脊柱矢状面失衡与骨质疏松症患者发生椎体压缩骨折的相关性研究  

Correlation between sagittal surface imbalance of spine and vertebral compression fracture in osteoporosis patients

作　　者：王斌 陈剑楼 郭平 钱明 李千千 徐沁 WANG Bin;CHEN Jianlou;GUO Ping;QIAN Ming;LI Qianqian;XU Qin(Department of Orthopedics,The Second People′s Hospital of Zhangjiagang City,Zhangjiagang 215600;Department of Orthopedics,Zhangjiagang Hospital Affiliated to Soochow University,Zhangjiagang 215600)

机构地区：[1]张家港市第二人民医院骨科,张家港215600 [2]苏州大学附属张家港医院骨科,张家港215600

出　　处：《颈腰痛杂志》2025年第1期13-18,共6页The Journal of Cervicodynia and Lumbodynia

基　　金：2023年度江苏省老年科研项目(LK2023055)。

摘　　要：目的探讨脊柱矢状面失衡与骨质疏松症患者发生骨质疏松性椎体压缩性骨折(OVCFs)之间的相关性。方法收集张家港市第二人民医院2020年1月至2022年10月确诊为骨质疏松症患者340例。根据随访中是否发生OVCFs分为实验组(椎体压缩性骨折)和对照组(无椎体压缩性骨折)。记录患者基本信息,并测量影像学脊柱参数,包括胸腰椎后凸(TLK)、骨盆倾斜(PT)、C_(7)-S_(1)矢状垂直轴(C_(7)-S_(1)SVA)、C_(2-7)矢状垂直轴(C_(2-7)SVA)。并使用Pearson和Spearman相关系数计算各参数之间的相关性。分类变量采用χ^(2)检验;对于正态分布的连续变量,采用独立样本t检验;对于非正态分布变量,采用双样本非参数检验。采用二元Logistic回归分析和受试者工作特征(ROC)曲线分别确定独立危险因素和临界值。结果共纳入340例骨质疏松症患者,实验组为150例,对照组为190例。最长随访时间为44个月,最短随访时间为12个月,平均为(25.2±10.2)个月。两组患者的TLK、PT、C_(7)-S_(1)SVA、C_(2-7)SVA差异均有统计学意义(P<0.05)。在性别、体质量指数(BMI)方面差异无统计学意义(P>0.05)。通过二元Logistic回归分析发现,骨密度、用药治疗有规律性及C_(7)-S_(1)SVA是椎体压缩性骨折的独立危险因素。ROC曲线显示,C_(7)-S_(1)SVA预测精度最高。结论当C_(7)-S_(1)SVA大于3.81 cm时,OVCFs的发生概率增加,且C_(7)-S_(1)SVA每增加1 cm,OVCFs的发生率增加0.324倍(P<0.01,OR=1.324)。Objective To investigate the correlation between sagittal surface imbalance of the spine and osteoporotic vertebral compression fractures(OVCFs)in patients with osteoporosis.Methods 340 patients diagnosed with osteoporosis in the second people′s hospital of Zhangjiagang city from January 2020 to October 2022 were collected.According to whether OVCFs occurred during the follow-up,they were divided into experimental group(vertebral compression fracture)and control group(no vertebral compression fracture).Basic patient information was recorded and radiographic spinal parameters were measured,including thoracolumbar kyphosis(TLK),pelvic tilt(PT),C_(7)-S_(1)sagittal vertical axis(C_(7)-S_(1)SVA),and C_(2-7) sagittal vertical axis(C_(2-7)SVA).Pearson and Spearman correlation coefficients were used to calculate the correlation among the parameters.The categorical variables were tested by chi-square test.For continuous variables with normal distribution,independent sample t test was used.For non-normal distribution variables,the two-sample non-parametric test was used.Binary Logistic regression analysis and receiver operating characteristic(ROC)curve were used to determine independent risk factors and critical values,respectively.Results A total of 340 patients with osteoporosis were included,with 150 in the experimental group and 190 in the control group.The longest follow-up time was 44 months,the shortest follow-up time was 12 months,and the average follow-up time was(25.2±10.2)months.There were significant differences in TLK,PT,C_(7)-S_(1)SVA and C_(2-7)SVA between 2 groups(P<0.05).There were no significant differences in gender,body mass index(BMI).By binary Logistic regression analysis,bone mineral density,medication regularity and C_(7)-S_(1)SVA were found to be independent risk factors for vertebral compression fractures.ROC curve showed that C_(7)-S_(1)SVA had the highest prediction accuracy.Conclusion We found that when C_(7)-S_(1)SVA was greater than 3.81 cm,the incidence of OVCFs increased,and the incidenc

关 键 词：脊柱矢状面失衡 骨质疏松症 椎体压缩性骨折 C_(7)-S_(1)SVA 相关性 影像学检查 

分 类 号：R683.2[医药卫生—骨科学]