腰椎骨折患者经皮椎体成形术后再骨折的相关因素分析

Related factors of refracture after percutaneous vertebroplasty in patients with fracture of lumbar vertebrae

目的观察腰椎骨折患者经皮椎体成形术(PVP)后再骨折发生情况,并探讨其相关影响因素。方法抽取2018年1月至2020年1月于河南大学附属南阳南石医院接受PVP术治疗的122例腰椎骨折患者,设计基线资料统计表并详细记录患者的基线资料,记录患者术后1年再骨折发生情况,纳入全部可能因素,经单因素及多因素分析找出腰椎骨折患者行PVP术后发生再骨折的影响因素。结果122例腰椎骨折患者行PVP术后1年发生再骨折23例,再骨折发生率为18.85%。单因素及多元Logistic回归分析结果显示,骨水泥椎间隙渗漏、骨水泥注入量高、骨密度T值低、椎体前缘高度恢复率高、椎体内裂隙样变是腰椎骨折患者PVP术后再骨折发生的影响因素(OR>1,P<0.05)。结论腰椎骨折患者行PVP后有较高的再骨折发生风险,与骨水泥椎间隙渗漏、骨水泥注入量多、骨密度T值低、椎体前缘高度恢复率高、椎体内裂隙样变有关,临床应据此采取相关措施,预防再骨折的发生。

Objective To observe the incidence of refracture after percutaneous vertebroplasty(PVP)in patients with fracture of lumbar vertebrae,and to investigate its related influencing factors.Methods A total of 122 patients with fracture of lumbar vertebrae who received PVP for treatment in Nanyang Nanshi Hospital Affiliated to Henan University from January 2018 to January 2020 were selected.The baseline data table was designed,and the baseline data of patients were recorded in detail.The occurrence of refracture 1 year after operation was recorded.All possible factors of refracture were included,and the influencing factors of refracture after PVP were analyzed by univariate and multivariate analysis.Results Among 122 patients with fracture of lumbar vertebrae after 1 year of PVP,there were 23 cases of refracture,and the incidence of refracture was 18.85%.The results of single factor and multivariate Logistic regression analysis showed that bone cement leakage in intervertebral space,high amount of bone cement injection,low T value of bone mineral density,high recovery rate of anterior vertebral height,and intravertebral fissure-like change were the influencing factors of refracture after PVP(OR>1,P<0.05).Conclusions Patients with fracture of lumbar vertebrae have a high risk of refracture after PVP,which is related to the leakage of bone cement,high amount of bone cement injection,low T value of bone mineral density,high recovery rate of anterior vertebral height,and intravertebral fissure-like change.Therefore,relevant measures need to be taken to prevent the occurrence of refracture.