摘要
目的分析经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体骨折(OVF)术后残留痛的危险因素。方法回顾性分析2020年1月至2021年12月苏州大学附属第一医院骨科行单节段PKP治疗的221例OVF患者资料。男40例,女181例;年龄(69.6±8.2)岁。将患者按照术后第3天疼痛视觉模拟评分(VAS)分成两组,即残留痛组(VAS评分≥4分)和对照组(VAS评分<4分)。先对两组患者的性别、年龄、骨密度T值、体重指数、有无长期激素使用史、随访时间、病程、骨折节段、骨折压缩严重程度、有无合并椎体内裂隙征、有无累及中柱、有无腰背筋膜损伤、麻醉方式、穿刺方式、骨水泥注入量、骨水泥是否与终板接触、骨水泥分布形态、骨水泥渗漏部位、椎体高度恢复值、术前cobb角和cobb角纠正值进行单因素分析。将筛选出的P<0.1的因素纳入进行logistic回归分析,筛选最终变量。结果本研究中19例患者纳入残留痛组,202例患者则纳入对照组。单因素分析结果显示:体重指数(P=0.059)、椎体内裂隙征(P=0.049)和腰背筋膜损伤(P<0.001)增加残留痛风险。Logistic回归分析结果显示:腰背筋膜损伤是残留痛的危险因素(OR=6.127,95%CI:2.240~16.755,P<0.001)。结论腰背筋膜损伤是PKP治疗OVF术后残留痛的危险因素。
Objective To analyze the risk factors for residual pain after percutaneous kyphoplasty(PKP)for osteoporotic vertebral fractures(OVF).Methods Retrospectively analyzed were the patients with OVC who had been treated at Department of Orthopaedic Surgery,The First Affiliated Hospital of Soochow University by single level PKP from January 2020 to December 2021.They were 40 men and 181 women,with an age of(69.6±8.2)years.By the pain score of visual analogue scale(VAS)on the postoperative day 3,they were assigned into 2 groups:a residual pain group(VAS≥4)and a control group(VAS<4).The general demographics,radiographic and surgical related data of the 2 groups were analyzed by single factor analysis,including their gender,age,bone mineral density,body mass index,glucocorticoid usage,follow-up time,duration of symptoms,fracture location,severity of fracture compression,intravertebral cleft,middle column involvement,thoracolumbar fascia injury,anesthesia method,puncture method,volume of bone cement injected,cement-endplates contact,pattern of cement distribution,cement leakage,vertebral height restoration,preoperative cobb angle and correction of cobb angle.The P<0.1 factors screened were further analyzed by the multivariate logistic regression to determine the final variables.Results In the present study,19 patients were assigned into the residual pain group and 202 patients the control group.The univariate analysis showed that body mass index(P=0.059),intravertebral cleft(P=0.049)and thoracolumbar fascia injury(P<0.001)increased the risk for residual pain.The multivariate logistic regression analysis showed that thora-columbar fascia injury was an independent risk factor for residual pain(OR=6.127,95%CI:2.240 to 16.755,P<0.001).Conclusion Thoracolumbar fascia injury is an independent risk factor for residual pain after PKP for OVF.
作者
钮俊杰
倪莉
宋达玮
王金宁
冯焘
金盛阳
杨炎
杨惠林
邹俊
Niu Junjie;Ni Li;Song Dawei;Wang Jinning;Feng Tao;Jin Shengyang;Yang Yan;Yang Huilin;Zou Jun(Department of Orthopaedic Surgery,The First Affiliated Hospital of Soochow University,Suzhou 215000,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2023年第1期31-36,共6页
Chinese Journal of Orthopaedic Trauma
关键词
骨质疏松
脊柱骨折
椎体成形术
危险因素
残留痛
腰背筋膜损伤
Osteoporosis
Spinal fractures
Percutaneous kyphoplasty
Risk factors
Residual pain
Thoracolumbar fascia injury
