摘要
目的分析骨质疏松性椎体压缩骨折(OVCF)行PVP术后早期残留腰背痛(UBPR)的风险因素。方法纳入2016年3个月~2020年5月行PVP手术治疗的312例OVCF患者,观察其术后1个月内的UBPR发生情况,并据此分为UBPR组和非UBPR组。统计两组患者的人口学资料、手术资料、影像学资料和基础疾病等因素,进行组间单因素分析和多因素Logistic回归分析。结果术后1个月内发生UBPR21例,发生率6.7%,纳入UBPR组;其余291例纳入非UBPR组。UBPR组术后1周、1个月和3个月的VAS评分、ODI指数改善效果均显著差于非UBPR组(P<0.05)。单因素分析显示,UBPR组和非UBPR组的骨密度T值、腰背筋膜损伤、骨水泥分布、骨折椎体数目、骨水泥填充量等因素,均有统计学意义(P<0.05)。多因素Logistic回归分析显示,骨密度值(OR=3.562)、腰背筋膜损伤(OR=3.812)、骨水泥分布(OR=3.084)、骨折椎体数目(OR=3.452)均是PVP术后1个月内发生UBPR的风险因素;而骨水泥填充量(OR=0.062)则是其保护因素。结论骨密度偏低、合并腰背筋膜损伤、多节段OVCF、骨水泥分布不满意、骨水泥填充量偏少,是PVP术后发生UBPR的独立风险因素。
Objective To analyze the risk factors of early unsatisfactory back pain relief(UBPR)after percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture(OVCF).Methods From March 2016 to May 2020,312 patients with OVCF who underwent PVP were included.The occurrence of UBPR within 1 month after operation was observed,and the patients were divided into UBPR group and non-UBPR group.The demographic data,surgical data,imaging data and basic diseases of the two groups were counted,and the univariate analysis and multivariate Logistic regression analysis were carried out.Results Twenty-one cases of UBPR occurred within one month after operation,with an incidence rate of 6.7%.The remaining 291 cases were included in the non-UBPR group.The improvement effects of VAS score and ODI index in UBPR group at 1 week,1 month and 3 months after operation were significantly worse than those in non-UBPR group(P<0.05).Univariate analysis showed that the bone mineral density(BMD)T value,lumbar fascia injury,bone cement distribution,the number of fractured vertebral bodies and the amount of bone cement filling between UBPR group and non-UBPR group had statistically significant differences(P<0.05).Multivariate Logistic regression analysis showed that BMD(OR=3.562),low back fascia injury(OR=3.812),bone cement distribution(OR=3.084)and the number of fractured vertebral bodies(OR=3.452)were the risk factors of UBPR within 1 month after PVP.The filling amount of bone cement(OR=0.062)was the protective factor.Conclusion Low BMD,combined with low back fascia injury,multi-level OVCF,unsatisfactory distribution of bone cement and less filling of bone cement are independent risk factors for UBPR after PVP.
作者
张成祺
裴济民
赵永辉
王鑫
ZHANG Cheng-qi;PEI Ji-min;ZHAO Yong-hui;WANG Xin(Department of Orthopedics,the First People's Hospital of Xinxiang,Xinxiang,Henan,453000,China)
出处
《颈腰痛杂志》
2022年第2期204-207,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
骨质疏松症
压缩性椎体骨折
经皮椎体成形术
残留腰背痛
风险因素
osteoporosis
compression vertebral fracture
percutaneous vertebroplasty
residual low back pain
risk factor
