PKP术后新发椎体骨折危险因素分析

发布时间：2018-03-07 05:36

本文选题：骨质疏松压缩骨折　切入点：经皮椎体后凸成形术　出处：《重庆医科大学学报》2017年02期 　论文类型：期刊论文

【摘要】：目的:探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松压缩骨折(osteoporosis vertebral compression fracture,OVCF)术后新发椎体骨折的危险因素。方法:回顾性分析2011年7月至2013年7月我科采用PKP治疗的86例OVCF患者,根据是否有非手术椎体新发骨折分为新发骨折组(A组)及未骨折组(B组)。采用t检验、方差分析、logistic回归分析新发椎体骨折的危险因素:年龄、性别、骨密度(bone mineral density,BMD)、骨水泥注入量、骨折椎体压缩程度、骨水泥椎间盘漏、骨折椎体数量。结果:21例患者(24.4%)新发骨折,15例发生在术后3个月内,6例发生在3个月后,16例为邻近椎体骨折,5例为非邻近椎体骨折;A组BMD(-3.43±0.42)低于B组(-2.91±0.20)(P=0.000);A组骨水泥椎间盘漏发生率大于B组(P=0.031);A组术前多椎体骨折发生率(≥2个)大于B组(P=0.000)。2组患者的年龄(P=0.453)、性别(P=0.841)、骨水泥注入量(P=0.081)、骨折椎体压缩程度无差别(P=0.717)。logistic回归分析结果:骨密度OR=36 277.255、95%CI=60.057~21 913 095.13、P=0.001,术前存在2个及2个以上椎体骨折OR=13.275、95%CI=1.746~100.938、P=0.012,术中骨水泥发生椎间盘漏OR=26.785、95%CI=1.355~529.551、P=0.031。结论:骨密度低、术前存在2个及2个以上椎体骨折、术中骨水泥发生椎间盘漏是PKP术后新发椎体骨折的危险因素。
[Abstract]:Objective: To investigate the effect of percutaneous kyphoplasty (percutaneous kyphoplasty, PKP) in treatment of osteoporotic compression fractures (osteoporosis vertebral compression fracture, OVCF) the new risk factors of vertebral fracture after operation. Methods: a retrospective analysis of 86 cases of OVCF patients from July 2011 to July 2013 in our hospital treated with PKP, according to whether there is a non surgical vertebral body new fracture divided into new fracture group (A group) and non fracture group (group B). The t test, variance analysis, logistic regression analysis on risk factors of new vertebral fractures: age, gender, bone mineral density (bone mineral, density, BMD), bone cement injection volume, the degree of vertebral compression fractures. Bone cement leakage of intervertebral disc, vertebral fracture. Results: 21 patients (24.4%) new fractures, 15 cases occurred within 3 months after operation, 6 cases occurred after 3 months, 16 cases of adjacent vertebral fractures, 5 cases of non adjacent vertebral fracture group (-3.43 + BMD; A 0 .42) lower than that of group B (-2.91 + 0.20) (P=0.000); group A bone cement intervertebral disc leakage rate is higher than that of group B (P=0.031); group A preoperative vertebral fracture incidence (more than 2) higher than that of group B (P=0.000).2 groups of patients with age (P=0.453), gender (P=0.841). The amount of bone cement injection (P=0.081), no difference in the degree of vertebral compression fractures (P=0.717).Logistic regression analysis showed that the bone density of OR=36 277.255,95%CI=60.057~21 913095.13, P=0.001, preoperative 2 and more than 2 vertebral fracture OR=13.275,95%CI=1.746~100.938, P=0.012, incidence of bone cement leakage of intervertebral disc OR=26.785,95%CI=1.355~529.551, P=0.031. conclusion: low bone density, preoperative there are 2 or more than 2 vertebral fractures, bone cement leakage occurred in the intervertebral disc surgery are risk factors of PKP postoperative new vertebral fractures.

【作者单位】：西南医科大学附属医院脊柱外科;西南医科大学图书馆;
【分类号】：R687.3;R580

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