摘要
目的研究老年骨质疏松性椎体压缩性骨折(OVCF)患者经皮球囊扩张椎体后凸成形术(PKP)术后脊柱骨盆矢状面参数和骨密度与继发骨折的关系。方法回顾性分析200例接受PKP治疗的老年OVCF患者的病历资料,根据患者是否发生继发骨折分为继发组52例和对照组148例。比较两组患者术后脊柱骨盆矢状面参数水平及骨密度水平,分析老年OVCF患者PKP术后脊柱骨盆矢状面参数和骨密度与继发骨折的关系。结果脊柱骨盆矢状面参数中骨盆入射角(PI)、骶骨倾斜角(SS)、腰椎前凸角(LL)水平以及骨密度水平与老年OVCF患者PKP术后继发骨折呈反比(rs分别=-0.32、-0.36、-0.33、-0.42,P均<0.05),脊柱骨盆矢状面参数中胸椎后凸角(TK)、矢状位轴向距离(SVA)水平与老年OVCF患者PKP术后继发骨折呈正比(rs分别=0.33、0.43,P均<0.05)。logistic回归分析显示,TK、SVA为影响老年OVCF患者PKP术后继发骨折的危险因素,脊柱骨盆矢状面参数PI、SS、LL及骨密度为影响老年OVCF患者PKP术后继发骨折的保护因素(OR分别=1.11、1.41、0.88、0.88、0.92、0.88,P均<0.05)。结论老年OVCF患者PKP术后脊柱骨盆矢状面参数中PI、SS、LL水平越高,TK、SVA水平越低,且患者骨密度越高,患者出现继发骨折的风险越低。
Objective To study the relationship between spino-pelvic sagittal parameters,bone mineral density and secondary fracture in elderly patients with osteoporotic vertebral compression fractures(OVCF)after percutaneous kypho-plasty(PKP).Methods The medical records of 200 elderly patients with OVCF who underwent PKP were analyzed ret-rospectively.According to whether the patients had secondary fractures after surgery,they were divided into recurrent group(52 patients)and control group(148 patients).Postoperative spino-pelvic sagittal parameters and bone mineral density were compared between the two groups.The relationship between spino-pelvic sagittal parameters,bone mineral density and secondary fractures in elderly patients with OVCF after PKP was analyzed.Results Pelvic incidence(PI),sacral slope(SS),lumbar lordosis(LL),and bone mineral density were negative related with secondary fractures after surgery in elderly OVCF patients(rs=-0.32,-0.36,-0.33,-0.42,P<0.05).Thoracic kyphosis(TK),and C7-S1 sagittal vertical axis(SVA)were positive related with secondary fractures after surgery in elderly OVCF patients(rs=0.33,0.43,P<0.05).Logistic regression analysis results showed that spino-pelvic sagittal parameters TK and SVA were the risk fac-tors for secondary fractures after PKP in elderly patients with OVCF,and spine and pelvic sagittal parameters PI,SS,LL and bone mineral density were protective factors for secondary fractures after PKP in elderly patients with OVCF(OR=1.11,1.41,0.88,0.88,0.92,0.88,P<0.05).Conclusion The higher the levels of PI,SS,LL,the lower the levels TK and SVA the higher the bone density.Moreover,the lower the risk of secondary fractures in elderly OVCF patients after RKP.
作者
周庭捷
杨江
杨军
洪杰
ZHOU Tingjie;YANG Jiang;YANG Jun(Department of Orthopaedics,Sanmen County People's Hospital of Zhejiang Province,Sanmen 317100,China)
出处
《全科医学临床与教育》
2024年第7期616-619,共4页
Clinical Education of General Practice
关键词
骨质疏松性椎体压缩性骨折
老年
脊柱骨盆矢状面
骨密度
继发骨折
osteoporotic vertebral compression fractures
elderly
spino-pelvic sagittal plane
bone mineral density
secondary fracture
