胸腰椎骨折复位术后椎体“空壳现象”的相关因素分析

发布时间：2018-07-10 03:58

本文选题：胸腰椎骨折 + 空壳现象　；参考：《中国脊柱脊髓杂志》2017年03期

【摘要】：目的 :探讨胸腰椎骨折复位术后椎体"空壳现象"的相关因素。方法 :对2013年1月~2015年12月我科行后路椎弓根钉棒系统复位内固定术治疗的116例胸腰椎单节段骨折患者进行回顾性分析。分别记录患者的年龄、性别、病程、术前椎体压缩程度、术前矢状面Cobb角、骨折类型、骨密度、伤椎置钉、骨折撑开复位情况、椎体复位程度、螺钉位置等相关因素,观察患者术后椎体"空壳现象"的发生情况,应用单因素和多因素Logistic回归分析研究各因素与椎体"空壳现象"发生的相互关系。结果:116例患者中有72例患者术后发生椎体"空壳现象",发生率为62.1%。单因素分析结果显示患者骨折撑开复位情况、椎体复位程度、术前椎体压缩程度及骨密度与术后椎体"空壳现象"的发生有明显的相关性(P0.05),而患者的年龄、性别、病程、骨折类型、术前矢状面Cobb角、伤椎置钉情况、螺钉位置与术后椎体"空壳现象"的发生无相关性(P0.05)。多因素分析结果显示患者术前椎体压缩程度及骨密度是影响术后椎体"空壳现象"发生的独立危险因素。结论:胸腰椎骨折复位术后出现椎体"空壳现象"受多种因素影响,其中椎体压缩程度和骨密度可能是造成上述问题的主要原因。
[Abstract]:Objective: to investigate the factors related to the phenomenon of hollow shell of vertebral body after reduction of thoracolumbar fractures. Methods: 116 patients with single segment thoracolumbar fractures treated by posterior pedicle screw and rod system from January 2013 to December 2015 were retrospectively analyzed. Age, sex, course of disease, degree of vertebral compression, preoperative sagittal Cobb angle, type of fracture, bone mineral density, traumatic screw insertion, open reduction of fracture, degree of reduction of vertebral body, screw position, and so on were recorded respectively. The occurrence of "empty shell phenomenon" in vertebral body after operation was observed, and the relationship between each factor and the occurrence of "empty shell phenomenon" of vertebral body was studied by univariate and multivariate logistic regression analysis. Results among 116 cases, 72 cases had "empty shell" of vertebral body after operation, the incidence rate was 62.1%. The results of univariate analysis showed that there was a significant correlation between the open reduction of fracture, the degree of reduction of vertebral body, the degree of compression of vertebral body before operation and the occurrence of "empty shell phenomenon" of vertebral body after operation (P0.05), and the age, sex, course of disease of the patient, and the degree of reduction of vertebral body. The type of fracture, preoperative Cobb angle of sagittal plane, screw placement and screw position had no correlation with the occurrence of "empty shell phenomenon" after operation (P0.05). The results of multivariate analysis showed that the degree of vertebral compression and bone mineral density were independent risk factors for the occurrence of "empty shell phenomenon" after operation. Conclusion: after reduction of thoracolumbar fracture, the phenomenon of "empty shell" of vertebral body is affected by many factors, among which the degree of vertebral compression and bone mineral density may be the main causes of the above problems.
【作者单位】：四川省自贡市第四人民医院骨一科;
【基金】：四川省卫生和计划生育委员会项目(编号:16PJ596) 自贡市科技局项目(编号:2016SF04)
【分类号】：R687.3

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