摘要
目的:探讨骨质疏松椎体压缩性骨折(OVCFs)经皮椎体成形术(PVP)后非手术椎体骨折的相关危险因素。方法:对2010年3月。2013年3月收治的76例因OVCFs行PVP患者的临床资料进行回顾性分析,包括患者的一般情况、个人史及既往病史、腰椎骨密度、术中骨水泥注入量、病椎压缩程度、骨折椎体个数及节段、骨水泥椎间盘渗漏情况、术后抗骨质疏松治疗情况;收集患者术后第1、3、6、12、18个月来院复诊时测定的骨代谢相关生化指标数据,包括:血钙、磷、降钙素、I型胶原氨基端前肽、甲状旁腺激素、25-羟维生素D[25-(OH)D]。将上述指标作为可能相关因素纳入单因素研究,并通过多因素Logistic回归分析得出术后非手术椎体骨折的相关危险因素。结果:76例原发性OVCFs患者共89节椎体骨折,术后共17例患者19个椎体出现压缩性骨折,单因素分析显示术中骨水泥注入量、骨水泥椎间盘渗漏、术后有无抗骨质疏松治疗、血25-(OH)D水平与术后非手术椎体骨折存在显著相关性(P〈0.05).而与患者性别、年龄、体重指数、骨密度值、病椎压缩程度、手术入路等无显著相关性(P〉0.05)。多因素分析结果显示骨水泥椎间盘渗漏、术后未进行抗骨质疏松治疗、25-(OH)D水平较低是PVP术后非手术椎体骨折的危险因素(P〈O.05)。结论:OCVFs患者PVP术后发生非手术椎体骨折与骨水泥渗漏至椎间盘、术后未抗骨质疏松治疗及低25-(0H)D水平有关。
Objectives: To explore the risk factors associated with the onset of vertebral compression frac- tures after percutaneous vertebroplasty(PVP). Methods: A total of 76 patients undergoing PVP due to osteo- porotic vertebral compression fractures(OVCFs) from March 2010 to March 2013 was retrospectively analyzed, the data included age, body mass index, bone mineral density, number of initial vertebral fractures, bone ce- ment leakage into discs, use of antiosteoporotic medications. And the data of their bone metabolistie markers and 25-(OH)D levels of different periods after PVP were also assessed. Results: 17 patients experienced 19 subsequent fractures. Univariate analysis showed that bone cement injection volume, bone cement leakage into discs, use of antiosteoporotic medications and levels of 25-(OH)D were the variables associated with the onset of vertebral fractures(P〈0.05). In contrast, age, sex, operation approach, body mass index and bone mineral density showed no significant differences. Muhiple-factors logistic regression analysis showed that bone cement leakage into discs, lower level of 25-(OH)D and absence of antiosteoporotie medication were the predominant correlative factors associated with the onset of vertebral fracture. Conclusions: The most important risk factors associated with onset of OVCFs are absence of antiosteoporotie medication and bone cement leakage into discs and low serum 25-(OH)D level.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
北大核心
2014年第1期63-67,共5页
Chinese Journal of Spine and Spinal Cord