河北医科大学学报

• 论著 • 上一篇    下一篇

PVP/PKP术后继发邻近椎体压缩骨折危险因素的研究分析

  

  1. 1.河北省石家庄市第一医院骨四科,河北 石家庄 050011;2.河北医科大学第一医院骨一科,河北 石家庄 050031;
    3.河北省新乐市中心医院骨科,河北 新乐 050700
  • 出版日期:2019-11-25 发布日期:2019-11-21
  • 作者简介:李晓华(1984-),男,山东临沂人,河北省石家庄市第一医院主治医师,医学硕士,从事骨外科疾病诊治研究。
  • 基金资助:
    河北省重点研发计划自筹项目(172777228)

Analysis of risk factors for adjacent vertebral compression fractures after PVP/PKP#br#

  1. 1.The Fourth Department of Orthopedic Surgery, the First Hospital of Shijiazhuang, Hebei Province,
    Shijiazhuang 050011, China; 2.The First Department of Orthopedic Surgery, the First Hospital of
    Hebei Medical University, Shijiazhuang 050031, China; 3.Department of Orthopedic Surgery,
    Xinle Central Hospital, Hebei Province, Xinle 050700, China
  • Online:2019-11-25 Published:2019-11-21

摘要: [摘要]
〖HTH〗目的〖HTSS〗〖KG*2〗分析经皮椎体成形术(percutaneous vertebroplasty,PVP)及经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)后继发邻近椎体压缩骨折危险因素,探讨引起再骨折的主因。
〖HTH〗方法〖HTSS〗〖KG*2〗回顾性分析行手术治疗的176例患者,根据随访结果折分为A组(骨折组,共21例)和B组(对照组,含手术椎体再骨折3例,跳跃椎体骨折2例,未骨折150例,共155例),记录年龄、性别、手术方式、穿刺方式、体重指数、术前骨密度、骨水泥注射量、骨水泥是否渗漏、是否抗骨质疏松治疗及脊柱矢状面是否失衡等因素,并进行组间对比分析。
〖HTH〗结果〖HTSS〗〖KG*2〗A组与B组在性别、年龄、骨水泥注射量及骨水泥是否渗漏方面差异均无统计学意义(P>0.05),而2组在是否进行抗骨质疏松及脊柱矢状面失衡方面差异均有统计学意义(P<0.05)。
〖HTH〗结论〖HTSS〗〖KG*2〗术前低骨密度值、脊柱矢状面失衡是导致PVP/PKP术后继发邻近椎体压缩骨折发生的危险因素,而与年龄、性别、手术方式、穿刺方式、体重指数、骨水泥注射量、骨水泥是否渗漏等无明显关系;对患者进行积极抗骨质疏松治疗,能明显降低术后邻近椎体压缩骨折的发生率。

关键词: 脊柱骨折, 椎体成形术, 继发骨折, 危险因素

Abstract: [Abstract] Objective〖HTSS〗To analyze the risk factors of adjacent vertebral compression fractures after percutaneous vertebroplasty and percutaneous kyphoplasty ,and to explore the main causes of re-fracture.
〖HTH〗〖WTHZ〗Methods〖HTSS〗A retrospective analysis of 176 patients undergoing surgical treatment was divided into group A(fracture group, 21 cases) and group B(control group, 155 cases,including 3 cases of surgical vertebral fractures, 2 cases of jumping vertebral fractures, and 150 cases without fractures). Age, gender, surgical approach,puncture method, BMI, preoperative bone mineral density, bone cement injection, bone cement leakage, anti-osteoporosis treatment and imbalance of the sagittal plane of the spine were recorded and compared.
〖HTH〗〖WTHZ〗Results〖HTSS〗There was no significant difference between group A and group B in sex, age, amount of bone cement injection and whether bone cement leakage occurred(P>0.05), but there was significant difference in anti-osteoporosis and spinal sagittal imbalance between two groups(P<0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗Preoperative bone mineral density,sagittal imbalance of the spine are the risk factors for the occurrence of secondary vertebral compression fractures after PVP/PKP, but there is no significant correlation with age, gender, surgical approach,puncture method, BMI, bone cement injection, bone cement leakage. Patients with active anti-osteoporosis treatment can significantly reduce the incidence of adjacent vertebral body fractures.

Key words: spinal fractures, vertebroplasty, secondary fracture, risk factors