胸腰椎压缩性骨折术后再发骨折的相关影响因素分析

Analysis of related influencing factors of recurrent fracture after thoracolumbar compression fractures

目的探讨胸腰椎压缩性骨折术后再发骨折的相关影响因素。方法回顾性分析2017年7月至2019年7月本院收治的62例胸腰椎压缩性骨折行经皮椎体成形术(PVP)患者作为研究对象,根据患者术后是否再发骨折分为研究组(再发骨折,n=11)和对照组(未再发骨折,n=51),收集两组患者临床资料,单因素及多因素Logistic回归分析患者再发骨折的危险因素。结果两组年龄、骨密度、损伤椎体数量、骨水泥渗漏、单节骨水泥用量、手术前后椎体高度差、后凸角变化比较差异有统计学意义(P<0.05);两组性别、体重指数、手术方式、手术部位比较差异无统计学意义。多因素Logistic回归分析结果显示,年龄、骨密度、损伤椎体数量、骨水泥渗漏、单节骨水泥用量、手术前后椎体高度差、后凸角变化均为胸腰椎压缩性骨折患者术后再发骨折的危险因素(P<0.05)。结论胸腰椎压缩性骨折术后再发骨折危险因素较多,应积极应对风险因素,加强防控措施,以降低再发骨折的风险。

Objective To investigate the related influencing factors of recurrent fracture after thoracolumbar fracture surgery.Methods 62 patients with thoracolumbar compression fractures who underwent percutaneous vertebroplasty(PVP)in our hospital from July 2017 to July 2019 were retrospectively analyzed,they were divided into study group(recurrent fractures,n=11)and control group(non-recurrent fractures,n=51)according to whether the patients had recurrent fractures after surgery.Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of recurrent fracture.Results There were significant differences in the age,bone mineral density,number of injured vertebrae,bone cement leakage,dosage of bone cement per section,the vertebral height difference before and after operation and kyphosis angle between the two groups(P<0.05).There was no significant difference in the gender,body mass index,surgical method and surgical site between the two groups.The results of multivariate Logistic regression analysis showed that the age,bone mineral density,number of injured vertebrae,bone cement leakage,dosage of bone cement per section,vertebral height difference before and after operation and kyphosis angle were all risk factors for postoperative recurrent fracture in patients with thoracolumbar compression fracture(P<0.05).Conclusion There are many risk factors for recurrent fracture after thoracolumbar compression fracture surgery.We should actively deal with the risk factors and strengthen the prevention and control measures to reduce the risk of recurrent fracture.