定向球囊扩张PKP治疗老年骨质疏松性椎体压缩骨折的效果及影响因素分析  

The efficacy and influencing factors of directional balloon kyphoplasty PKP in the treatment of osteoporotic vertebral compression fractures in the elderly patients

作　　者：杨代洪 汪礼军 唐鹏 刘剑 周易 YANG Daihong;WANG Lijun;TANG Peng;LIU Jian;ZHOU Yi(Chongqing Dazu District People's Hospital,Affiliated Dazu Hospital of Chongqing Medical University,Dazu 402360,Chongqing,China)

机构地区：[1]重庆市大足区人民医院重庆医科大学附属大足医院,重庆大足402360

出　　处：《中南医学科学杂志》2025年第2期316-320,共5页Medical Science Journal of Central South China

基　　金：重庆市科卫联合医学科研项目(2019QNXM016)。

摘　　要：目的 观察定向球囊扩张经皮椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩骨折的效果,并分析术后骨水泥渗漏和腰背痛的影响因素。方法 选取老年骨质疏松性椎体压缩骨折患者110例,给予定向球囊扩张PKP治疗。观察其手术治疗情况以及术后1个月腰背痛和骨水泥渗漏发生情况。比较其发生和未发生术后腰背痛、骨水泥渗漏患者的临床资料。采用Logistic回归分析发生术后骨水泥渗漏、术后腰背痛的影响因素。结果 所有患者术后Oswestry功能障碍指数(ODI)低于术前,脊柱侧位Cobb角低于术前(P<0.05)。术后1个月腰背痛发生率为29.09%,骨水泥渗漏发生率为32.73%。发生骨水泥渗漏患者年龄、术前Cobb角、椎体后壁不完整、术前骨密度T值<-2.5SD、双侧穿刺路径高于未发生骨水泥渗漏患者(P<0.05)。发生术后腰背痛患者伤椎个数为2个、术前骨密度T值<-2.5SD、有筋膜损伤、有骨水泥渗漏比例高于未发生术后腰背痛患者(P<0.05)。术前Cobb角、椎体后壁情况、术前骨密度T值、穿刺路径是发生骨水泥渗漏的影响因素(P<0.05)。伤椎个数、术前骨密度T值、筋膜损伤、骨水泥渗漏是发生术后腰背痛的影响因素(P<0.05)。结论 定向球囊扩张PKP手术治疗老年骨质疏松性椎体压缩骨折有较好的效果;术后骨水泥渗漏受术前Cobb角、椎体后壁情况等因素影响;术后腰背痛受伤椎个数、术前骨密度T值等因素影响。Aim To observe the effect of targeted balloon kyphoplasty(PKP) in the treatment of elderly patients with osteoporotic vertebral compression fractures and to analyze the influencing factors of postoperative bone cement leakage and persistent lower back pain.Methods A total of 110 elderly patients with osteoporotic vertebral compression fractures were selected and treated with directional balloon kyphoplasty PKP.The surgical treatment situation,the occurrence of persistent low back pain after the operation and bone cement leakage were observed.The clinical differences between the patients with and without persistent low back pain after the operation and bone cement leakage were compared and analyzed.Logistic regression analysis was used to identify the influencing factors of postoperative bone cement leakage and lower back pain.Results The Oswestry Disability Index(ODI) of all patients was lower one month after the operation compared with that before the operation(P<0.05);the Cobb angle of the lateral spine was lower one month after the operation than that before the operation(P<0.05).The incidence of persistent low back pain one month after the operation was 29.09%;the incidence of bone cement leakage one month after the operation was 32.73%.The age,Cobb angle before the operation,incomplete posterior vertebral wall,bone mineral density T value <-2.5SD before the operation,and bilateral puncture pathway of the patients with bone cement leakage were higher than those of the patients without bone cement leakage(P<0.05).The proportion of patients with two fractured vertebrae,bone mineral density T value<-2.5SD before the operation,fascial injury,and the proportion of bone cement leakage in the patients with persistent low back pain after the operation were higher than those in the patients without persistent low back pain after the operation(P<0.05).Cobb angle before the operation,the condition of the posterior vertebral wall,the bone mineral density T value before the operation,and the puncture pathway were the infl

关 键 词：定向球囊扩张 老年人 骨质疏松性椎体压缩骨折 骨水泥渗漏 腰背痛 影响因素 

分 类 号：R683[医药卫生—骨科学]