骨质疏松患者PVP/PKP术后新发椎体压缩性骨折相关危险因素

Risk factor of developing new verterbral compression fracture after percutaneous vertebroplasty or kyphoplasty in osteoporotic patients

[目的]探讨骨质疏松性椎体压缩性骨折PVP或PKP治疗术后新发椎体压缩性骨折的发生概率与相关危险因素。[方法]回顾分析PVP和PKP治疗的骨质疏松性椎体压缩性骨折患者362例。将患者年龄、性别、身体质量指数、骨密度、椎体骨折部位、治疗方式、骨水泥注入量、骨水泥椎体内分布类型、骨折椎体前后缘高度比、骨水泥漏等纳入新发椎体骨折的危险因素,进行新发椎体骨折组与对照组之间的比较和多因素Logistic回归分析。[结果]共有30例患者出现了新的椎体骨折,占总人数的8.28%。其中26例为邻近椎体骨折,占新发椎体骨折总人数的86.67%。术后出现新发椎体骨折的平均天数为600 d。新发椎体骨折组与对照组间比较患者年龄、治疗方式、骨密度和骨水泥漏比例两组间差异有统计学意义(P<0.05)。患者年龄大、骨密度低和骨水泥漏是影响邻近椎体再骨折发生最确定的因素。[结论]患者年龄、骨质疏松和骨水泥漏是影响椎体成形术后新发椎体骨折最重要的危险因素。

[ Objective ] To investigate the incidence and the risk factor of new vertebral compression fractures （NVCFs） af- ter treatment with percutaneous vertebrnplasty （PVP） and percntaneous kyphoplasty （PKP） for osteoporotic vertebral compres- sion fractures（OVCFs）. [ Method] The authors retrospectively analyzed the occurrence of NVCFs in 362 patients treated with PVP or PKP for osteoporotic VCFs. Several possible risk factors, such as age, gender, body mass index, bone mineral density （ BMD）, location of treated vertebra, treatment modality, amount of bone cement injected, pattern of cement distribution in verte- bral, anterior- posterior ratio of the fractured vertebra, and cement leakage were chosen to assess. Logistic regression analysis was used to performed muhivariable analysis. [ Result] Thirty patients （8.28% of total patients） suffered NVCFs. Twenty-six （86.67%） of the 30 patients had an NVCFs on the adjacent vertebral. NVCF with a median time to new fractures was of 600 days after the operation. Significant differences （P 〈 0.05 ） were found between the NVCFs and control groups in regard to age, treatment modality, BMD, and the proportion of bone cement leakage. Greater age, low BMD and bone cement leakage were considered to be most important risk factors causing adjacent NVCFs. [ Conclusion] The patients＇age, osteoporosis and bone cement leakage are the most important risk factors affecting NVCFs.