骨质疏松性椎体压缩骨折PVP术后相邻椎体骨折的相关因素分析

Correlative factors of adjacent vertebral fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures

中文关键词:  经皮椎体成形术  椎体骨折  骨质疏松  相关因素

英文关键词:Percutaneous vertebroplasty  Vertebral fractures  Osteoporosis  Correlative factors

中文摘要:

  【摘要】 目的：探讨骨质疏松性椎体压缩性骨折（OVCFs）患者行经皮椎体成形术（PVP）后相邻椎体骨折的相关因素。方法：对2004年3月～2008年6月112例行单节段PVP 治疗的OVCFs患者进行回顾性分析。记录患者的年龄、性别、病程、有无外伤、术前椎体压缩程度、骨密度、手术入路（单侧或双侧）、麻醉方式、有无侧凸畸形、骨水泥剂量、骨水泥渗漏至椎间盘等情况。应用单因素和多因素Logistic回归分析研究各因素与PVP术后发生相邻椎体骨折的关系。结果：112例患者中有21例患者术后发生相邻椎体骨折共23个椎体，发生率为18.8%。单因素分析结果显示患者术前椎体压缩程度、骨密度、骨水泥剂量、骨水泥渗漏至椎间盘与术后发生相邻椎体骨折有显著相关性（P＜0.05），而患者年龄、性别、病程、有无外伤、手术入路、麻醉方式、有无侧凸畸形与术后相邻椎体骨折无显著相关性（P＞0.05）。多因素分析结果显示患者术前椎体压缩程度较重、骨水泥注射量较大及骨水泥渗漏至椎间盘与术后发生相邻椎体骨折相关（P＜0.05）。结论：OVCFs患者PVP术后相邻椎体骨折可能与术前椎体压缩程度、骨水泥渗漏至椎间盘、骨水泥注射量等因素相关。

英文摘要:

  【Abstract】 Objective：To investigate the correlative factors of adjacent vertebral fractures after percutaneous vertebroplasty（PVP） for osteoporotic vertebral compression fractures（OVCFs）.Method：112 patients who underwent single level PVP for OVCFs from March 2004 to June 2008 were retrospectively reviewed.The correlative factors including age，sex，history of trauma，preoperative degree of vertebral compression，bone mineral density，surgical approach（unilateral or bilateral），analgesia means，presence of lumbar scoliosis，cement injection volume and intradisc cement leakage among patients who sustained adjacent vertebral compession fractures were analysed．Screening of single and multiple-factors Logistic regression analysis was used to determine independent factors.Result：21 of the 112 patients had new adjacent vertebral compression fractures after PVP in a total of 23 vertebraes，with the total rate of 18.8%.Univariate analysis showed that preoperative degree of vertebral compression，bone mineral density，cement injection volume and intradisc cement leakage were the variables associated with the onset of adjacent vertebral fractures（P<0．05）.In contrast，there was no significantly difference with regard to age，sex，history of trauma，operative approach，analgesia means，presence of lumbar scoliosis（P>0.05）.Multiple-factors Logistic regression analysis showed that the positive correlation between reoperative vertebral compression and the cement volume and intradisc leakage was one predominant corelative factor associated with adjacent vertebral fractures.Conclusion：Adjacent vertebral fractures after PVP for OVCFs may be associated with preoperative degree of vertebral compression，the cement injection volume of injected cement and intradisc cement leakage.