骨质疏松性椎体压缩骨折患者PVA术后继发邻椎骨折的多因素分析

Multivariate analysis of adjacent vertebral fractures after percutaneous vertebral augmentation in patients with osteoporotic vertebral compression fractures

目的分析骨质疏松性椎体压缩骨折(OVCF)患者经皮椎体强化术(PVA)治疗后继发邻椎骨折的危险因素,为临床预防提供理论依据。方法回顾性分析2019年5月至2020年12月在泰兴市人民医院接受手术治疗的62例OVCF患者的临床资料,根据术后是否发生邻锥骨折分为骨折组20例和非骨折组42例。制作继发邻锥骨折的危险因素调查表调查明确相关因素,并进行单因素分析和Logistic回归多因素分析。结果经单因素分析结果显示,两组患者的年龄、伤椎数、骨水泥是否渗漏、骨密度以及骨折程度是OVCF患者PVA术后邻椎骨折的相关因素(P<0.05);Logistic回归多因素分析结果显示,年龄大、伤椎数>2个、骨水泥渗漏、骨折程度严重以及骨密度低是PVA术后邻椎骨折的危险因素(P<0.05)。结论年龄大、伤椎数多、骨水泥发生渗漏、骨折程度严重以及骨密度低是OVCF患者PVA术后继发邻椎骨折的危险因素,临床上应重视这些危险因素,防止术后邻椎骨折。

Objective To analyze the risk factors of adjacent vertebral fractures after percutaneous vertebral augmentation(PVA) in patients with osteoporotic vertebral compression fractures(OVCF),and provide a theoretical basis for clinical prevention.Methods The diagnosis and treatment of 62 patients with OVCF who were treated in Taixing People’s Hospital from May 2019 to December 2020 were retrospectively analyzed.According to whether or not adjacent cone fractures occurred after surgery,they were divided into a fracture group(n=20) and a non-fracture group(n=42).Questionnaire on the risk factors of secondary adjacent cone fractures was made,and the relevant factors were investigated to clarify the relevant factors.Univariate analysis and logistic regression multivariate analysis were performed.Results Univariate analysis showed that age,the number of injured vertebrae,whether the bone cement leaked,bone density,and the degree of fracture were related to the adjacent vertebral fracture after PVA operation in OVCF patients(P<0.05).Logistic results showed that older age,number of injured vertebrae>2,bone cement leakage,severe fracture degree,and low bone density were risk factors for adjacent vertebral fractures after PVA(P<0.05).Conclusion Older age,large number of injured vertebrae,bone cement leakage,severe fracture degree,and low bone density are the risk factors for adjacent vertebral fractures after PVA in OVCF patients,and these factors should be paid attention to in clinical practice to achieve effective prevention and prevent postoperative fracture of adjacent vertebrae.