骨质疏松性胸腰椎骨折术后发生骨缺损的危险因素分析

Analysis of Risk Factors for Bone Defects in Patients After the Surgery for Osteoporotic Thoracolumbar Vertebral Fractures

目的分析骨质疏松性胸腰椎骨折术后发生骨缺损的危险因素。方法选取2020年3月至2022年3月河南科技大学第一附属医院收治的40例骨质疏松性胸腰椎骨折术后发生骨缺损的患者(设为发生组),以及54例骨质疏松性胸腰椎骨折术后未发生骨缺损的患者(设为未发生组)作为研究对象,收集患者性别、年龄、体重指数、受伤原因、受伤部位、椎间盘是否受损、椎体前缘压缩程度、骨密度T值以及是否植骨等情况,采用多因素Logistic回归分析骨质疏松性胸腰椎骨折术后发生骨缺损的相关危险因素。结果单因素分析结果显示,发生组椎间盘受损、椎体前缘压缩程度≥50%、未进行植骨的患者比例均明显高于未发生组(χ^(2)=25288、27885、40021,P均<0001),骨密度T值明显小于未发生组(t=4242,P<0001);多因素Logistic回归分析结果显示,椎间盘受损、椎体前缘压缩程度≥50%、骨密度T值较小以及未进行植骨是骨质疏松性胸腰椎骨折术后发生骨缺损的独立危险因素(95%CI为4864~35722、4423~31093、2252~17893、8492~94879,P均<0001)。结论骨质疏松性胸腰椎骨折术后骨缺损的发生与患者椎间盘受损情况、椎体前缘压缩程度、骨密度T值以及是否进行植骨有关。

Objective To analyze the risk factors for bone defects in patients after the surgery for osteoporotic thoracolumbar vertebral fractures.Methods The research subjects were 40 patients who suffered bone defects after the surgery for osteoporotic thoracolumbar vertebral fractures,being set as the occurrence group,and 54 patients who did not suffer bone defects after the surgery,being set as the non-occurrence group,admitted into The First Affiliated Hospital of Henan University of Science and Technology from March 2020 to March 2022,and their data were collected including sex,age,body mass index,cause of injury,injured location,presence of intervertebral disc damage,compression degree of the anterior vertebral body edge,bone mineral density T-value,and with bone grafting or not.Multivariate Logistic regression analysis was carried out to determine the risk factors associated with the occurrence of bone defects in patients after the surgery for osteoporotic thoracolumbar vertebral fractures.Results Univariate analysis results showed higher percentages of patients with intervertebral disc damage,compression degree of the anterior vertebral body edge≥50%,and without bone grafting in the occurrence group as opposed to the non-occurrence group(χ^(2)=25288,27885 and 40021,all P<0001),whereas the bone mineral density T-value of patients in the occurrence group was significantly lower than that in the non-occurrence group(t=4242,P<0001);results of multivariate Logistic regression analysis presented that the presence of intervertebral disc damage,compression degree of the anterior vertebral body edge≥50%,low bone mineral density T-value,and without bone grafting are the independent risk factors of bone defects in patients after the surgery for osteoporotic thoracolumbar vertebral fractures(95%CI:4864-35722,4423-31093,2252-17893 and 8492-94879,all P<0001).Conclusion The occurrence of bone defects after the surgery for osteoporotic thoracolumbar vertebral fractures is correlated with such factors as the damage degree of intervertebral disc,compression degree of the anterior vertebral body edge,bone mineral density T-value,and with bone grafting or not.