骨质疏松性椎体压缩骨折PVP术后非手术椎体骨折的相关因素分析

Correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures

中文关键词:  骨质疏松性椎体压缩骨折  经皮椎体成形术  非手术椎体骨折  相关因素

英文关键词:Osteoporotic vertebral compression fractures  Percutaneous vertebroplasty  Non-surgical vertebral fractures  Correlative factors

中文摘要:

  【摘要】　目的：探讨骨质疏松性椎体压缩骨折（OVCFs）经皮椎体成形术（PVP）后非手术椎体骨折的相关因素。方法：2007年1月～2010年3月门诊和病房共收治OVCFs PVP术后非手术椎体骨折患者42例，男8例，女34例，年龄55～82岁，平均67.3岁，均行脊柱X线片及MRI检查，确诊为相邻或非相邻椎体骨折；选取同期随访的PVP术后非手术椎体无骨折患者68例，男17例，女51例，年龄52～75岁，平均60.1岁。应用双能X线吸收法测定腰椎（L2～L4）骨密度值，并记录患者年龄、性别、体重指数、术前是否长期（超过1年）服用糖皮质激素类药物、手术部位（胸椎或腰椎）及单双侧入路等情况，分析引起非手术椎体骨折的相关因素。结果：单因素分析显示两组患者在年龄、骨密度及是否长期服用糖皮质激素方面比较差异有统计学意义（P＜0.05），在性别、体重指数、手术部位及入路方面比较差异无统计学意义（P＞0.05）。多因素分析显示高龄、骨密度T值≤-2.5SD及长期服用糖皮质激素是导致PVP术后非手术椎体骨折的危险因素，其OR值分别为3.775、5.980、3.401（P＜0.05）。结论：高龄、骨质疏松及服用糖皮质激素药物超过1年是导致OVCFs患者PVP术后非手术椎体骨折的相关因素。

英文摘要:

  【Abstract】 Objective：To investigate the correlative factors associated with non-surgical vertebral fractures after percutaneous vertebroplasty（PVP） for osteoporotic vertebral compression fractures（OVCFs）.Method：From January 2007 to March 2010，42 out- and in-patients with non-surgical vertebral fractures after PVP for OVCFs were included in this study.There were 8 males and 34 females with the average age of 67.3 years（range，55-82 years old）.All patients underwent X-Ray and MRI to confirm the onset of non-surgical segment fracture.68 patients without the non-surgical segment fracture after PVP were selected as the control, who were 17 males and 51 females with an average age of 60.1 years（range，52-75 years old）.The bone mineral density（BMD） of lumbar spine was measured by dual-energy X-ray absorptiometry，and the patients′ age，sex，body mass index（BMI），operative site and approach，administration of glucocorticoids for more than 1 year or without were recorded.The correlative factors associated with the non-surgical vertebral fractures were analyzed.Result：Univariate analysis showed statistically significant differences（P＜0.05） between two groups with respect to age，BMD，whether to take glucocorticoids,whereas no significant differences（P＞0.05） with regard to sex，BMI，operative site and approach.Multiple logistic regression analysis showed old age，BMD≤-2.5SD，administration of glucocorticoids for more than 1 year were the predominant risk factors associated with non-surgical segment fracture，with the OR value of 3.775，5.980 and 3.401 respectively（P＜0.05）.Conclusion：Old age，osteoporosis and administration glucocorticoids for more than 1 year are the relative risk factors of non-surgical vertebral fractures after PVP for OVCFs.