摘要
目的探讨稳定型胸腰椎爆裂骨折(thoracolumbar burst fractures,TBF)非手术治疗的失败率和预测因素。方法选择2015年1月~2020年12月在该院接受非手术治疗的稳定型TBF患者资料进行回顾性分析,记录患者非手术治疗失败率。观察非手术治疗失败和非手术治疗成功患者的性别、年龄、体质量指数(body mass index,BMI)、个人史、伴随疾病、损伤原因、损伤椎体、疼痛视觉模拟评分(visual analogue scale,VAS)、椎体压缩率(vertebral body compression rate,VBCR)、椎体前缘高度压缩百分比(percentage anterior high compression,PAHC)、Cobb角、椎弓根间距(interpedicular distance,IPD)和椎管压缩程度,采用Logistic回归分析确定影响非手术治疗效果的独立因素。结果71例患者有21例非手术治疗失败,发生率29.58%。非手术治疗失败患者年龄、BMI、糖尿病、VBCR、PAHC、Cobb角、IPD、椎管压缩和VAS均高于非手术治疗成功患者(P<0.05)。多因素Logistic回归分析结果显示,年龄和IPD是影响非手术治疗效果的独立风险因素(P<0.05)。年龄预测非手术治疗失败的灵敏度、特异性、截断值和AUC分别为71.40%、86.00%、47岁、0.811,IPD预测非手术治疗失败的灵敏度、特异性、截断值和AUC分别为71.43%、88.00%、16.7%和0.771。结论年龄和IPD是影响稳定型TBF患者非手术治疗失败的风险因素,对预测手术失败具有一定临床价值。
Objective To investigate the failure rate and predictive factors of non-operative treatment for stable thoracolumbar burst fractures(TBF).Methods The data of TBF patients who received non-operative treatment in our hospital from January 2015 to December 2020 were retrospectively analyzed,and the failure rate of non-operative treatment was recorded.The sex,age,body mass index(BMI),personal history,concomitant diseases,causes of injury,injured vertebral bodies,pain visual analogue scale(VAS),vertebral body compression rate(VBCR),percentage anterior high compression(PAHC),Cobb angle,interpedicular distance(IPD)and spinal canal compression of patients with non-operative treatment failure and successful non-operative treatment were observed.The independent factors affecting the effect of non-operative treatment were determined by logistic analysis.Results Altogether 21 of 71 patients failed non-operative treatment,with the incidence of 29.58%.The age,BMI,diabetes,VBCR,PAHC,Cobb angle,IPD,vertebral canal compression and VAS of patients with non-operative treatment failure were higher than those of patients with non-operative treatment success(P<0.05).Multivariable logistic analysis showed that age and IPD were independent risk factors affecting the effect of non-operative treatment(P<0.05).The sensitivity,specificity,cut-off value and AUC of age predicting non-operative treatment failure was 71.40%,86.00%,47 years old,0.811,and the sensitivity,specificity,cut-off value and AUC of IPD predicting non-operative treatment failure was 71.43%,88.00%,16.7%and 0.771 respectively.Conclusion Age and IPD are the risk factors for non-operative treatment failure in patients with stable TBF,which have certain clinical value in predicting surgical failure.
作者
高爽
李健辉
田水净
GAO Shuang;LI Jian-hui;TIAN Shui-jing(Department of Surgery,Qinhuangdao Second Hospital,Qinhuagndao,Hebei 066600,China)
出处
《颈腰痛杂志》
2024年第1期19-23,共5页
The Journal of Cervicodynia and Lumbodynia
关键词
胸腰椎爆裂性骨折
非手术治疗
预测因素
thoracolumbar burst fracture
non-operative treatment
predictors
