PKP术后相邻椎体再骨折的相关因素分析

Associated factors of adjacent vertebral refracture after percutaneous kyphoplasty

目的探讨骨质疏松性椎体压缩骨折经皮椎体后凸成形(PKP)术后相邻椎体再骨折的相关因素。方法回顾性分析自2010-06—2015-06行PKP的单节段骨质疏松性胸腰椎压缩骨折254例,其中36例相邻椎体再骨折(骨折组),218例纳入未骨折组。采用单因素Logistic回归分析年龄、性别、骨密度、术前责任节段、责任节段终板情况、骨水泥注入方式、骨水泥注入量、骨水泥渗漏至椎间盘、术后责任椎高度恢复率、术后正规抗骨质疏松治疗与PKP术后相邻椎体再骨折的相关性。结果 254例获得平均13.4(12~18)个月随访。36例出现相邻椎体骨折,再骨折率14.2%。单因素Logistic回归分析提示,年龄、性别、术前责任节段、责任节段终板情况、骨水泥注入方式、骨水泥渗漏至椎间盘与术后相邻椎体再骨折无明显相关性(P>0.05),而骨密度、骨水泥注入量、椎体高度恢复率、术后是否正规抗骨质疏松治疗与PKP术后相邻椎体再骨折可能相关(P<0.05)。结论骨质疏松性胸腰椎压缩骨折PKP术后相邻椎体再骨折可能与患者骨质疏松严重程度、术中骨水泥注入量、术后责任椎高度恢复率以及是否正规抗骨质疏松治疗密切相关。

Objective To investigate the associated factors of adjacent vertebral refracture after percutaneous kypboplasty （PKP） in the treatment of osteoporotic vertebral compressive fractures （OVCF）. Methods A retrospective analysis was conducted on 254 patients with OVCF from June 2010 to June 2015, 36 patients with adjacent vertebral refracture（fracture group） and 218 patients without refracture. The age, gender, bone mineral density, the part of vertebral body, the end plate of vertebral body, the injection methods, the dose and the leakage of bone cement, recovery rate of vertebral body height and osteoporosis treatment after operation were recorded. Results All 254 patients were followed up for 12-18 months（average 13.4 months）. Thirty six patients had adjacent vertebral body refracture and the rate of refracture was 14.2%. According to single factor Logistic regression, the age, gender, the part of vertebral body, the end plate of vertebral body, the injection- methods and the leakage of bone cement into intervertebral disc were not the associated factors（P 〉0.05）, but the bone mineral density, recovery rate of vertebral body height, the dose of bone cement and osteoporosis treatment after operation were associated with adjacent vertebral refraeture after PKP （P 〈0.05）. Conclusion The reasons of adjacent vertebral body, refracture after PKP maybe relate to bone mineral density, recovery rate of vertebral body height, the dose of bone cement and the osteoporosis treatment after operation.