| 陈国辉,郭景芳,陈焱.骨质疏松性椎体压缩骨折术后相邻椎体骨折的原因分析.骨科,2018,9(2): 102-106. |
| 骨质疏松性椎体压缩骨折术后相邻椎体骨折的原因分析 |
| Possible causes of the re-fractures of adjacent vertebral bodies after percutaneous vertebroplasty for osteoporotic vertebral compression fracture |
| 投稿时间：2017-04-04 |
| DOI：10.3969/j.issn.1674-8573.2018.02.004 |
| 中文关键词: 脊柱 椎体成形术 骨质疏松 手术后并发症 危险因素 |
| 英文关键词: Spine Vertebroplasty Osteoporosis Postoperative complications Risk factors |
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| 中文摘要: |
| 目的 探讨经皮椎体成形术（percutaneous vertebroplasty, PVP）术后相邻椎体再骨折发生的可能原因。方法 回顾性分析2014年1月至2016年3月于我科收治的经PVP治疗的骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures, OVCF）的82例病例，男27例、女55例，年龄为63~88岁，平均75岁，单椎体52例、≥2个节段30例（63个椎体）。术后平均随访12个月，根据病人是否发生相邻椎体骨折分为单椎体（52例）和多椎体（30例），记录病人的年龄、性别等11项基本信息。并应用单因素和多因素Logistic回归分析研究各因素与PVP术后发生相邻椎体骨折的关系。结果 术后18例病人发生相邻椎体骨折，单因素Logistic分析提示：与病人骨水泥渗漏至椎间盘（P=0.045）、骨密度（P=0.020）、椎体压缩比例（P=0.014）、骨水泥剂量（P=0.038）相关；与病人的年龄、性别、病程、有无外伤、手术入路、麻醉方式、有无侧凸畸形均无相关性（均P＞0.05）。多因素Logistic分析结果显示：病人术后发生相邻椎体骨折与骨水泥渗漏（P=0.029）、术前严重的椎体压缩（P=0.021）及大剂量的骨水泥注射（P=0.008）相关。结论 术前椎体压缩比例、骨水泥渗漏至椎间盘情况、骨水泥注射量与PVP术后发生相邻椎体骨折有关。 |
| 英文摘要: |
| Objective To investigate the possible causes of the re-fractures of adjacent vertebral bodies after percutaneous vertebroplasty (PVP). Methods A retrospective analysis was performed on 82 cases of osteoporotic vertebral compression factures (OVCF) undergoing PVP in out department from January 2014 to March 2016. Among them, there were 27 males and 55 females aged from 63 to 88 years, with the average of 75 years. There were 52 cases of re-fractures of single vertebra and 30 cases of re-fractures of more than 2 vertebrae (63 vertebrae). After an average follow-up of 12 months, based on whether there was adjacent vertebral fracture to the patients, two groups were set up: single vertebra re-frature (52 cases) and multi-vertebrae re-fracture (30 cases). The age, gender and other 11 items of basic information were recorded. The univariate and multivariate logistic regression analyses were performed to probe into the relationship between various factors and adjacent vertebral fractures after PVP. Results Eighteen cases had adjacent vertebral fracture. Univariate logistic analysis shows that the adjacent vertebral re-fractures were related to the leakage of bone cement to the intervertebral disc (P=0.045), bone mineral density (P=0.020), vertebral compression (P=0.014), and bone cement dosage (P=0.038), but not with age, gender, course of disease, trauma, surgical approach, anesthesia, or the presence of scoliosis (P＞0.05 for all). Multivariate logistic analysis revealed that the adjacent vertebral re-fractures were significantly related to the leakage of bone cement (P=0.029), preoperative severe vertebral compression (P=0.021), and high-dose of bone cement injection (P=0.008). Conclusion Adjacent vertebral fractures after PVP are correlated with preoperative compression of vertebral body, bone cement leakage to the disc, and bone cement injection. |
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