骨质疏松性胸腰椎骨折术后骨折延迟愈合的危险因素及相关性分析

Risk Factors and Correlation Analysis of Delayed Fracture Healing after Osteoporotic Thoracolumbar Fracture Surgery

目的分析骨质疏松性胸腰椎骨折术后骨折延迟愈合的危险因素及其相关性。方法选取2019年6月至2021年6月周口市中医院收治的98例拟行经皮椎体成形术治疗的骨质疏松性胸腰椎骨折患者作为研究对象,收集患者性别、年龄、骨折节段、骨水泥用量、手术入路方式、术前血清血小板衍生生长因子(PDGF)及骨形成蛋白-2(BMP-2)水平等资料,并根据术后4个月的骨折愈合情况将其分为延迟组和正常组,多因素Logistic回归分析骨质疏松性胸腰椎骨折术后骨折延迟愈合的相关危险因素,点二列相关分析各危险因素与骨质疏松性胸腰椎骨折术后骨折延迟愈合的相关性。结果经皮椎体成形术后4个月,98例骨质疏松性胸腰椎骨折患者中出现骨折延迟愈合12例(12.24%),设为延迟组;骨折愈合86例(87.76%),设为正常组。多因素Logistic回归分析结果显示,术前血清PDGF、BMP-2低水平是骨质疏松性胸腰椎骨折术后骨折延迟愈合的独立危险因素(95%CI为0.946~0.985、0.925~0.997,P<0.001、P=0.035)。点二列相关分析结果显示,术前血清PDGF、BMP-2水平与骨质疏松性胸腰椎骨折术后骨折延迟愈合呈显著负相关性(r=-0.696、-0.707,P均<0.001)。结论骨质疏松性胸腰椎骨折患者术后骨折延迟愈合与术前血清PDGF、BMP-2水平密切相关。

Objective To analyze the risk factors and correlation of delayed fracture healing after osteoporotic thoracolumbar fracture surgery.Methods 98 patients with osteoporotic thoracolumbar fracture,admitted into Zhoukou Hospital of TCM for percutaneous vertebroplasty(PVP)surgery between June 2019 and June 2021,were enrolled as study subjects,and patients’data,including sex,age,fracture segment,bone cement dosage,surgical approach,the levels of preoperative serum platelet⁃derived growth factor(PDGF)and bone morphogenetic protein⁃2(BMP⁃2),were collected.The patients were divided,according to the fracture healing condition 4 months after surgery,into delayed group and normal group.Multivariate Logistic regression analysis was performed to analyze the related risk factors resulting in delayed healing of osteoporotic thoracolumbar fracture after surgery.Point⁃biserial correlation analysis was conducted to analyze the correla⁃tion between the risk factors and delayed healing of osteoporotic thoracolumbar fracture after surgery.Results Four months after the PVP surgery,12 cases of the 98 patients(12.24%)suffered delayed fracture healing,being set as the delayed group,and the other 86 cases(87.76%),achieved normal fracture healing,were set as the normal group.Multivariate Logistic regression analysis showed that low levels of preoperative serum PDGF and BMP⁃2 were independent risk factors for delayed fracture healing after the PVP surgery for osteoporotic thoracolumbar fracture(95%CI:0.946-0.985,0.925-0.997,P<0.001,P=0.035).Point⁃biserial correlation analysis showed that the levels of preoperative serum PDGF and BMP⁃2 were negatively correlated with the delayed fracture healing after the PVP surgery for osteoporotic thoracolumbar fracture(r=-0.696 and-0.707,both P<0.001).Conclusion The delayed fracture healing of patients after the PVP surgery for osteoporotic thoracolumbar fracture is closely related to the levels of preoperative serum PDGF and BMP⁃2.