摘要
目的探讨骨水泥相关因素对经皮椎体成形(PVP)术后非伤椎再骨折的影响。方法回顾性分析2016年1月—2018年12月于太康济民骨科医院行PVP手术的469例骨质疏松性椎体压缩性骨折(OVCF)患者的临床资料,其中460例患者完成1年以上随访。将随访期间发生非伤椎再骨折的79例患者纳入观察组,未发生再骨折的381例患者纳入对照组。记录两组患者年龄、性别、骨密度、骨水泥注射方式(单侧或双侧注射)和渗漏情况,采用骨水泥量体指数和分布指数评估骨水泥分布情况,对上述指标进行单因素和多因素Logistic回归模型分析。结果两组患者年龄、性别、骨水泥量、骨水泥量体指数相近(P>0.05)。观察组中双侧骨水泥注射25例,对照组均为双侧骨水泥注射,对两组骨水泥注射方式进行比较,差异具有统计学意义(P<0.05);观察组骨密度低于对照组,骨水泥渗漏率高于对照组(P<0.05)。单因素分析显示骨水泥注射方式、骨密度、骨水泥渗漏、骨水泥分布指数是PVP术后发生非伤椎再骨折的影响因素(P<0.05);多因素Logistic回归模型分析显示上述4项指标为独立危险因素。结论骨水泥注射方式、渗漏和分布情况对PVP术后非伤椎再骨折的发生具有重要影响;双侧注射骨水泥、及时监测骨水泥渗漏和分布情况可有效预防PVP术后非伤椎再骨折。
Objective To investigate the effect of bone cement related factors on the refracture of non injured vertebral body after percutaneous vertebroplasty(PVP).Methods Clinical data of 469 patients with osteoporotic vertebral compression fracture(OVCF)who underwent PVP operation in Taikang Jimin Orthopedic Hospital from January 2016 to December 2018,were analyzed retrospectively.A total of 460 patients completed at least one year follow-up.Seventy-nine patients suffered from non injured vertebral refracture during the follow-up were included into the observation group,while 381 patients without the refracture were included into the control group.Age,gender,bone mineral density(BMD),bone cement injection mode(unilateral or bilateral injection)and cement leakage of patients in two groups were recorded,distribution of bone cement was evaluated by bone cement volume index(BCVI)and distribution index(BCDI).The above indicators were analyzed by univariate and multivariate logistic regression models.Results Age,gender,bone cement volume and BCVI were similar between the two groups(P>0.05).In the observation group,bilateral bone cement injection was used in 25 cases,while in the control group,all patients performed bilateral bone cement injection,there was statistical significance between the two groups(P<0.05);In the observation group,BMD was lower,and the leakage rate of bone cement was higher when compared with those in the control group(P<0.05).Univariate analysis showed that bone cement injection mode,BMD,bone cement leakage and BCDI were the influence factors of non injured vertebral refracture after PVP(P<0.05);Multivariate logistic regression model analysis showed that the above four indicators were independent risk factors.Conclusions It has important influence of injection mode,leakage and distribution of bone cement on postoperative non injured vertebral refracture.Bilateral injection of bone cement and timely monitoring of bone cement leakage and distribution can effectively prevent non injured vertebral refracture
作者
张荷权
张西龙
谢承辉
ZHANG Hequan;ZHANG Xilong;XIE Chenghui(Department of Orthopaedics,Taikang Jimin Orthopedic Hospital,Luoyang,Henan 461443,China)
出处
《中国骨科临床与基础研究杂志》
2020年第3期138-142,共5页
Chinese Orthopaedic Journal of Clinical and Basic Research
