老年椎骨压缩性骨折椎体增强术后新发骨折的因素

Factors related to new-onset fractures secondary to vertebral body augmentation for osteoporotic vertebral compression fracture in elderly

[目的]探讨胸腰椎骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture, OVCF)椎体增强术后非原伤椎新发骨折的相关因素。[方法]回顾性分析经皮椎体成形术(percutaneous vertebroplasty, PVP)及椎体后凸成形术(percutaneous balloon kyphoplasty, PKP)治疗的68例OVCF患者的临床资料,根据12个月以上随访是否出现非原伤椎新发骨折,将患者分为两组,单项因素比较两组资料。[结果] 12个月以上随访显示,32例出现非原伤椎体新发骨折,占47.06%;36例无新发骨折,占52.94%。单因素分析结果显示,两组患者在年龄、性别、身高、体重、椎体骨水泥量等方面比较差异无统计学意义(P>0.05)。与非新发骨折组相比,新发骨折组的术前ODI评分高、术前骨密度低、术前局部Cobb角度大、PVP手术比率高、单侧穿刺比率高,差异均有统计学意义(P<0.05)。[结论] PVP术式、单侧穿刺、Cobb角大是OVCF椎体增强术后非原伤椎新发骨折的危险因素。

[Objective] To explore the factors related to the new-onset fractures(NOF) of non-original-injured vertebrae secondary to vertebral body augmentation for osteoporotic vertebral compression fracture(OVCF) in the elderly. [Methods] A retrospective study was conducted on 68 patients who underwent percutaneous vertebroplasty(PVP) or percutaneous kyphoplasty(PKP) for OVCF. Based on whether or not new-onset fractures of non-original-injured vertebrae were found in follow up more than 12 months, the patients were divided into two groups. The documents were univariately compared between the two groups. [Results] As results of follow up more than 12 months, 32 patients were diagnosed of NOF, accounting for 47.06%, while 36 patients were of non-NOF, accounting for 52.94%. Regarding to univariate comparison, there were no statistically significant differences between the two groups in terms of age, gender, height, weight, and amount of vertebral bone cement injected(P>0.05). However, the NOF group had significantly higher preoperative ODI score, lower bone mineral density, greater the preoperative local Cobb angle, higher ration of PVP/PKP, and higher ratio of unilateral puncture than the nonNOF group, which all proved statistically significant(P<0.05). [Conclusion] The PVP, unilateral puncture, and large Cobb angle might be the risk factors for new-onset fracture of non-original injured vertebral secondary to vertebral body augmentation for OVCF.