胸椎骨质疏松性压缩骨折患者发生肋间痛的危险因素分析

Analysis of risk factors of intercostal pain in patients with osteoporotic vertebral compression fracture of thoracic spine

目的:分析胸椎骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者发生肋间痛的危险因素。方法:回顾性分析2020年12月~2022年6月于我院就诊的胸椎OVCF患者205例,其中男性40例,女性165例,年龄74.5±8.2岁。根据患者是否伴肋间痛症状,分为肋间痛组(A组)和无肋间痛组(B组),提取患者相关因素信息,包括性别、年龄、是否具有合并症(糖尿病、高血压及冠心病等)、骨折节段(上、中、下胸椎)、体质指数(body mass index,BMI)、骨密度(bone mineral density,BMD)、骨折类型(楔型、双凹型、扁平型)、有无椎管侵占、椎体稳定性、骨折严重程度[非重度(轻度、中度)、重度]以及椎间孔面积减小率等内容。采用SPSS 24.0软件对数据进行统计学分析,对数据进行单因素筛选分析,再对其有效结果行多因素Logistic回归分析。结果:单因素分析显示两组患者性别、年龄、是否具有合并症(糖尿病、高血压、冠心病)、BMI、BMD无统计学差异(P>0.05),而骨折类型、骨折严重程度(非重度、重度)、有无椎管侵占、椎体是否稳定、椎体骨折节段(中、下胸椎)与椎间孔面积减小率有统计学差异(P<0.05)。多因素Logistic回归显示,胸椎OVCF后肋间痛发生的独立危险因素为椎间孔面积减小率[(OR=1.106,95%CI为1.059~1.156,P=0.000)]。结论:患者骨折严重程度、椎体骨折节段、骨折类型、椎体稳定性、椎管侵占与椎间孔面积减小率是胸椎OVCF后发生肋间痛的相关因素。而椎间孔面积减小率是胸椎OVCF后发生肋间痛的独立危险因素。

Objectives:To analyze the risk factors of intercostal pain in patients with osteoporotic vertebral compression fracture(OVCF)of thoracic spine.Methods:A retrospective analysis was performed on 205 patients with thoracic OVCF admitted to our hospital from December 2020 to June 2022,including 40 males and 165 females,aged 74.5±8.2 years.According to whether presenting with intercostal pain,the patients were divided into intercostal pain group(group A)and none-intercostal pain group(group B).Information including gender,age,comorbidities(diabetes,hypertension,and coronary heart disease),fracture segments(upper,middle and lower thoracic vertebrae),body mass index(BMI),bone mineral density(BMD),fracture type(wedge,biconcave,crush),spinal canal invasion,vertebral body stability,fracture severity[non-severe(mild,moderate),severe],and reduction rate of intervertebral foraminal area.SPSS 24.0 software was used for statistical analysis,and after single factor screening analysis of the data,multi-factor Logistic regression analysis was performed on the effective results.Results:Univariate analysis showed that there were no significant differences in gender,age,comorbidities(diabetes,hypertension,and coronary heart disease),BMI,and BMD between the two groups(P>0.05),while there were significant differences in fracture type(wedge,biconcave,crush),fracture severity(non-severe and severe),spinal canal invasion,vertebral body stability,fracture segments(middle and lower thoracic vertebrae),and the reduction rate of intervertebral foraminal area between groups(P<0.05).Multivariate Logistic regression showed that the independent risk factor of intercostal pain after thoracic OVCF was the reduction rate of intervertebral foraminal area[(OR=1.106,95%CI 1.059-1.156,P=0.000)].Conclusions:Vertebral fracture severity,fracture segment,fracture type,vertebral stability,spinal canal invasion,and reduction rate of intervertebral foraminal area are the relavant factors for intercostal pain after thoracic OVCF,and foraminal area reduction rate is an independent risk factor.