摘要
[目的]探讨影响高原地区骨质疏松性椎体压缩骨折椎体成形术后非手术椎体新发骨折的相关因素。[方法]回顾分析2015年12月～2018年3月在本院行经皮椎体成形术的104例患者。依据术后是否发生骨折,将患者分为新发骨折组和无骨折组。比较两组间可能的新发骨折相关的因素:包括年龄、性别、体重指数、骨密度、初次强化椎体个数、骨折压缩程度、椎体后凸角度、骨水泥灌注量、骨水泥渗漏情况、术后抗骨质疏松时间、每天日照时间、是否长期使用糖皮质激素、是否合并糖尿病及初次手术节段;并将各相关因素引入逻辑回归,分析术后非手术椎体新发骨折的危险因素。[结果]平均随访(12.63±9.61)个月,共有23例患者发生非手术椎体新发骨折,新发骨折的发生率为22.11%,新发骨折距初次手术的时间1～30个月,平均(11.5±7.96)个月。分析显示患者骨密度、初次强化椎体个数、术后抗骨质疏松时间、每天日照时间是影响新发骨折的相关因素。[结论]高原地区患者骨质疏松程度重,初次强化椎体个数多是导致术后非手术椎体新发骨折的危险因素,增加术后抗骨质疏松时间和每天日照时间可以预防新发骨折的发生。
[Objective] To investigate the related factors of new-onset osteoporotic vertebral compression fractures(OVCFs) secondary to the primary percutaneous vertebroplasty(PVP) in the plateau area. [Methods] From December 2015 to March 2018, a total of 104 patients who had undergone percutaneous vertebroplasty for OVCFs in our department were retrospectively analyzed. Based on whether or not new-onset OVCFs confirmed, the patients were divided into the fracture group and the non-fracture group. The factors that might be related to the new-onset OVCFs, such as age, sex, body mass index(BMI),bone mineral density(BMD), number of bone cement augmented vertebrae, extent of compression, Cobb angle of kyphosis, bone cement volume injected, bone cement leakage, postoperative anti-osteoporosis time, daily sunshine time, the long-term use of glucocorticoids, diabetes and operative vertebral segment involved, were compared between the two groups. In addition, logistic regression was conducted to search the risk factors of new-onset OVCFs after primary PVP. [Results] All the 104 patients were followed up for(12.63±9.61) months on average. Of them, 23 patients were confirmed new-onset OVCFs, accounting for22.11%, with time elapsed between primary PVP and new-onset fracture ranged from 1 month to 30 months, with an average of(15.5±7.96) months, while the remaining 81 patients had no fracture. As results of comparison between the two groups and logistic regression, BMD, the number of bone cement augmented vertebrae, anti-osteoporosis time, daily sunshine time were related factors of new-onset vertebral compression fractures. [Conclusion] The extent of osteoporosis and the number of bone cement augmented vertebras are the risk factors of new-onset vertebral compression fractures, while increasing postoperative anti-osteoporosis time and daily sunshine time are the protective factors of the fractures in the plateau area.
作者
张洋
肖杰
邹伟
龙浩
刘杰
ZHANG Yang;XIAO Jie;ZOU Wei;LONG Hao;LIU Jie(Department of Spine Surgery,The Fourth People's Hospital of Guiyang City,Guiyang 550001,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第6期511-514,共4页
Orthopedic Journal of China
基金
贵阳市卫生和计划生育委员会科学技术计划项目(编号:2017筑卫计科技合同字第043号)
关键词
骨质疏松性椎体压缩性骨折
椎体成形术
新发骨折
相关因素
osteoporotic vertebral compression fractures(OVCFs)
percutaneous vertebroplasty(PVP)
newonset fractures
related factor
作者简介
张洋,副主任医师,研究方向:脊柱外科,(电话)13037885765,(电子信箱)wyqyangzhang@163.com;通信作者:肖杰,(电子信箱)jx4363@sina.com。
