椎体CT值与经皮椎体成形术骨水泥渗漏的相关性研究  

Correlation Study between Vertebral CT Values and Bone Cement Leakage in Percutaneous Vertebral Augmentation for Osteoporotic Vertebral Compression Fractures

作　　者：高志超 李哲[1] 许财元 张仁赞 王建华[1] 孙贺[1] GAO Zhichao;LI Zhe;XU Caiyuan(Affiliated Hospital of Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院脊柱外科,河北承德067000

出　　处：《河北医学》2023年第12期2063-2068,共6页Hebei Medicine

基　　金：河北省承德市科学技术研究与发展计划项目(编号:201904A038)。

摘　　要：目的:分析椎体CT值与骨质疏松性椎体压缩性骨折(OVCF)的患者行经皮椎体成形术(PVP)治疗发生骨水泥渗漏是否具有一定相关性。方法:收集承德医学院附属医院在2019年9月至2022年10月之间因骨质疏松性椎体压缩骨折住院并且行PVP治疗的患者61例,将所有椎体按照是否发生骨水泥渗漏分为渗漏组和未渗漏组,并记录两组患者的性别、年龄、术中骨水泥的注入量,骨折部位(胸椎或腰椎)、骨折压缩程度及腰1椎体CT值。结果:两组的性别、年龄、骨折部位(胸椎或腰椎)及骨水泥注入量的变化差异无统计学意义(P>0.05),骨折压缩程度、腰1椎体的CT值差异有统计学意义(P<0.05),将两者纳入多因素二元Logistic分析后得出腰1椎体CT值的变化与骨水泥渗漏的关联有统计学意义(P<0.05),进一步做ROC曲线分析,曲线下的面积(AUC)为0.674(95%CI:0.524~0.824,P=0.025),得出腰1椎体CT值的最佳截断值为62.1HU时,其敏感度为79.5%,特异度为63.6%。结论:腰1椎体CT值与PVP治疗骨质疏松性椎体压缩骨折骨水泥渗漏具有相关性,在术前测量患者的腰1椎体CT值在评估骨水泥渗漏方面有一定的指导意义。Objective:To analyze the correlation between vertebral CT values and the occurrence of bone cement leakage in patients undergoing percutaneous vertebral augmentation(PVA)for osteoporotic verte-bral compression fractures(OVCF).Methods:A total of 61 patients with osteoporotic vertebral compression fractures admitted and treated with PVA at the Affiliated Hospital of Chengde Medical College between Sep-tember 2019 and October 2022 were included.The patients were divided into the leakage group and non-leak-age group based on whether bone cement leakage occurred.Patient demographics,including gender,age,in-traoperative bone cement injection volume,fracture location(thoracic or lumbar),fracture compression de-gree,and CT values of the L1 vertebra,were recorded for both groups.Results:There were no statistically significant differences in gender,age,fracture location,and bone cement injection volume between the two groups(P>0.05).However,differences in fracture compression degree and CT values of the L1 vertebra were statistically significant(P<0.05).Multivariate logistic analysis revealed a statistically significant associ-ation between changes in L1 vertebra CT values and bone cement leakage(P<0.05).Further ROC curve a-nalysis showed an area under the curve(AUC)of 0.674(95%CI:0.524~0.824,P=0.025).The optimal cutoff value for L1 vertebra CT values was 62.1 HU,with a sensitivity of 79.5%and specificity of 63.6%.Conclusion:Vertebral CT values of the L1 vertebra are correlated with bone cement leakage in PVA treatment for osteoporotic vertebral compression fractures.Preoperative measurement of L1 vertebra CT values has a cer-tain guiding significance in evaluating bone cement leakage.

关 键 词：CT值 经皮椎体成形术 骨水泥渗漏 骨质疏松 椎体压缩骨折 

分 类 号：R687.3[医药卫生—骨科学]