骨质疏松椎体压缩性骨折经皮椎体成形术后Cobb角继发增大的危险因素分析

Risk factors of secondary kyphotic angle increment after veterbroplasty for osteoporotic vertebral body compression fractures

目的分析经皮椎体骨水泥成形术后继发椎体高度丢失的危险因素。方法2005年2月至2006年5月应用骨水泥成形术对32例骨质疏松性椎体压缩骨折患者45椎进行治疗。记录手术时间、骨水泥注射量、骨密度值、术前术后及末次随访的VAS疼痛评分、伤椎前中后缘高度、后凸Cobb角;以末次随访和术后早期的后凸Cobb角差值作为后凸角继发增大值;做相关及回归分析。结果术后后凸角、骨密度值及术后椎体中线高度与术后后凸Cobb角继发增大存在相关。结论骨质疏松程度重、骨水泥成形术后椎体中线高度恢复欠佳及后凸Cobb角过大是后期后凸Cobb角继发增大的危险因素。

Objective To study the risk factors of secondary kyphotic angle increment after bone cement vertebroplasty for osteoporotic vertebral compression fractures. Methods From October 2005 to May 2006, 32 （45 vertebrae） bone cement vertebroplasty procedures were performed. The operation time, injected cement volume, bone mineral density, visual analog scale （VAS） pain score, vertebral height, and kyphotic angle were recorded. The secondary increment of the kyphotic angle was calculated, and correlation analysis and linear regression analysis were performed. Results The bone mineral density, the postoperative kyphotic angle and the vertebral midline height were significantly correlated to the secondary increment of the kyphotic angle. Conclusion Large postoperative kyphotic angle, poor postoperative recovery of the vertebral midline height, and low bone mineral density are all risk factors of secondary increment of the kyphotic angle.