骨质疏松性椎体压缩骨折经皮椎体强化术后并发残余腰背痛的危险因素  

Risk factors of residual low back pain after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures

作　　者：苏晓慧 芮晶晶 陈文月[1] 秦晓冬 SU Xiaohui;RUI Jingjing;CHEN Wenyue;QIN Xiaodong(Department of Orthopedics,Gulou Hospital,School of Medicine,Nanjing University,Nanjing 210000,China)

机构地区：[1]南京大学医学院附属鼓楼医院骨科,南京210000

出　　处：《临床与病理杂志》2023年第7期1384-1391,共8页Journal of Clinical and Pathological Research

摘　　要：目的:探讨骨质疏松性椎体压缩骨折经皮椎体强化术后并发残余腰背痛的危险因素。方法:回顾性分析南京大学医学院附属鼓楼医院2020年6月至2022年6月收治的骨质疏松性椎体压缩骨折患者150例,采集患者临床资料,并采用视觉模拟评分法(Visual Analogue Scale,VAS)评估术后1 d、1周、1个月、3个月及6个月的腰背疼痛感,任意一次VAS评分≥4判定为术后残余腰背痛,将30例发生术后残余腰背痛者纳入残余痛组,将120例未发生术后残余腰背痛者纳入无残余痛组。对术后并发残余腰背痛的危险因素进行单因素、多因素logistic回归分析。结果:残余痛组术后1 d、1周、1个月、3个月VAS评分均高于无残余痛组(均P<0.05);单因素分析显示:残余痛组体重指数、骨密度、术后椎体高度恢复率、术后Cobb角改善率、有无腰背筋膜损伤、有无腰背痛史、有无邻椎骨折与无残余痛组比较,差异均有统计学意义(均P<0.05);多因素logistic回归分析显示:体重指数、骨密度、术后椎体高度恢复率、术后Cobb角改善率、腰背筋膜损伤、邻椎骨折最终进入回归方程(均P<0.05)。结论:体重指数、骨密度、术后椎体高度恢复率、术后Cobb角改善率、腰背筋膜损伤、邻椎骨折是经皮椎体强化术后并发残余腰背痛的独立危险因素,临床应及时采取预防性措施,降低术后残余腰背痛的发生率。Objective:To investigate the risk factors of residual low back pain after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures.Methods:A total of 150 patients with osteoporotic vertebral compression fractures admitted to Gulou Hospital, School of Medicine, Nanjing University from June 2020 to June 2022 were retrospectively studied. The clinical data of patients were collected and the visual analogue score (VAS) was obtained. The sense of lumbago and back pain was evaluated 1 d, 1 week, 1 month, 3 months, and 6 months after the operation. Any VAS score≥4 points was determined as postoperative residual lumbago and back pain. Thirty patients with postoperative residual lumbago and back pain were included in the residual pain group, and 120 patients without postoperative residual lumbago and back pain were included in the non-residual pain group. The risk factors of postoperative residual low back pain were analyzed by univariate and multivariate logistic regression. Results: The VAS scores in the residual pain group were higher than those in the non residual pain group 1 day, 1 week, 1 month, and 3 months after operation (all P<0.05). Single factor analysis showed that compared with the non-residual pain group, the body mass index, bone mineral density, postoperative vertebral height recovery rate, postoperative Cobb angle improvement rate, whether there was back fascia injury, whether there was a history of back pain, whether there was adjacent vertebral fracture and whether there was residual pain in the residual pain group had significant difference (P<0.05). Multiple factor logistic regression analysis showed that the body mass index, bone mineral density, postoperative vertebral height recovery rate, postoperative Cobb angle improvement rate, lumbar back fascia injury, and adjacent vertebral fracture finally entered the regression equation (all P<0.05). Conclusion: Body mass index, bone mineral density, postoperative vertebral height recovery rate, postoperative Cobb angle impr

关 键 词：骨质疏松性椎体压缩骨折 经皮椎体强化术 残余腰背痛 危险因素 

分 类 号：R687.3[医药卫生—骨科学]