椎体骨质疏松性压缩性骨折患者经皮椎体后凸成形术术后再塌陷的危险因素分析  

Analysis of risk factors for recurrent collapse in patients with osteoporotic vertebral compression fractures after percutaneous kyphoplasty

作　　者：杨文明 Yang Wenming(Department of Orthopaedics 6,Chengdu Bayi Orthopedic Hospital,Chengdu 610017,China)

机构地区：[1]成都八一骨科医院骨六科,成都610017

出　　处：《中国医师杂志》2024年第9期1385-1389,共5页Journal of Chinese Physician

摘　　要：目的探讨脊柱椎体骨质疏松性压缩性骨折(OVCF)患者接受经皮椎体后凸成形术(PKP)治疗后再次发生伤椎塌陷的危险因素及其预防措施。方法回顾性选取2020年5月至2022年5月在成都八一骨科医院接受PKP治疗且术后1年内再次出现伤椎塌陷的OVCF患者33例作为塌陷组,选取同期67例接受PKP治疗且术后未出现再塌陷的OVCF患者作为对照组,对比分析两组患者的一般资料、骨密度、手术治疗指标、手术后影像学指标,并采用多因素模型分析法筛选OVCF患者PKP手术后发生再塌陷的危险因素。结果入选的33例PKP术后再次发生伤椎塌陷的患者,出现再次塌陷的时间为术后4~12(8.3±1.7)个月,其中轻度塌陷患者6例、中度塌陷患者24例、重度塌陷患者2例、极重度塌陷患者1例。塌陷组患者的年龄大于对照组,差异有统计学意义(P<0.05)。塌陷组与对照组患者的BMI、吸烟、饮酒、性别、合并疾病情况对比,差异均无统计学意义(均P>0.05)。塌陷组患者的腰椎骨密度T值小于对照组,术后骨水泥渗漏发生率、骨水泥呈致密型分布的比例高于对照组,抗骨质疏松药物使用率低于对照组,差异均有统计学意义(均P<0.05)。塌陷组与对照组患者的骨折部位、骨水泥注入量、术后侧凸角度数、术后后凸畸形角度、术后椎体高度恢复率、术后椎体Oswestry功能障碍指数(ODI)值比较差异均无统计学意义(均P>0.05)。Logistic回归模型分析结果显示:年龄增大、发生骨水泥渗漏、椎体骨水泥呈致密型分布是OVCF患者PKP手术后发生再塌陷的独立危险因素(均P<0.05),骨密度T值大、使用抗骨质疏松药物能有效降低OVCF患者PKP手术后发生再塌陷的风险(均P<0.05)。结论OVCF患者PKP手术后发生再塌陷的风险因素很多,高龄、骨质疏松严重、发生骨水泥渗漏、骨水泥呈致密型分布会增大患者发生伤椎再塌陷的风险,使用抗骨质疏松药物能降�Objective To explore the risk factors and preventive measures for recurrent vertebral collapse in patients with osteoporotic compression fractures(OVCF)undergoing percutaneous kyphoplasty(PKP)treatment.Methods A retrospective analysis was conducted on 33 OVCF patients who received PKP treatment at the Chengdu Bayi Orthopedic Hospital from May 2020 to May 2022 and experienced recurrent vertebral collapse within one year after surgery,as the collapse group.A total of 67 OVCF patients who received PKP treatment during the same period and did not experience recurrent collapse after surgery were selected as the control group.The general information,bone density,surgical treatment indicators,and postoperative imaging indicators of the two groups of patients were compared and analyzed.Multivariate model analysis was used to screen the risk factors for recurrent collapse in OVCF patients after PKP surgery.Results Among the 33 patients selected for PKP surgery,the time of recurrent vertebral collapse was 4-12(8.3±1.7)months after surgery,including 6 patients with mild collapse,24 patients with moderate collapse,2 patients with severe collapse,and 1 patient with extremely severe collapse.The age of patients in the collapse group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in body mass index(BMI),smoking,alcohol consumption,gender,and comorbidities between the collapse group and the control group(all P>0.05).The lumbar spine bone density T value of the collapse group patients was lower than that of the control group,and the incidence of postoperative bone cement leakage,the proportion of bone cement with a dense distribution were all higher than those of the control group,and the use of anti-osteoporosis drugs was lower than that of the control group,with statistically significant differences(all P<0.05).There was no statistically significant difference in the fracture site,bone cement injection volume,postoperative con

关 键 词：椎体 骨质疏松性骨折 骨折 压缩性 椎体后凸成形术 伤椎塌陷 

分 类 号：R580[医药卫生—内分泌] R687.3[医药卫生—内科学]