摘要
目的探讨椎体骨质量(VBQ)分数联合股骨颈骨密度(BMD)在预测经皮球囊扩张椎体后凸成形术(PKP)术后再发邻近椎体骨折(AVF)的作用。方法选取2020年1月至2021年12月在本院因单节段椎体压缩性骨折行PKP手术的患者102例。术后进行随访,根据是否发生邻椎再骨折,分为未骨折组和再骨折组。同时记录年龄、性别、椎体损伤节段、术后是否规范接受抗骨质疏松治疗、VBQ分数、股骨颈BMD及椎体高度恢复率,分别采用单因素及多因素回归对术后是否再发邻椎骨折进行危险因素分析,引用受试者工作特征(ROC)曲线分析VBQ分数和股骨颈BMD在单独及联合预测PKP术后再发邻椎骨折的价值。结果所有接受PKP患者中出现术后邻椎再骨折发生率为16.67%(17/102),单因素结果显示VBQ分数、股骨颈BMD及术后是否抗骨质疏松治疗与PKP术后再发骨折具有相关性(P<0.05)。在多因素分析中,较高的VBQ分数、低股骨颈BMD、术后未抗骨质疏松治疗是PKP术后再发相邻椎体骨折的独立危险因素(P<0.05)。ROC曲线显示,VBQ分数和股骨颈BMD在联合预测PKP患者术后再发相邻椎体骨折的AUC为0.792,且价值优于两项指标的单独预测。结论VBQ分数是PKP患者术后相邻椎体再发骨折的危险因素,且VBQ分数联合股骨颈BMD对PKP术后再发AVF具有更高预测价值。
Objective To compare the value of vertebral bone quality(VBQ)score combined with bone mineral density(BMD)in predicting the recurrence of adjacent vertebral fractures(AVF)after percutaneous balloon kyphoplasty(PKP).Methods 102 patients who underwent PKP for vertebral compression fracture were selected and followed up.According to whether the patients had refracture of adjacent vertebrae,they were divided into the non-fracture group and the refracture group.At the same time,the age,sex,vertebral body injury segment,whether the patients received standard anti osteoporosis treatment after operation,VBQ score,femoral neck bone mineral density and vertebral body height recovery rate were recorded.The risk factors of postoperative recurrence of adjacent vertebral fracture were analyzed by single factor and multi factor regression.The value of VBQ score and femoral neck BMD in predicting the recurrence of adjacent vertebral fracture after PKP was analyzed by quoting the receiver operating characteristic(ROC)curve.Results Among all patients receiving PKP,the incidence of postoperative adjacent vertebral fracture was 16.67%(17/102).Univariate results showed that vertebral body bone mass fraction,femoral neck BMD and postoperative anti osteoporosis treatment were correlated with postoperative recurrent fracture of PKP,with statistical significance(P<0.05).In multivariate analysis,higher vertebral body mass fraction,lower femoral neck BMD and no anti osteoporosis treatment were independent risk factors for recurrent adjacent vertebral body fractures after PKP,with statistical significance(P<0.05).ROC curve showed that the AUC of VBQ score and femoral neck BMD in predicting the recurrence of adjacent vertebral fractures in PKP patients was 0.792,and the value was better than that of the two indicators alone.Conclusion VBQ score is a risk factor for recurrent fractures of adjacent vertebral bodies in patients with PKP,and VBQ score combined with femoral neck BMD has a higher predictive value for recurrent AVF after PKP.
出处
《浙江临床医学》
2023年第3期407-410,共4页
Zhejiang Clinical Medical Journal
