椎体高度丢失率与OVCF患者PKP术后邻近椎体骨折的相关性分析  

Correlation analysis of vertebral height loss rate and adjacent vertebral fractures in patients with OVCF after PKP

作　　者：苏秦 张华 SU Qin;ZHANG Hua(Gansu University of Traditional Chinese Medicine,Lanzhou,Gansu 730000,China;Orthopedics Department of Liangzhou Hospital in Wuwei City,Lanzhou,Gansu 730000,China;Orthopedics Department of Affiliated Hospital of Gansu University of Traditional Chinese Medicine,Lanzhou,Gansu 730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]武威市凉州医院骨科,甘肃武威733000 [3]甘肃中医药大学附属医院骨科,甘肃兰州730000

出　　处：《颈腰痛杂志》2024年第3期488-491,495,共5页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的 探讨椎体高度丢失率与骨质疏松性椎体压缩骨折(OVCF)患者行PKP术后邻近椎体骨折(AVF)的相关性。方法 选择2019年1月至2021年12月在该院接受PKP治疗的147例OVCF患者病历资料进行回顾性分析,根据患者术后是否发生AVF,将患者分为A组(AVF组,28例)和B组(非AVF组,119例),观察两组患者椎体高度丢失率(本文采取两种方式计算椎体高度丢失率,分别为VBHL1和VBHL2),剔除混杂因素后,分析VBHL1、VBHL2与AVF的关系。结果 术前A组VBHL1和VBHL2均高于B组,差异均有统计学意义(P<0.05);术后两组患者VBHL1和VBHL2均较术前显著下降,术后A组VBHL1和VBHL2均高于同期B组,VBHL1和VBHL2手术前后变化量均高于B组,差异均有统计学意义(P<0.05)。多因素Logistic分析显示,VBHL1术前≥61.3%或VBHL2≥术前62.1%是AVF的风险因素(P<0.05)。Spearman相关性分析显示,VBHL1与骨水泥体积、局部后凸角、楔形角及VBHL1变化量呈正相关(r=0.308、0.605、0.572、0.588,P均<0.05),VBHL2与骨水泥体积、局部后凸角、楔形角及VBHL2变化量呈正相关(r=0.337、0.677、0.593、0.601,P均<0.05)。结论 OVCF患者行PKP术后AVF的发生率较高,与椎体高度丢失率有明显相关性,临床中应针对性进行预防和干预。Objective To investigate the correlation between vertebral height loss rate and adjacent vertebral fracture(AVF)in patients with osteoporotic vertebral compression fracture(OVCF)after PKP.Methods The medical records of 147 patients with OVCF treated with PKP in our hospital from January 2019 to December 2021 were retrospectively analyzed.According to whether AVF occurred,the patients were divided into group A(AVF group,28 case)and group B(non AVF group,119 case).The rate of vertebral body height loss(This paper adopted two methods to calculate the vertebral body height loss rate,namely VBHL1 and VBHL2)in the two groups was observed,and the relationship between VBHL1 and VBHL2 and AVF after removing confounding factors.Results VBHL1 and VBHL2 in group A were significantly higher than those in group B(P<0.05).After operation,VBHL1 and VBHL2 in group A were significantly higher than those in group B,and the changes of VBHL1 and VBHL2 before and after operation were significantly higher than those in group B(P<0.05).Multivariate logistic analysis showed that VBHL1≥61.3%or VBHL2≥62.1%were the risk factors of AVF(P<0.05).Spearman correlation showed that vbhl1 was positively correlated with bone cement volume,local kyphosis angle,wedge angle and VBHL1 change(r=0.308,0.605,0.572 and 0.588,all P<0.05),and VBHL2 was positively correlated with bone cement volume,local kyphosis angle,wedge angle and vbhl1 change(r=0.337,0.677,0.593 and 0.601,all P<0.05).Conclusion The incidence of PKP after PKP in OVCF patients is higher,which is significantly correlated with the loss rate of vertebral body height,and targeted prevention and intervention should be carried out in clinical practice.

关 键 词：骨质疏松性椎体压缩骨折 经皮球囊扩张椎体后凸成形术 相邻椎体骨折 椎体高度丢失率 

分 类 号：R683.2[医药卫生—骨科学]