骨质疏松性椎体骨折患者椎体成形后邻近椎体再发骨折的影响因素  

Influencing factors of adjacent vertebral re-fracture in patients with osteoporotic vertebral fractures after percutaneous vertebroplasty

作　　者：童奕博 李明辉[1,2] Tong Yibo;Li Minghui(Jianghan University,Wuhan 430056,Hubei Province,China;Department of Orthopedics,Wuhan Fifth Hospital,The Second Affiliated Hospital of Jianghan University,Wuhan 430050,Hubei Province,China)

机构地区：[1]江汉大学,湖北省武汉市430056 [2]江汉大学第二附属医院,武汉市第五医院骨科,湖北省武汉市430050

出　　处：《中国组织工程研究》2024年第8期1241-1246,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:对于骨质疏松性椎体压缩骨折,椎体成形术后邻近椎体再发骨折率较高,但其发生原因仍存在争议。目的:探究单节段骨质疏松性椎体压缩性骨折患者行经皮椎体成形后邻近椎体再发骨折的影响因素。方法:回顾性分析2016年6月至2020年6月就诊于江汉大学第二附属医院武汉市第五医院,由X射线片、MRI检查确诊为新发单节段骨质疏松性椎体压缩性骨折,且行经皮椎体成形的患者210例,随访时间大于18个月。收集患者术前一般资料(年龄、性别、体质量指数、骨折节段位置、骨折天数、骨折造成原因、是否伴有糖尿病、是否伴有肾脏甲状腺功能障碍、入院疼痛目测类比评分)、术后指标(椎体前缘恢复率、骨水泥弥散程度、骨水泥有无渗漏、是否使用骨材料、骨水泥单双侧注入方式、伤椎中柱术后恢复率、伤椎术后局部Cobb角)。根据术后邻近椎体是否再发骨折将其分为2组,A组(术后邻近椎体未再发骨折组)190例,B组(术后邻近椎体再发骨折组)20例。将术后伤椎邻近椎体有无再发骨折作为因变量,术前一般资料及术后指标等分类变量作为自变量进行统计学分析。结果与结论:①经皮椎体成形术后患者邻近椎体再发骨折与年龄、体质量指数、术后椎体前缘恢复率、骨水泥弥散程度、骨水泥渗漏情况比较差异有显著性意义(P<0.05);性别、骨折时间、骨折造成方式、是否伴糖尿病或肾脏疾病或甲状腺疾病、初次椎体骨折节段位置、骨水泥注入方式、伤椎局部Cobb角度、伤椎中柱恢复率、骨组织的使用与经皮椎体成形术后邻近椎体再发骨折无统计学意义(P>0.05);②多因素Logistic回归分析显示,年龄、椎体前缘恢复率、渗漏是经皮椎体成形术后邻近椎体再发骨折的独立危险因素;③提示年龄、术后椎体前缘恢复率、骨水泥渗漏是经皮椎体成形术后邻近椎体再发骨折的影响BACKGROUND:Osteoporotic vertebral compression fractures have a high rate of recurrent fractures in adjacent vertebrae after percutaneous vertebroplasty,but the cause of their occurrence is still controversial.OBJECTIVE:To explore the influencing factors of adjacent vertebral re-fractures after percutaneous vertebroplasty in patients with single-segment osteoporotic vertebral compression fractures.METHODS:A retrospective analysis was performed in 210 patients admitted to the Fifth Hospital of Wuhan City,Second Affiliated Hospital of Jianghan University from June 2016 to June 2020,who had been diagnosed with new single-segment osteoporotic vertebral compression fractures by X-ray and MRI examinations,and received percutaneous vertebroplasty.The patients were followed up for more than 18 months.The general preoperative data and postoperative indicators were collected.The general preoperative data included age,sex,body mass index,fracture segment location,fracture days,fracture cause,whether accompanied by diabetes mellitus,whether accompanied by renal and thyroid dysfunction,and visual analogue scale score on admission.The postoperative indicators included recovery rate of anterior edge of the vertebral body after operation,degree of dispersion of bone cement,leakage of bone cement,use of bone material,single or bilateral injection of bone cement,recovery rate of the injured vertebral mid-column after operation,local Cobb angle of the injured vertebra after operation.According to their real conditions,the patients were divided into a group without adjacent vertebral re-fractures(n=190)and a group with adjacent vertebral re-fractures(n=20).The presence or absence of postoperative re-fracture of the adjacent vertebrae of the injured spine was used as the dependent variable and the categorical variables such as preoperative general data and postoperative indicators were used as independent variables for statistical analysis.RESULTS AND CONCLUSION:After percutaneous vertebroplasty,patients with adjacent vertebral re-fra

关 键 词：经皮椎体成形 骨质疏松性椎体压缩性骨折 邻近椎体 再发骨折 影响因素 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R445