650),17.9%(116/650);χ^(2)=11.85,P<0.001;χ^(2)=6.42,P=0.011;χ^(2)=8.56,P=0.003].The OVCF with fasciitis had higher ratio of two comorbidities(23.7%,126/532)than

关 键 词：椎体 骨质疏松性骨折 背部肌肉 椎旁肌 筋膜炎 背痛 

分 类 号：R687.3[医药卫生—骨科学]