骨质疏松性胸腰段脊柱骨折PVP治疗后邻椎再发骨折情况及影响因素分析

Analysis of the Occurrence of Adjacent Vertebral Refracture and Influencing Factors after Percutaneous Vertebroplasty in Patients with Osteoporotic Fracture of Thoracolumbar Spine

目的分析骨质疏松性胸腰段脊柱骨折患者经皮椎体成形术(percutaneous vertebroplasty,PVP)后邻椎再发骨折情况及影响因素。方法选取我院2014年6月—2016年6月收治的行PVP治疗的200例骨质疏松性胸腰段脊柱骨折患者,根据术后是否出现邻椎再发骨折分为未骨折组和再骨折组。采用单因素分析和多因素logistic回归分析探讨PVP后邻椎再发骨折的影响因素。结果随访2~3年,200例术后邻椎再发骨折56例(28.00%)。年龄>60岁、椎体高度恢复程度高、Cobb角<25°、骨密度<2.5个标准差和骨水泥渗漏是骨质疏松性胸腰段脊柱骨折患者PVP后邻椎再发骨折的危险因素。结论骨质疏松性胸腰段脊柱骨折患者PVP后邻椎再发骨折率较高,术后邻椎再发骨折与患者年龄、骨密度、椎体高度恢复程度、Cobb角和骨水泥渗漏密切相关。

Objective To analyze the occurrence of refracture of adjacent vertebrae and influencing factors in patients with osteoporotic fracture of thoracolumbar spine after treatment with percutaneous vertebroplasty(PVP).Methods Two hundred patients with osteoporotic fracture of thoracolumbar spine who were treated with PVP in our hospital from June 2014 to June 2016 were selected.According to the presence of adjacent vertebral refracture after surgery,they were divided into non-fracture group and refracture group.Univariate analysis and multivariate logistic regression analysis were used to investigate the influencing factors of adjacent vertebral refracture after PVP treatment.Results During 2-3 years of follow-up,there were 56 cases(out of 200 cases,28.00%)with adjacent vertebral refracture.Age>60 years,good recovery of vertebral height,Cobb angle<25°,bone density<2.5 standard deviation and presence of bone cement leakage were risk factors for the occurrence of adjacent vertebral refracture after PVP treatment in patients with osteoporotic fracture of thoracolumbar spine.Conclusion The incidence of adjacent vertebral refracture is higher in patients with osteoporotic fracture of thoracolumbar spine after PVP treatment,and postoperative recurrence of adjacent vertebral refracture is closely related to age,bone density,recovery of vertebral height,Cobb angle and bone cement leakage.