骨质疏松性椎体压缩骨折患者腰背筋膜水肿的危险因素分析  

Analysis of risk factors for lumbar fascial edema in patients with osteoporotic vertebral compression fractures

作　　者：陈浩 吴丕根 滕嘉麒 张亮 冯新民 Chen Hao;Wu Pigen;Teng Jiaqi;Zhang Liang;Feng Xinmin(Clinical Medical College of Yangzhou University,Yangzhou 225000,Jiangsu Province,China)

机构地区：[1]扬州大学临床医学院,江苏省扬州市225000

出　　处：《中国组织工程研究》2025年第29期6174-6179,共6页Chinese Journal of Tissue Engineering Research

基　　金：扬州市重点研发项目(社会发展)(YZ2021083/YZ2022091),项目负责人:张亮;苏北人民医院院级扶持技术项目(FCJS202319),项目负责人:张亮。

摘　　要：背景:相关研究表明,骨密度、术后感染、邻近椎体再骨折以及腰背筋膜水肿可能是椎体成形术后残余痛的危险因素。目的:对骨质疏松性椎体压缩骨折患者腰背筋膜水肿的危险因素进行分析,并探讨腰背筋膜水肿对椎体成形术后残余痛的影响。方法:回顾性分析扬州大学临床医学院2022年2-10月收治行经皮穿刺椎体成形治疗的204例骨质疏松性椎体压缩骨折患者的病历资料,根据术前MRI结果分为无腰背筋膜水肿组(n=84)和腰背筋膜水肿组(n=120)。收集患者的年龄、性别、身高、体质量、体质量指数、骨密度、血清总蛋白、血清白蛋白、炎症因子(C-反应蛋白及血沉)水平、骨折压缩程度、是否有陈旧性压缩性骨折及骨折数量、是否合并腰椎不稳等疾病、日本老年人独立评分等术前资料,术后随访记录新发椎体骨折部位数量及目测类比评分等资料。采用Logistic回归法分析腰背筋膜水肿的危险因素,并通过受试者工作特征曲线确定危险因素是否具有相关诊断意义。结果与结论:①年龄、陈旧性椎体压缩骨折数量、日本老年人独立评分以及是否合并腰椎不稳是骨质疏松性椎体压缩骨折患者发生腰背筋膜水肿的危险因素,4个危险因素的比值比分别为2.76,1.70,2.56及4.74;②将术后1个月时的目测类比评分4分作为区分术后残余痛的阈值,腰背筋膜水肿组共有31例存在术后残余痛,无筋膜水肿组仅有8例,差异有显著性意义(P<0.01);③筋膜水肿组患者术后1个月目测类比评分(2.12±1.35)明显高于无筋膜水肿组(1.67±1.08),差异有显著性意义(P<0.01);④提示年龄、日本老年人独立评分、陈旧性压缩骨折数量及合并有腰椎不稳等是骨质疏松性椎体压缩骨折患者术后发生腰背筋膜水肿的独立危险因素,腰背筋膜水肿是患者椎体成形术后腰背部残余痛的危险因素。BACKGROUND:Related studies have shown that bone density,postoperative infection,adjacent vertebral fracture,and lumbar fascial edema may be risk factors for lingering pain after vertebroplasty.OBJECTIVE:To scrutinize the risk factors for lumbar fascia edema in osteoporotic vertebral compression fractures patients and investigate its influence on lingering pain after vertebroplasty.METHODS:A retrospective analysis was conducted on 204 osteoporotic vertebral compression fractures patients who underwent percutaneous vertebroplasty at the Clinical Medical College of Yangzhou University from February to October 2022.Patients were categorized based on MRI findings into two groups:without lumbar fascia edema(84 cases)and with lumbar fascia edema(120 cases).Preoperative data,encompassing age,gender,height,weight,body mass index,bone density,serum total protein,serum albumin,inflammatory markers(C-reactive protein and erythrocyte sedimentation rate),degree of fracture compression, presence of prior compression fractures, fracture count, lumbar instability, and Japanese senile independence score were gathered. Postoperative follow-up recorded data such as the number of new vertebral fractures and visual analog scale scores were recorded. Logistic regression method was used to analyze the risk factors of lumbar fascial edema, and the receiver operating characteristic curve was used to determine whether the risk factors had relevant diagnostic significance. RESULTS AND CONCLUSION: (1) Age, prior vertebral compression fractures, Japanese senile independence score score, and lumbar instability presence emerged as autonomous risk factors for lumbar fascia edema in osteoporotic vertebral compression fractures patients, with corresponding odds ratios of 2.76, 1.70, 2.56, and 4.74, respectively. (2) Employing a visual analog scale score of 4 at 1 month postoperatively to distinguish residual pain revealed 31 cases with residual pain in the lumbar fascia edema group, in contrast to only 8 cases in the non-fascia edema group (P < 0.

关 键 词：腰背筋膜水肿 骨质疏松 椎体压缩骨折 经皮椎体成形 MRI 危险因素 LOGISTIC回归分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R683