OVCFs患者经椎体成形术治疗后邻近椎体骨折相关因素分析  

Study on the adjacent vertebral fracture and its related risk factors after vertebroplasty

作　　者：刘成洲 贾宝欣[1] 任聪慧[1] 王亭[2] 郎军涛 LIU Chengzhou;JIA Baoxin;REN Conghui;WANG Ting;LANG Juntao(Department of Spinal Orthopedics,People's Hospital of Linqu County,Linqu 262600,Shandong,China;Department of Spinal Surgery,Affiliated Hospital of Qingdao University,Qingdao 266000,Shangdong,China;Department of Radiology,Zhongshan Hospital Affiliated to Fudan University,Shanghai 200030,China)

机构地区：[1]临朐县人民医院脊柱骨科,山东临朐262600 [2]青岛大学附属医院脊柱外科,山东青岛266000 [3]复旦大学附属中山医院放射科,上海200030

出　　处：《中国现代手术学杂志》2023年第4期312-317,共6页Chinese Journal of Modern Operative Surgery

基　　金：潍坊市卫生健康委员会科研项目(wfwsjk_2019_036)。

摘　　要：目的观察骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCFs)患者在行经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗后邻近椎体骨折的发生情况,并分析相关风险因素。方法回顾性分析2019年2月~2022年1月我院收治的315例因胸腰椎OVCFs行PVP治疗的患者临床资料。男114例,女201例;年龄65~89岁,平均(76.97±4.92)岁;单椎体骨折216例,双椎体骨折85例,三椎体骨折14例。对患者行PVP治疗,术后追踪1年,观察患者术后1年内邻近椎体骨折情况,将发生邻近椎体骨折的患者纳入观察组,未骨折者纳入对照组。对两组患者手术时骨水泥用量、骨水泥渗漏情况、术后Cobb角、是否行抗骨质疏松治疗等指标进行单因素及多因素Logistic回归分析,探讨邻近椎体发生骨折的风险因素。结果经过1年的追踪随访,315例患者中有39例患者出现邻近椎体骨折,发生率为12.4%。其中术后3个月内骨折者23例,术后4~6个月骨折者11例,术后7~12个月骨折者5例,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,既往椎体骨折史、骨水泥渗漏、术后Cobb角偏大、骨密度T值偏低及未行抗骨质疏松治疗为PVP术后邻近椎体发生骨折的风险因素(均为P<0.05)。结论OVCFs患者行PVP治疗后的前6个月是邻近椎体骨折的高发期,对于存在多种风险因素的患者进行相应的防护对预防邻近椎体骨折有重要意义。Objective To observe the incidence of adjacent vertebral fractures in patients with osteoporotic vertebral compression fractures(OVCFs)after percutaneous vertebroplasty(PVP),and to study the related risk factors.Methods The clinical data of 315 patients admitted to our hospital for PVP treatment due to OVCFs from February 2019 to January 2022 were analyzed retrospectively.They were 114 males and 201 females,aged 65~89 years with an average of(76.97±4.92)years.There were 216 cases of single vertebral fracture,85 cases of double vertebral fractures and 14 cases of three vertebral fractures.The patients were treated with PVP and followed up for a period of 1 year to observe the occurrence of adjacent vertebral body fractures within 1 year after operation.According to the occurrence of the adjacent vertebral body fracture,the patients were divided into two groups,the observation group with adjacent vertebral body fractures,and the control group without.The amount of bone cement,the leakage of bone cement,the post operative Cobb angle,and the anti-osteoporosis treatment of the two groups were compared by single factor and multiple factor logistic regression analysis to explore the risk factors of the adjacent vertebral body fracture.Results After one year's follow-up,39 of 315 patients had fractures of adjacent vertebral bodies,with an incidence of 12.4%.There were 23 cases occurred within 3 months after operation,11 cases within 4~6 months,and 5 cases within 7~12 months.The difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that previous fracture history,bone cement leakage,larger postoperative Cobb angle,lower T-value of bone mineral density and no anti-osteoporosis treatment were risk factors for recurrent fractures of adjacent vertebral body after PVP(P<0.05).Conclusion The first 6 months after PVP treatment in OVCFs patients is the high incidence period of adjacent vertebral fracture,which is of great significance for patients with multiple risk factors to take corr

关 键 词：骨质疏松 椎体压缩性骨折 椎体成形术 邻近椎体骨折 

分 类 号：R687.3[医药卫生—骨科学]