经皮椎体成形术后新发椎体压缩性骨折的发生率及相关危险因素分析

The incidence and risk factors of postoperative new vertebral compression fractures after percutaneous vertebroplasty

目的研究经皮椎体成形术后新发椎体压缩性骨折的发生率及相关危险因素。方法收集2007年3月～2012年3月椎体压缩性骨折急性期行择期经皮椎体成形术患者200例,新发骨折分为骨折组,未出现新发骨折患者分为对照组,进行单因素和多因素分析其相关因素。结果术后1周及随访截止日VAS评分显著低于术前(P<0.01)。新发骨折34例,发生率为17.00%,骨折组和对照组骨折程度、手术部位、骨水泥量、骨水泥渗漏例数及骨水泥渗漏部位无显著差异(P>0.05),骨折组年龄、女性比例、BMI、骨折病史率、BMD的T值、术前伤椎数、手术椎体数均显著高于对照组(P<0.05),年龄、BMD的T值、术前伤椎数、手术椎体数为经皮椎体成形术后新发椎体压缩性骨折危险因素(P<0.05)。结论经皮椎体成形术可有效缓解椎体压缩性骨折疼痛,高龄、骨质疏松、伤椎及手术椎体数多为术后新发骨折的危险因素。

Objective To investigate the incidence and risk factors of postoperative new vertebral compression fractures af- ter percutaneous vertebroplasty. Methods From March 2007 to March 2012, vertebral compression fractures acute phase of elective patients undergoing percutaneous vertebroplasty 200 cases, new fractures are divided into the fracture group, no new fractures were divided into control group, univariate and multivariate analysis, the relevant factors. Results One week after surgery and follow-up deadline for VAS scores were significantly lower than the preoperative （P 〈 0.01）. 34 cases of new fractures, the rate was 17.00%, the fracture model extent, the surgical site, the bone cement volume and the number of cases of leakage of bone cement and bone cement leakage area was no significant difference （P 〉 0.05）, the fracture group, age, female ratio, BMI, fracture history rate of BMD T-values, number of fractured vertebral body in the preoperative, oper- ative vertebral number was significantly higher （P 〈 0.05）, age, BMD T-values, number of injured vertebral preoperative surgical vertebral body for percutaneous vertebroplasty postoperative vertebral compression fracture risk factors （P 〈 0.05）. Conclusion Percutaneous vertebroplasty surgery can effectively relieve the risk factors for vertebral compression fracture pain, ohl age, osteoporosis, fractured vertebral body and surgical vertebral number for postoperative fractures.