摘要
目的 探讨经皮椎体强化术后再发骨折的影响因素.方法 对我院2007年1月至2013年12月收治的行经皮椎体强化术治疗256例骨质疏松性椎体压缩骨折（OVCF）患者的临床资料进行回顾性分析,按患者术后是否发生椎体再发骨折分为再发骨折组（59例）和未再发骨折组（197例）.分析比较两组患者的年龄、性别、BMI、骨密度值、手术方式、骨水泥注入量、是否存在骨水泥渗漏及椎体高度恢复率.并进行多因素Logistic回归分析,分析各因素与椎体再发骨折的相关性.结果 再发骨折组、未再发骨折组患者的年龄[（75.9±4.6）、（69.9±5.0）岁]、BMI[（23.5±0.6）、（25.4±0.7）kg/m2]、骨密度[（-3.67±0.68）、（-2.75±0.98）]、骨水泥渗漏率（22.0％、5.1％）及椎体高度恢复率[（24.1±2.9）％、（14.9±3.0）％]比较差异均有统计学意义（P值分别为0.046、0.047、0.046、0.026、0.023）.多因素Logistic回归分析显示,年龄、BMI与术后再发骨折无关（P值分别为0.140、0.137）,与骨密度、骨水泥渗漏及椎体高度恢复率相关（P值分别为0.018、0.000、0.000）.结论 骨密度低、发生骨水泥渗漏及伤锥高度过多恢复是经皮椎体强化术后再发骨折的危险因素.
Objective To evaluate the influencing factors of recurrence of fracture after percutaneous vertebral augmentation.Methods From January 2007 to December 2013,256 cases patients with percutaneous vertebral augmentation in treatment of osteoporotic vertebral compression fractures in the Central Hospital of Chaoyang were retrospectively reviewed.After operation,the patients were divided into recurrent fracture group （59 cases） and no recurrence group （197 cases） according to whether postoperative recurrence of vertebral fracture.The age,sex,body mass index （BMI）,bone mineral density,operation mode,bone cement injection volume,the existence of bone cement leakage and vertebral body height recovery rate were compared between the two groups respectively.Multi factor Logistic regression analysis was performed to analyze the correlation between the factors and the recurrence of vertebral body fractures.Results The age（（75.9±4.6） years old vs.（69.9±5.0） years old）,BMI（（23.5±0.6） kg/m2 vs.（25.4±0.7） kg/m2）,bone mineral density（（-3.67±0.68）vs.（-2.75 ±0.98））,the existence of bone cement leakage rate（22.0% vs.5.1%） and vertebral body height recovery rate （（24.1±2.9） % vs.（14.9±3.0）%） between recurrent fracture group and no recurrence group had statistically significant differences （P=0.046,0.047,0.046,0.026,0.023）.Multi factor Logistic regression analysis showed that age,BMI were not related to postoperative recurrence of fracture（P=0.140,0.137）,and bone density,bone cement leakage and vertebral body height recovery rate were related to recurrence of fracture （P=0.018,0.000,0.000）.Conclusion Low bone mineral density,existence of bone cement leakage and high body height recovery rate are the risk factors of recurrence of fracture after percutaneous vertebral augmentation.
出处
《中国综合临床》
2016年第6期492-495,共4页
Clinical Medicine of China
关键词
胸腰椎骨折
经皮椎体成形术
经皮椎体后凸成形术
再发椎体骨折
骨密度
骨水泥渗漏
椎体高度恢复率
Thoracic and lumbar vertebrae fracture
Percutaneous vertebral angioplasty
Percutaneous kypho-plasty
Recurrence of vertebral fracture
Bone mineral density
Bone cement leakage
Vertebral body height recovery rate
