骨质疏松患者胸腰椎压缩性骨折PKP术后再发骨折的风险因素分析

The risk factors analysis of postoperative fracture for osteoporosis patients with thoracolumbar compression fractures underwent PKP

目的探讨骨质疏松患者胸腰椎压缩性骨折PKP术后再发骨折的风险因素。方法回顾性分析2011年3月~2016年1月于我院因骨质疏松胸腰椎压缩性骨折行PKP术治疗的患者共214例,根据术后随访结果是否发生椎体骨折,分为骨折组和正常组,根据两组患者的一般资料和相关检查结果分析其相关的风险因素。结果共有31例发生椎体骨折,再发骨折的概率为14.5%,年龄(OR:3.512,95%CI:1.452-4.243)、骨密度(OR:4.952,95%CI:1.832-7.523)、手术椎体数(OR:5.642,95%CI:1.677-6.672)、单节骨水泥量(OR:4.576,95%CI:1.434-5.185)、手术前后的高度变化(OR:2.752,95%CI:0.742-3.532)、后凸角变化(OR:3.421,95%CI:0.876-3.014)和骨水泥渗漏(OR:6.562,95%CI:1.522-7.524)均为PKP术后再发骨折的独立风险因素。结论年龄、骨密度、手术椎体数、单节骨水泥量、骨水泥渗漏、手术前后的高度和后凸角变化是PKP术后再发骨折的风险因素。

Objective To study the risk factors of postoperative fracture for osteoporosis patients with thoracolumbar compression fractures underwent PKP. Methods A retrospective analysis from Mar 2011 to Jan 2016 in our hospital for thoracolumbar compression fractures of osteoporosis patients, which underwent the treatment of PKP. A total of 214 cases were included in this study, according to the results that whether vertebral fracture of follow-up, the paitents were divided into the fracture group and the normal group, to analysis the risk factors of two groups of patients with general information and relevant test. Results A total of 31 vertebral fracture in the fracture group, PKP the recurrence rate was 14.5%, the age（OR ： 3.512, 95% CI ： 1.452-4.243）, the bone mineral density（OR ： 4.952, 95% CI ： 1.832-7.523）, the number of surgical vertebral body（OR ： 5.642, 95% CI ： 1.677-6.672）, the single section of bone cement volume（OR ： 4.576, 95% CI ： 1.434-5.185）, the height and the convex Angle of the change before and after surgery（OR ： 2.752, 95% CI ： 0.742 3.532）, （OR ： 3.421, 95% CI ： 0.876 3.014）, the leakage of bone cement（OR ： 6.562, 95% CI ： 1.522 7.524）were independent risk factors for postoperative fractures of PKP. Conclusion The age, the bone mineral density, the surgical vertebral body number, the single section of bone cement volume, the height and the convex Angle of the change before and after surgery and the leakage of bone cement of PKP paitients are the risk factors for postoperative of fracture.