椎体后凸成形术后椎体再骨折相关因素分析研究

Correlative factor analysis on recurrent vertebral fractures after percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture

背景:椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折取得了令人鼓舞的临床效果,但是术后椎体发生再骨折时有报道,越来越引起临床医生的重视。目的:探讨PKP治疗骨质疏松性椎体压缩骨折术后出现椎体再骨折的相关危险因素。方法:回顾性分析209例因骨质疏松性椎体压缩骨折而接受PKP手术治疗患者的相关临床资料,其中男43例,女166例,年龄51～88岁,平均73.0岁。所有患者术后随访时间均为1年以上,根据术后是否出现椎体再骨折分为再骨折组(42例)和对照组(167例),比较两组患者的相关临床资料,分析椎体再骨折的可能危险因素。结果:两组患者在年龄、性别、身高、体重、平均单椎体骨水泥注入量、术后椎体高度压缩率等方面无统计学差异(P>0.05),但是两组患者的骨水泥椎间盘渗漏率和术前骨密度存在统计学差异(P<0.05)。结论:骨水泥椎间盘渗漏和骨质疏松严重程度可能是骨质疏松性椎体压缩骨折PKP术后椎体再骨折的危险因素。

Background： Osteoporotic vertebral compression fractures （OVCFs） are being increasingly treated with minimally invasive bone augmentation techniques such as percutaneous kyphoplasty （PKP）. PKP is reported to be an effective means of pain relief. However, there may be an increased risk of developing subsequent vertebral compression fractures after the procedure. Objective： To explore the risk factors of new vertebral fractures after PKP in the treatment of OVCFs. Methods： The clinical data of 209 patients with OVCFs who underwent PKP were analyzed retrospectively There were 43 males and 166 females with an average age of 73.0 years. All patients were followed-up for above 12 months. New vertebral fractures occurred in 42 patients （new fracture group）. The remaining 167 cases had no new vertebral fractures （control group）. Results： There was no significant difference in age, gender, body weight, body height, amount of injected bone cement per vertebra and postoperative vertebral compression rate between the two groups （P〉0.05）. But there was significant difference in the rate of cement intradiscal leakage and preoperative bone mineral density （P〈 0.05）. Conclusions： Intraoperative cement intradiscal leakage and preoperative bone mineral density may be correlated with recurrent new vertebral fractures after PKP in the treatment of OVCFs.