胸腰椎压缩性骨折患者经皮椎体成形术后发生邻近椎体再骨折的影响因素

Influencing Factors of Adjacent Vertebral Body Refracture After Percutaneous Vertebroplasty in Patients with Thoracolumbar Compression Fracture

目的探讨胸腰椎压缩性骨折患者经皮椎体成形术(PVP)后发生邻近椎体再骨折的影响因素。方法选取2019年3月至2021年10月濮阳市中医医院收治的120例胸腰椎压缩性骨折患者为研究对象,经相关检查后所有患者接受PVP治疗,观察并统计PVP术后6个月内邻近椎体再骨折的发生情况,将其分为再骨折未发生组和再骨折发生组。统计所有患者一般资料,并于治疗后第2天检测所有患者血小板参数[血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)]以及术后骨水泥渗漏发生情况、骨密度等,分析血小板参数与胸腰椎压缩性骨折患者PVP后发生邻近椎体再骨折的关系。结果术后6个月,120例胸腰椎压缩性骨折患者PVP后发生邻近椎体再骨折18例,占比15.00%;未发生组骨水泥渗漏、骨密度、PLT与发生组对比,差异有统计学意义(P<0.05)。两组年龄、体质量、PDW、MPV等其他资料对比,差异无统计学意义(P>0.05);经logistic回归分析得出,骨密度低、骨水泥渗漏、PLT水平高是胸腰椎压缩性骨折患者PVP后邻近椎体再骨折发生的影响因素(P<0.05)。结论胸腰椎压缩性骨折患者PVP后邻近椎体再骨折的发生与骨密度低、骨水泥渗漏、PLT水平高有关,临床中需对其加以控制,预防邻近椎体再骨折发生。

Objective To investigate the influencing factors of adjacent vertebral body refracture after percutaneous vertebrolplasty(PVP)in patients with thoracolumbar compression fracture.Methods A total of 120 patients with thoracolumbar compression fracture admitted in Puyang Hospital of Traditional Chinese Medicine from March 2019 to October 2021 were selected as the study objects.After relevant examinations,all patients were treated with PVP.The incidence of adjacent vertebral body fractures within 6 months after PVP was observed and counted,and they were divided into non-refracture group and refracture group.The researchers counted the baseline data of all patients,and detected the platelet parameters[platelet count(PLT),mean platelet volume(MPV),platelet hematocrit(PCT),platelet distribution width(PDW)],as well as the occurrence of bone cement leakage and bone mineral density in all patients 2 days after treatment,and analyzed the relationship between platelet parameters and the occurrence of refracture of adjacent vertebral body after PVP in patients with thoracolumbar compression fracture.Results Six months after operation,18 cases(15.00%)of 120 patients with thoracolumbar compression fracture developed refracture of adjacent vertebral body after PVP.There were statistical differences in bone leakage,bone mineral density and PLT between non-refracture group and refracture group(P<0.05).There was no statistical difference in age,weight,PDW,MPV and other data between the two groups(P>0.05).Logistic regression analysis showed that low bone mineral density,bone leakage,and high PLT level were the influencing factors of refracture of adjacent vertebral body after PVP in patients with thoracolumbar compression fracture(P<0.05).Conclusion The occurrence of refracture of adjacent vertebral body after PVP in patients with thoracolumbar compression fracture is related to low bone density,bone leakage and high PLT level,which should be controlled in clinical practice to prevent the occurrence of re fracture of adjacent vertebral body.