摘要
目的:探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)后邻近椎体骨折(adjacent vertebral fractures,AVF)的影响因素及其与骨水泥渗漏类型的关系。方法:回顾性分析2016年1月-2019年8月柳州市人民医院行PVP术后发生骨水泥渗漏的80例骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)患者的临床资料。所有患者均行PVP,收集所有患者的体重指数(body mass index,BMI)和骨水泥注入量,PVP术后3 d内行X线检查,并根据解剖位置方法对骨水泥渗漏进行分型,术后至少随访2年,采用电话随访及门诊随访的方式。统计不同类型骨水泥渗漏患者AVF发生率。对PVP术后AVF的发生进行单因素及多因素分析。结果:80例患者中椎体周围渗漏型、椎间盘内渗漏型、椎旁软组织内渗漏型、椎管内硬膜外渗漏型及椎间孔内渗漏型发生率分别为40.00%、35.00%、20.00%、3.75%、1.25%。椎间盘内渗漏型患者的AVF发生率明显高于椎旁软组织内渗漏型及椎体周围渗漏型患者(P<0.05)。PVP术后发生AVF患者年龄和骨水泥注入量均明显大于PVP术后未发生AVF患者,合并椎体周围渗漏型占比低于PVP术后未发生AVF患者,合并椎间盘内渗漏型占比高于PVP术后未发生AVF患者(P<0.05)。Logistic回归分析显示,椎间盘内渗漏型、高龄、骨水泥注入量多均是PVP术后AVF发生的独立危险因素(P<0.05)。结论:OVCF患者PVP术后发生AVF的危险因素较多,椎间盘内渗漏型是影响PVP术后AVF发生的主要骨水泥渗漏类型。
Objective:To investigate influence factors of the occurence of adjacent vertebral fractures(AVF)after percutaneous vertebroplasty(PVP)and its relationship with bone cement leakage type.Method:The clinical data of 80 osteoporotic vertebral compression fractures(OVCF)patients with bone cement leakage after PVP in Liuzhou People’s Hospital from January 2016 to August 2019 were analyzed retrospectively.All patients underwent PVP,and the body mass index(BMI)and bone cement injection volume of all patients were collected,X-ray examination was performed within 3 days after PVP,and bone cement leakage was classified according to the anatomical location.The patients were followed up for at least 2 years by telephone follow-up and outpatient follow-up method after surgery.The incidence of AVF in patients with different types of bone cement leakage was counted.The occurrence of AVF after PVP was analyzed by univariate and multivariate analysis.Result:Among the 80 patients,the incidences of perivertebral leakage type,intervertebral disc leakage type,paravertebral soft tissue leakage type,intraspinal epidural leakage type and intervertebral foramen leakage type were 40.00%,35.00%,20.00%,3.75%and 1.25%respectively.The incidence of AVF in patients with intervertebral disc leakage type was significantly higher than that in patients with paravertebral soft tissue leakage type and perivertebral leakage type(P<0.05).The age and bone cement injection volume of patients with AVF after PVP were significantly greater than those in patients without AVF after PVP,the proportion of patients with perivertebral leakage type was lower than those in patients without AVF after PVP,and the proportion of patients with intervertebral disc leakage type was higher than those in patients without AVF after PVP(P<0.05).Logistic regression analysis showed that intervertebral disc leakage type,advanced age and large amount of bone cement injection were independent risk factors for the occurence of AVF after PVP(P<0.05).Conclusion:There are many risk f
作者
蒋人杰
JIANG Renjie(Liuzhou People’s Hospital,Liuzhou 545006,China)
出处
《中外医学研究》
2022年第13期53-57,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
骨质疏松性椎体压缩性骨折
经皮椎体成形术
骨水泥渗漏
类型
邻近椎体骨折
Osteoporotic vertebral compression fractures
Percutaneous vertebroplasty
Bone cement leakage
Types
Adjacent vertebral fractures
