经皮椎体成形术治疗骨质疏松性胸腰段脊柱骨折后邻近椎体再骨折的危险因素分析

Analysis of Risk Factors of Adjacent Vertebral Fracture in Patients after Percutaneous Vertebroplasty in Treatment of Osteoporotic Vertebral Compression Fracture

目的探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)术后邻近椎体再骨折的危险因素。方法选择2012年1月—2015年1月收治的OVCF患者300例为研究对象,均行PVP术治疗。根据术后是否发生再骨折分为再骨折组104例和未再骨折组196例。对两组临床资料进行单因素分析,将差异有统计学意义的变量纳入多因素Logistic回归分析,分析PVP术后邻近椎体再骨折的危险因素。结果多因素Logistic回归分析显示,年龄、椎体高度恢复、Cobb角、骨水泥渗漏为OVCF患者PVP术后邻近椎体再骨折的独立危险因素,骨密度为保护因素(P<0.05,P<0.01)。结论 OVCF患者行PVP术后发生邻近椎体再骨折与年龄、椎体高度恢复、Cobb角、骨水泥渗漏有关,临床应采取相应预防措施。

Objective To investigate risk factors of adjacent vertebral fracture in patients after percutaneous vertebroplasty(PVP)in treatment of osteoporotic vertebral compression fractures(OVCF).Methods A total of300OVCF patients admitted during January2012and January2015underwent PVP,and then the patients were divided into refracture group(n=104)and non-refracture group(n=196)according to whether having postoperative refracture or not.In two groups,clinical data was analyzed by univariate analysis,and then the statistical differences were performed multivariate Logistic regression analysis to analyze risk factors of adjacent vertebral refracture after PVP.Results Multivariate Logistic regression analysis showed that age,recovery of vertebral height,Cobb corner and leakage of bone cement were independent risk factors,while bone mineral density was protective factor of adjacent vertebral refracture after PVP(P<0.05,P<0.01).Conclusion Adjacent vertebral refracture in patients after percutaneous vertebroplasty in treatment of osteoporotic vertebral compression fractures is related to age,recovery of vertebral height,Cobb corner and leakage of bone cement.Clinicians should take corresponding measures to prevent incidence of PVP.