| 陈涛,杨建东,张亮,等.骨质疏松性胸腰椎骨折椎体强化术后发生邻近椎体骨折的危险因素分析.骨科,2017,8(3): 190-193,199. |
| 骨质疏松性胸腰椎骨折椎体强化术后发生邻近椎体骨折的危险因素分析 |
| Risk factors of adjacent vertebral fractures following percutaneous vertebrae augmentation in osteoporotic thoracolumbar fractures |
| 投稿时间：2016-09-08 |
| DOI：10.3969/j.issn.1674-8573.2017.03.007 |
| 中文关键词: 脊柱骨折 骨质疏松 危险因素 |
| 英文关键词: Spinal fractures Osteoporosis Risk factors |
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| 中文摘要: |
| 目的 探讨骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fracture, OVCF）病人椎体强化术治疗后发生邻近椎体骨折的高危因素。方法 回顾性研究2012年3月至2014年8月苏北人民医院骨科收治的OVCF病人200例（263椎），收集病人的年龄、性别、椎体高度恢复、Cobb角、脊柱侧凸畸形、骨折病史、骨水泥量、骨水泥渗漏、骨密度等资料，应用单因素分析观察每种因素与椎体再骨折发生的相关性，筛查出可疑的相关因素，然后采用多因素Logistic回归分析得出影响椎体强化术后发生邻近椎体骨折的高危因素。结果 所有病人均获2年以上随访，平均随访时间为2.5年。共35例（45椎）发生再骨折，再骨折率为17.5％。单因素统计分析发现对椎体成形术后邻近节段再发骨折有影响的变量有：年龄、椎体高度恢复、Cobb角恢复、脊柱侧凸畸形、骨折病史、骨水泥渗漏、骨密度。多因素Logistic回归分析结果显示，年龄（OR：1.08，95% CI：1.04~1.13）、椎体高度恢复（OR：1.06，95% CI：1.01~1.11）、Cobb角（OR：4.03，95% CI：1.21~13.40）、脊柱侧凸畸形（OR：2.56，95% CI：1.12~5.85）和发生骨水泥渗漏（OR：6.25，95% CI：0.04~0.73）是发生再骨折的危险因素，而骨密度（OR：0.37，95% CI：0.22~0.65）是发生再骨折的保护因素。结论 年龄越大、椎体高度恢复越高、Cobb角越大、骨密度越低、有脊柱侧凸畸形和骨水泥渗漏的病人更容易发生术后邻近椎体再骨折。 |
| 英文摘要: |
| Objective To investigate the risk factors of re-fracture in patients with osteoporotic vertebral compression fractures (OVCF) after vertebroplasty. Methods A total of 200 patients with osteoporotic fracture were treated from March 2012 to August 2014. The clinical data including age and sex, restoration of vertebral height and Cobb's angle, vertebral scoliosis, fracture history, bone cement volume, bone cement leakage and bone density of the patients were collected. The correlations between each factor and vertebral fracture of observation model were analyzed by the method of single factor analysis. By screening out the suspicious related factors, the risk factors of vertebral fracture were found by logistic regression analysis. Results 200 cases of osteoporotic thoracolumbar fractures including 263 vertebral bodies were followed up over 2 years when leaving the hospital. Re-fracture occurred in 35 cases (45 vertebrae) and re-fracture rate was 17.5%. The age, vertebral height, Cobb's angle, vertebral deformity, fracture recovery history, the leakage of bone cement and bone mineral density were the influencing variables of the re-fracture. Among them, the age (OR: 1.08, 95% CI: 1.04-1.13), vertebral height restoration (OR: 1.06, 95% CI: 1.01-1.11) and Cobb's angle (OR: 4.03, 95% CI: 1.21-13.40), vertebral scoliosis (OR: 2.56, 95% CI: 1.12-5.85) and the bone cement leakage (OR: 0.16, 95% CI: 0.04-0.73) were risk factors of re-fracture, and bone mineral density (OR: 0.37, 95% CI: 0.22-0.65) was protective factors for re-fracture. Conclusion The elders, the higher the recovery of the vertebral body, the greater the Cobb's angle, the lower the bone mineral density, and the more patients with scoliosis deformity and bone cement leakage are more likely to develop the adjacent vertebral fractures. |
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