骨水泥分布指数对椎体成形术后症状性邻近节段骨折的影响

发布时间：2018-03-02 06:16

本文关键词： 骨质疏松压缩骨折椎体成形术脊柱骨折　出处：《南方医科大学学报》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨骨水泥分布的评价方式及其对椎体成形术后邻椎骨折的影响。方法回顾分析2011年4月~2014年4月在我院诊断为骨质疏松压缩骨折并接受椎体成形手术的患者(54~91岁)143例,术后随访1年。134例完成随访,其中18例发生邻近节段骨折,为再骨折组,116例未发生邻近节段骨折,为对照组。所有患者术后均复查X线,将骨水泥按照形态和位置分为5种类型。根据术中注射骨水泥的量和椎体体积计算骨水泥的量体指数。分析两组患者的年龄、性别、骨密度、骨水泥量、骨水泥分布指数、量体指数、骨水泥渗漏等的差异。选择有差异的变量纳入Logistic回归进行多因素分析。结果再骨折组的骨密度显著低于对照组(P0.05),骨水泥渗漏的发生率显著高于对照组(P0.05)。两组患者骨水泥分布指数有统计学差异(P0.05)。但是,两组患者性别、年龄、骨水泥量及量体指数均无显著性差异(P0.05)。Logistic回归分析表明,低骨密度、骨水泥渗漏和骨水泥的不同分布类型显著影响邻椎骨折的发生率。结论骨水泥分布指数低、骨水泥渗漏及低骨密度可能是椎体成形术后邻椎再骨折的危险因素。
[Abstract]:Objective to evaluate the distribution of bone cement and its effect on vertebral fracture after vertebroplasty. Methods from April 2011 to April 2014, 143 cases of osteoporotic compression fracture diagnosed as osteoporotic compression fracture and underwent vertebroplasty in our hospital were analyzed retrospectively. One year after operation, 134 cases were followed-up. Among them, 18 cases had adjacent segment fracture, 116 cases had no adjacent segment fracture in refracture group. Bone cement was divided into five types according to its shape and position. The body mass index of bone cement was calculated according to the amount of bone cement injected during the operation and the volume of vertebral body. The age, sex, bone mineral density, bone cement volume, bone cement distribution index of the two groups were analyzed. Body index, The differences of bone cement leakage were analyzed by Logistic regression. Results the BMD in the refracture group was significantly lower than that in the control group (P 0.05), and the incidence of bone cement leakage was significantly higher than that in the control group (P 0.05). The distribution index of bone cement was significantly different from that of P0.05. however, There was no significant difference in sex, age, bone cement content and body mass index between the two groups. Logistic regression analysis showed that the bone mineral density was low. Conclusion the low distribution index of bone cement and low bone mineral density may be the risk factors of adjacent vertebral refracture after vertebroplasty.
【作者单位】：江门市中心医院脊柱外科;
【基金】：广东省医学科研基金(201611365148576)
【分类号】：R687.3

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