老年女性骨质疏松性椎体压缩骨折保守治疗邻近椎体骨折危险因素分析  

Analysis of risk factors for adjacent vertebral fractures after conservative treatment of osteoporotic vertebral compression fractures in elderly women

作　　者：李庆庆[1] 张军[1] 竺军高 茹选良[1] LI Qing-qing;ZHANG Jun;ZHU Jun-gao;RU Xuan-liang(Department of Orthopaedics,Zhejiang Hospital,Hangzhou 310013,Zhejiang,China)

机构地区：[1]浙江医院骨一科,浙江杭州310013

出　　处：《中国骨伤》2025年第2期147-151,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:研究老年女性骨质疏松性椎体压缩骨折保守治疗发生邻近椎体骨折的危险因素。方法:回顾分析2020年1月至2022年1月诊断为骨质疏松性椎体压缩性骨折的老年女性患者98例,年龄(73.05±7.38)岁。根据患者受伤后2年的复诊结果,将患者分为邻近椎体骨折组24例和无邻近椎体骨折组74例。分析比较患者年龄、初诊骨密度、复诊骨密度、骨密度变化、初诊疼痛视觉模拟评分(visual analogue scale,VAS)、骨折压缩程度、是否存在陈旧性骨折、是否使用唑来膦酸盐、是否使用甲状旁腺素类似物、是否出现并发症以及是否出现患椎进一步压缩等相关因素。通过单因素和多因素Logistic回归分析对相关危险因素进行分析。结果:单因素分析显示,在老年女性骨质疏松性椎体压缩骨折保守治疗中,骨折压缩程度、复诊骨密度、骨密度变化、是否使用唑来膦酸盐类药物、是否使用甲状旁腺素类似物差异有统计学意义(P<0.05)。多因素Logistic回归分析显示影响老年女性骨质疏松椎体骨折后邻近椎体再骨折的危险因素包括:骨折压缩程度95%CI(0.040,0.571),P=0.005,OR=0.151;骨密度变化95%CI(1.264,1360.732),P=0.036,OR=41.477;是否使用甲状旁腺素类似物95%CI(1.638,31.625),P=0.009,OR=7.196。结论:骨折压缩程度、骨密度变化以及使用甲状旁腺素类似物是影响老年女性骨质疏松性椎体压缩骨折后邻近椎体骨折的因素。对于一些骨折压缩程度Ⅰ度的患者,可以通过加强抗骨质疏松治疗和使用甲状旁腺素类似物进行保守治疗。Objective To study the relevant factors affecting the occurrence of adjacent vertebral fractures in women with osteoporotic vertebral compression fractures after conservative treatments.Methods A total of 98 elderly female patients diagnosed with osteoporotic vertebral compression fractures and treated from January 2020 to January 2022 were retrospectively analyzed.The average age was(73.05±7.38)years old.Based on the follow-up results after two years of injury,the patients were divided into the adjacent vertebral fracture group(24 cases)and the non-adjacent vertebral fracture group(74 cases).The following factors were recorded for each patient:age,initial bone density,follow-up bone density,bone density changes,initial VAS score,degree of fracture compression,presence of old fractures,use of zoledronic acid,use of parathyroid hormone analogs,occurrence of complications,and further compression of the affected vertebrae.Univariate and multivariate Logistic regression analyses were performed to analyze the associated risk factors.Results Univariate analysis revealed that in elderly women undergoing conservative treatment for osteoporotic vertebral compression fractures,the degree of fracture compression,follow-up bone density,changes in bone density,use of zoledronic acid,and use of parathyroid hormone analogs were statistically significant(P<0.05).Multivariate Logistic regression analysis demonstrated that the degree of fracture compression 95%CI(0.040,0.571),P=0.005,OR=0.151,changes in bone density 95%CI(1.264,1360.732),P=0.036,OR=41.477,and use of parathyroid hormone analogs 95%CI(1.638,31.625),P=0.009,OR=7.196 were risk factors affecting the occurrence of adjacent vertebral fractures following vertebral compression fractures in elderly women with osteoporosis.Conclusion The degree of fracture compression,changes in bone density,and the use of parathyroid hormone analogs are factors influencing the occurrence of adjacent vertebral fractures following vertebral compression fractures in elderly women with osteopo

关 键 词：骨质疏松 椎体压缩性骨折 邻近椎体骨折 保守治疗 危险因素 

分 类 号：R683.2[医药卫生—骨科学]