椎体成形术后椎体再发骨折的临床研究  

A Clinical Study on Recurrent Vertebral Fractures Following Vertebroplasty

作　　者：凌华光 朱宇[1] 李毅[1] 李高磊 樊晓韩 卢文龙 黎少言 梁龙博 王航 司苗呈 Ling Huaguang;Zhu Yu;Li Yi;Li Gaolei;Fan Xiaohan;Lu Wenlong;Li Shaoyan;Liang Longbo;Wang Hang;Si Miaocheng(Department of Orthopedics,Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第二附属医院骨科二病区,郑州450000

出　　处：《中华实验外科杂志》2024年第12期2864-2867,共4页Chinese Journal of Experimental Surgery

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230331)。

摘　　要：目的探讨骨质疏松性椎体压缩骨折(OVCF)患者在椎体成形术(PVP)后发生邻近椎体骨折(AVF)和远端椎体骨折(RVF)的倾向性及再发时间, 为术后预防椎体再骨折提供指导意见。方法回顾性收集并分析于郑州大学第二附属医院从2021年9月至2023年11月确诊为OVCF经PVP治疗后椎体再发骨折的患者的临床及影像学资料共61例, 按再发骨折类型分为AVF组和RVF组, 对比可能影响两组患者的骨折再发风险的因素及发生时间的差异。计量资料根据正态性选择独立样本t检验和Man-WhitneyU检验, 计数资料采用χ^(2)检验。结果两组患者的骨密度(BMD)T值与其再骨折发生率存在相关性(χ^(2)=31.24, P<0.01), 15例AVF的发生时间中位数为5.00(4.00, 6.00)个月, 46例RVF的发生时间中位数为10.50(7.00, 17.25)个月, 两组总体发生时间分布差异有统计学意义(Z=-4.20, P<0.01)。结论骨密度越低, 患者越易发生AVF, 骨密度较高或中等更可能发生RVF, AVF的发生时间中位数明显早于RVF。ObjectiveTo explore the propensity for adjacent vertebral fractures(AVF)and remote vertebral fractures(RVF)following percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fractures(OVCF),and to determine the timing of recurrent fractures,in order to provide guidance for the prevention of subsequent vertebral fractures after surgery.MethodsA retrospective analysis was conducted on the clinical and radiological data of 61 patients with OVCF who underwent PVP and subsequently experienced refracture at the Second Affiliated Hospital of Zhengzhou University from September 2021 to Noermber 2023.Patients were categorized into AVF and RVF groups to compare the risk factors associated with refracture development and the time of occurrence of the re-fracture.Quantitative data were analyzed using independent samples t-tests and Mann-Whitney U tests based on normality,while count data were analyzed using chi-square tests.ResultsA correlation was observed between bone mineral density(BMD)T-scores and the incidence of refracture(χ^(2)=31.24,P<0.01).The median time to occurrence for 15 cases of AVF was 5.00(4.00,6.00)months,while for 46 cases of RVF it was 10.50(7.00,17.25)months.The overall distribution of occurrence times between the two groups showed a statistically significant difference(Z=-4.20,P<0.01).ConclusionPatients with lower BMD are more prone to AVF,while those with higher or moderate BMD are more likely to experience RVF.The median time to occurrence of AVF is significantly earlier than that of RVF.

关 键 词：椎体成形术 椎体再发骨折 邻近椎体骨折 远端椎体骨折 

分 类 号：R687.3[医药卫生—骨科学]