| 隋吉生 王黎明 张绍东 曾逸文 孙强.创伤性椎体骨折行椎体成形术后复发的危险因素评估[J].,2015,15(36):7077-7080 |
| 创伤性椎体骨折行椎体成形术后复发的危险因素评估 |
| Risk Factor of Postoperative Recurrence of Traumatic Vertebral Fracturesafter Vertebroplasty Surgery |
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| DOI： |
| 中文关键词: 创伤性椎体骨折 椎体成形术 危险因素 术后复发 |
| 英文关键词: Traumatic vertebral fractures Vertebroplasty Risk factors Postoperative recurrence |
| 基金项目:南京市医学科技发展项目(YKK13112)；江苏省科技厅社会发展计划项目(BS2007076) |
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| 中文摘要: |
| 目的：对创伤性椎体骨折患者使用椎体成形术治疗后可能再次引起骨折的多个因素进行评估。方法：选取本院收治的经皮椎
体成形术（Percutaneous vertebroplasty，PVP）或经皮椎体后凸成形术（Percutaneous kyphoplasty，PKP）治疗的患者161 例，其中再次
发生骨折的患者113 例（131 椎），根据治疗方法（PVP 或PKP）和再次发生骨折的部位（手术椎体或非手术椎体）不同，将患者分成
A1 和A2（再发骨折部位是手术椎体）、B1 和B2（骨折部位为非手术椎体）、C1 和C2（手术椎体和非手术椎体）以及D 组（未再次
发生骨折）共七组，A1，B1，C1 三组使用PVP，A2，B2，C2三组使用PKP，记录各组患者可能导致再发骨折风险的因素并和D组比
较，分析PVP或PKP治疗后椎体再次发生骨折的高危因素。结果：患者身高、体重、年龄等一系列因素之间的差异没有统计学意
义（P>0.05）；而骨水泥注入的体积在再发骨折患者和D 组之间差异有统计学意义（P<0.05）；椎间盘骨水泥是否渗透和是否使用抗
骨质疏松药物治疗的差异有统计学意义（P<0.05）；再发骨折患者和D 组患者25-(OH)D 的浓度之间的差异有统计学意义（P<0.
05）。多因素Logistic 分析显示，椎间盘水泥渗透、低浓度的25-(OH)D 和未使用抗骨质疏松药物治疗是椎体成形术治疗后复发骨
折的危险因素（P<0.05）。结论：PVP或PKP治疗后椎体再次发生骨折的三个危险因素是椎间盘骨水泥渗透、较低的25-(OH)D 浓
度和未使用抗骨质疏松药物治疗。 |
| 英文摘要: |
| Objective:To analyze the risk factors of recurrence for patients with traumatic vertebral fractures who had taken the
vertebroplasty surgery.Methods:113cases (131 vertebrae) with recurrent vertebral fracture were selected from our hospital treated by
Percutaneous vertebroplasty（PVP）or Percutaneous kyphoplasty（PKP）. According to the different treatment methods (PVP or PKP) and
recurrence site of the fractures (surgery vertebrae or non-surgery vertebrae), they were divided into group A1, A2, B1, B2, C1, C2.
Another 56 cases without refracture after operation was selected as control (D group). The possible risk factors of recurrent fractures
were recorded and analyzed in each refractured group after compared with group D.Results:There was no statistical significance
between the patients' height, weight and age (P>0.05), and the volume of bone cement injected was statistically significant (P<0.05).
There were statistically significant differences in the cement penetration of intervertebral discs and the use of anti-osteoporosis drug (P<0.
05). There were statistically significant differences in the concentrations of 25- (OH) D between the refracture patients and group D. The
pelvic cement penetration, lower 25 - (OH) D concentration and without the use of anti-osteoporosis drugs were the risk factors of
recurrence of vertebral fractures (P<0.05).Conclusion:The pelvic cement penetration, lower 25 - (OH) D concentration and without the
use of anti-osteoporosis drugs are the risk factors of postoperative recurrence of vertebral fractures. |
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