影响经皮椎体后凸成形术矫正骨折椎体后凸畸形的多元线性回归分析

Multiple linear regression analysis on the influencing factors in percutaneous kyphoplasty in the treatment of fractured vertebral kyphosis

目的:利用多元线性回归分析影响经皮椎体后凸成形术(PKP)矫正骨质疏松椎体压缩性骨折(OVCF)后凸畸形程度的相关因素。方法:选择发生单个椎体OVCF并于我院行PKP治疗的116例患者作为研究对象。术前记录视觉模拟评分(VAS)、骨折椎体前缘高度(Ha)、中间高度(Hm)及椎体后凸角。术后24h及随访6个月复查VAS评分,椎体Ha、Hm及后凸角。对△VAS和△后凸角进行相关性分析以探讨与其相关的因素,利用多元线性回归探讨△VAS和△后凸角的影响因素。结果:患者椎体Ha、Hm在术前、术后和随访中逐渐上升(椎体Ha分别为63.90%±11.82%、76.88%±11.86%、76.38%±11.82%;椎体Hm分别为67.34%±12.51%、81.26%±12.52%、80.72%±12.46%),椎体后凸角、VAS逐渐下降(后凸角分别为17.84°±7.85°、12.39°±6.58°、12.41°±6.57°;VAS分别为8.27±1.44、4.45±1.91、3.26±2.21),差异均具有统计学意义(P值均<0.05)。多元线性回归分析结果显示,骨折严重程度、骨水泥渗漏、术前VAS评分与△VAS存在线性关系,其拟合方程为△VAS=4.124-0.554×骨折严重程度-1.359×骨水泥渗漏+0.319×术前VAS评分(R2=0.399)。骨密度、术前后凸角与△后凸角存在线性关系,其拟合方程为△后凸角=6.236+1.375×骨密度+0.199×术前后凸角(R2=0.795)。结论:多元线性回归分析结果提示OVCF后凸畸形的矫正程度主要与骨密度有关,其拟合方程可以较准确地预测后凸畸形的矫正程度。

Objective:The purpose of this study was to analyze the factors affecting the percutaneous kyphoplasty(PKP)in the treatment of kyphotic angle caused by osteoporotic vertebral compression fracture(OVCF)by using multiple linear regression analysis.Methods:A total of 116 patients with single vertebral OVCF treated by PKP in our hospital were recruited.The visual analogue score(VAS),anterior vertebral height(Ha),middle vertebral height(Hm),and kyphotic angle were recorded before surgery.The VAS,Ha,Hm and kyphotic angle were reviewed 24 hours after surgery and at6 months follow-up.Correlation analyses were performed onΔVAS and △kyphotic angle to explore the related factors.Multivariate linear regressions were used to explore the influencing factors ofΔVAS and△ kyphotic angle.Results:The Ha and Hm gradually increased(Ha:63.90%±11.82%,76.88%±11.86%,76.38% ±11.82%;Hm:67.34% ±12.51%,81.26% ±12.52%,80.72% ±12.46%)and the kyphotic angle and VAS gradually decreased(kyphotic angle:17.84°±7.85°,12.39°±6.58°,12.41°±6.57°;VAS:8.27±1.44,4.45±1.91,3.26±2.21)before and after the surgery,and also during follow-ups,with significant differences(All P<0.05).Multiple linear regression showed that there was a linear relationship between fracture severity,bone cement leakage,preoperative VAS score and△VAS.The fitting equation was:△VAS=4.124-0.554* Fracture severity-1.359* Bone cement leakage+0.319* Preoperative VAS score(R2=0.399).There was a linear correlation between bone density,preoperative kyphotic angle and△ kyphotic angle.The fitting equation was:△ kyphotic angle=6.236+1.375* bone density+0.199* preoperative kyphotic angle(R2=0.795).Conclusion:Multiple linear regression analysis suggests that the reduction degree of OVCF kyphosis is mainly related to bone density,and the fitting equation can accurately predict the reduction degree of kyphosis.