骨质疏松性椎体骨折经皮椎体成形术后邻近椎体骨折的风险因素分析

Risk factors of adjacent vertebrae refracture after percutaneous vertebroplasty in osteoporotic fracture

目的:探讨影响经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折(OVCF)后邻近椎体骨折的危险因素,并为临床提供指导。方法:采用回顾性分析PVP治疗单个OVCF并符合本研究纳入标准的168例患者,分为术后再骨折组与术后保持良好组,随访至少2年的时间,分析再骨折与邻椎风险因素[年龄、性别、胸腰椎骨折节段、体质量指数(BMI)、骨密度T值、骨折类型、注入的骨水泥量、骨水泥分布样式、术前骨折严重程度、术后复位角(Cobb角)]的关系,并进一步建立再塌陷的危险评分。结果:41例(24.4%)邻椎再骨折患者的BMI、骨密度T值、骨水泥注入量、骨水泥的分布样式以及术后Cobb角与邻椎再骨折的发生显著相关。结论:根据BMI、骨密度T值、骨水泥注入量、骨水泥的分布样式以及术后Cobb角的矫正等建立的危险因素评分,可有效预测PVP术后邻椎体骨折的风险。

Objective: To investigate the risk factors of adjacent osteoporotic vertebral compression fracture( OVCF) in the treatment of OVCF,and to provide guidance for clinical practice. Methods: A retrospective analysis of percutaneous vertebroplasty( PVP) in the treatment of single OVCF and 168 patients who met the inclusion criteria of this study was followed up for at least 2 years to analyze the risk factors of adjacent vertebrae( age,gender,BMI,bone mineral density T value,fracture type,injected). The amount of bone cement,the distribution pattern of bone cement,the severity of preoperative fracture,the relationship of postoperative Cobb angle,and further establish the risk score of re-collapse. Results: This study found 41 patients( 24. 4%) with adjacent vertebrae fractures,BMI,bone mineral density T value,bone cement injection volume,bone cement distribution pattern and postoperative Cobb angle correction were significantly correlated with the occurrence of adjacent vertebrae refracture. Conclusion: According to BMI,bone mineral density T value,bone cement injection volume,the risk factor scores established by the distribution pattern of cement and the correction of postoperative Cobb angle can effectively predict the adjacent fractures after PVP.