退变性脊柱侧凸患者发生骨质疏松性椎体压缩骨折的危险因素分析

Analysis of risk factors of osteoporotic vertebral compression fractures in patients with degenerative scoliosis

目的探讨退变性脊柱侧凸(degenerative scoliosis,DS)患者发生骨质疏松性椎体压缩骨折(osteoporotic vertebral compressive fracture,OVCF)的危险因素。方法回顾性分析自2011-03-2015-08收治的130例DS患者,依据发生OVCF与否,分为骨折组(37例)与非骨折组(93例),统计两组患者的相关指标数据,包括年龄、性别、吸烟史、酗酒史、体重指数(BMI)、骨密度值、外伤史,腰椎前凸角、侧凸角、VAS评分、形成骨桥与否等,进行单因素与多因素回归分析。结果单因素分析发现,年龄、外伤史、VAS评分、骨密度、形成骨桥等几项指标,在有骨折组与无骨折组之间的差异有显著性(P<0.05),提示上述指标与DS患者发生OVCF有关。多因素Logistic回归分析提示,骨质疏松(β=1.829,S.E=0.498,P=0.035)、形成骨桥(β=1.986,S.E=0.502,P=0.023)、外伤史(β=3.472,S.E=0.613,P=0.012),均是DS患者发生OVCF的独立危险因素。结论 DS合并OVCF患者的疼痛程度较高、年龄偏大;外伤史、骨桥形成、骨质疏松这三项均是影响患者发生OVCF的独立危险因素。

Objective To investigate the risk factors of degenerative scoliosis （DS） in patients with osteoporotic vertebral compression fractures （OVCF）, to provide reference for clinical prevention and control measures. Methods A retrospective analysis of 130 DS patients from March 2011 to August 2015 was conducted, according to OVCF or not, the patients were divided into fracture group （37 cases） and non-fracture group（93 cases）. The age, gender, smoking history, drinking history, body mass index（BMI）, bone mineral density, history of trauma, lumbar lordosis, scoliosis angle, VAS score, the formation of bone bridge or not, were analyzed in the two groups by single factor and muhi-factor regression analysis. Results Univariate analysis showed that age, history of trauma, VAS score, bone density, the formation of several indicators of bone bridge, had significant differences between the two groups（P〈0.05 ）, suggested that the occurrence of OVCF was related to the above indicators in patients with DS. Multivariate Logistic regression analysis showed that osteoporosis （P=1.829, S.E=0.498, P= 0.035 ）, the formation of bone bridge（P=1.986, S.E=0.502,P=0.023）, history of trauma（P=3.472, S.E= 0.613, P=.012）, were all independent risk factors in patients with DS OVCF. Conclusion DS patients with OVCF pain degree higher, older, had a history of trauma and bone bridge formation,osteoporosis, these are the independent risk factors of OVCF patients, the existence of the above- mentioned factors of patients, should strengthen the attention and intervention.