骨质疏松性骨折术后再发骨折的危险因素分析

Analysis of Risk Factors for Recurrent Fracture of PKP or PVP after Osteoporotic Fracture

目的:探讨骨质疏松性椎体骨折术后〔包括经皮椎体后凸成形术(PKP)及经皮椎体成形术(PVP)〕,椎体发生再发骨折的临床特点及危险因素。方法:回顾性分析2010年1月至2015年7月于濮阳市油田总医院因椎体压缩骨折行PKP或PVP的患者148例,其中再发骨折30例,未再发骨折118例,男37例,女111例。患者随访(34.86±7.18)个月。记录患者性别、是否再次骨折,体质量指数(BMI)、视觉模拟评分法(VAS)评分、Oswestry功能障碍指数问卷(ODI)、Barthel计分,并行统计学检验。结果:BMI> 24 kg·m^-2对老年骨质疏松性骨折PKP或PVP术后再发骨折有明显相关性,BMI> 24 kg·m^-2的患者较BMI <24 kg·m^-2的患者人群发生再发骨折几率大;ODI值越高患者人群中发生再发骨折的几率越大;术后VAS评分高的患者人群中发生再发骨折的几率越大。患者术后身体功能障碍对社会的依赖性的大小对老年骨质疏松性骨折PKP或PVP术后再发骨折没有明显影响。结论:BMI> 24 kg·m^-2、ODI评分高、术后VAS评分高是老年骨质疏松性骨折PKP或PVP术后再发骨折的危险因素;术后身体功能障碍对社会的依赖性的大小与老年骨质疏松性骨折PKP或PVP术后再发骨折无明显相关性。

Objective To investigate the osteoporotic vertebral fracture after operation of percutaneous kyphoplasty(PKP) and percutaneous vertebroplasty, clinical characteristics and risk factors for fracture of vertebrae. Methods A retrospective analysis of 148 patients with PKP or PVP due to vertebral compression fractures in Fuyang City Oilfield General Hospital from January2010 to July 2015, including 30 recurrent fractures, 118 recurrent fractures, and 37 males. 111 females. Patients were followed up(34.86 ± 7.18) months. Patient gender, re-fracture, body mass index(BMI), visual analog scale(VAS) score, Oswestry dysfunction index questionnaire(ODI), Barthel score, and parallel statistical test were recorded. Results The BMI, mean age, ODI score,and VAS scores of the two groups were statistically significant(P < 0.05). There was no significant difference in Barthel score(P > 0.05). Conclusion BMI > 24 kg · m^-2 was associated with PKP or PVP recurrence fractures in elderly osteoporotic fractures.Patients with BMI > 24 kg · m^-2 were more likely to have a BMI < 24 kg · m^-2 The incidence of recurrent fractures is large;The higher the ODI value, the greater the incidence of recurrent fractures in the patient population;the greater the incidence of recurrent fractures in patients with a high postoperative pain score. The social dependence of postoperative physical dysfunction in patients had no significant effect on the recurrent fracture of PKP or PVP in elderly patients with osteoporotic fracture.