脊柱矢状位失衡对骨质疏松性椎体压缩性骨折行椎体后凸成形术后新发骨折的影响  

Effect of sagittal imbalance of the spine on the new fracture in osteoporotic vertebral compression fracture after percutaneous kyphoplasty

作　　者：李瑶 戴健[1] 马健 杨钊琦 孙宇 唐晓明[1] LI Yao;DAI Jian;MA Jian;YANG Zhaoqi;SUN Yu;TANG Xiaoming(Department of Orthopedics,The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University,Huai'an,Jiangsu 223300,China;不详)

机构地区：[1]南京医科大学附属淮安第一医院骨科,江苏淮安223300 [2]南京医科大学,江苏南京211100

出　　处：《中国临床研究》2024年第5期699-702,708,共5页Chinese Journal of Clinical Research

摘　　要：目的探讨脊柱矢状位失衡与骨质疏松性椎体压缩性骨折(OVCF)患者接受经皮椎体后凸成形术(PKP)后新发椎体骨折的相关性,为临床预防新发骨折提供新的思路。方法回顾性选择南京医科大学附属淮安第一医院2020年2月至2023年6月因OVCF入院行PKP手术的患者,以术后有新发骨折的64例患者作为研究组,无新发骨折的64例作为对照组。分析比较两组患者术后1年随访时各脊柱矢状位参数之间的差异,同时比较两组患者术后VAS评分、日本骨科协会(JOA)评分、Oswestry功能障碍指数(ODI)。结果研究组的年龄、术后VAS评分、术后ODI评分显著高于对照组,而术后JOA评分显著低于对照组,差异有统计学意义(P<0.05)。研究组的骨盆倾斜角(PT)(22.66°±2.41°vs 20.36°±3.68°,t=4.18,P<0.01)和胸椎后凸角(TK)(45.95°±4.87°vs 40.22°±4.22°,t=7.12,P<0.01)大于对照组,而骶骨倾斜角(SS)(23.44°±6.35°vs 28.47°±5.46°,t=4.81,P<0.01)、骨盆入射角(PI)(46.09°±5.57°vs 48.83°±5.46°,t=2.80,P<0.01)和腰椎前凸角(LL)(39.06°±6.08°vs 44.30°±6.20°,t=4.83,P<0.01)小于对照组。结论脊柱矢状位失衡和OVCF患者行PKP术后新发椎体骨折具有密切的相关性。Objective To explore the correlation between sagittal imbalance of the spine and new fractures after percutaneous kyphoplasty(PKP)in patients with osteoporotic vertebral compression fracture(OVCF),providing a new idea for preventing new fracture.Methods Patients with OVCF admitted to The Affiliated Huai'an No.1 People's Hospital for PKP surgery between February 2020 and June 2023 were included in this retrospective study.Sixty-four patients with new fracture after surgery were selected as the study group,and 64 patients without new fracture were selected as the control group.The differences of sagittal spinal parameters between the two groups at 1 year after operation were analyzed and compared.Meanwhile,postoperative VAS scores,Japanese Orthopaedic Association(JOA)score and Oswestry disability index(ODI)of the two groups were analyzed and compared.Results The age,postoperative VAS score and ODI of the study group were significantly higher than those of the control group,while postoperative JOA score was significantly lower than that of the control group(P<0.05).The pelvic tilt(PT)(22.66°±2.41°vs 20.36°±3.68°,t=4.18,P<0.01)and thoracic kyphosis(TK)(45.95°±4.87°vs 40.22°±4.22°,t=7.12,P<0.01)of the study group were higher than those of the control group,while the sacral slope(SS)(23.44°±6.35°vs 28.47°±5.46°,t=4.81,P<0.01),pelvic incidence(PI)(46.09°±5.57°vs 48.83°±5.46°,t=2.80,P<0.01)and lumbar lordosis(LL)(39.06°±6.08°vs 44.30°±6.20°,t=4.83,P<0.01)were lower than those of the control group.Conclusion Sagittal imbalance of the spine is closely related to the occurrence of new vertebral fracture after PKP in patients with OVCFs.

关 键 词：骨质疏松性椎体压缩性骨折 脊柱矢状位失衡 新发骨折 经皮穿刺椎体后凸成形术 

分 类 号：R683[医药卫生—骨科学]