经皮椎体强化术后新发椎体压缩骨折的发生率及相关危险因素分析

Incidence and associated risk factors of new vertebral compression fractures following percutaneous vertebral augmentation

中文关键词:  椎体强化术  新发椎体压缩性骨折  骨质疏松

英文关键词:Percutaneous vertebral augmentation  New vertebral compression fractures  Osteoporosis

中文摘要:

  【摘要】 目的：探讨经皮椎体强化术后新发椎体压缩骨折的发生率及其相关因素。方法：2007年7月1日~2009年6月30日因骨质疏松性椎体压缩性骨折行椎体强化术治疗150例患者。其中128例患者未出现新发骨折，为A组；另外22例患者出现新发骨折，为B组。观察指标包括患者年龄、性别、骨密度、术前已存在的骨折椎体个数、椎体强化术治疗的椎体个数、已有骨折的部位、骨折椎体的严重程度、平均骨水泥注入量、椎体强化术的方式（PVP或PKP）、骨水泥渗漏、新发骨折的部位、新发骨折间期。结果：全部150例患者经至少12个月的随访，出现新发骨折的患者其术前存在的平均骨折椎体个数及平均强化的椎体个数较多（Ｐ＜０．０５）。而年龄、性别、骨密度、骨折椎体的严重程度、骨水泥注入量、骨水泥渗漏在A组和B组患者间差异无显著性（Ｐ＞０．０５）。行PVP治疗的患者新发骨折的发生率高于行PKP治疗的患者（Ｐ＜０．０５）。结论：术前存在的椎体骨折个数及平均强化椎体个数是术后新发骨折的危险因素。与PVP相比，PKP术后新发骨折的发生率较低。

英文摘要:

  【Abstract】 Objective：To investigate the incidence and associated risk factors of new vertebral compression fractures（VCFs） following percutaneous vertebral augmentation.Method：150 patients undergoing percutaneous vertebral augmentation due to osteoporotic vertebral fractures from July 1，2007 to June 30，2009 were reviewed retrospectively.128 patients had no new compression fracture termed as group A，while the other 22 patients with new onset compression fracture were termed as group B.The patient age，gender，bone mineral density，number of preexisting VCFs，number of augmentation vertebral，location of preexisting VCFs，severity of prevalent vertebral fractures，average amount of bone cement injection，method of vertebral augmentation（PVP or PKP），cement leakage，site of new compression fractures，period between primary and subsequent VCFs were reviewed.Result：All 150 patients were followed up for at least 12 months.22 patients（14.7%） experienced new VCFs during the follow-up period.Of these，more preexisting VCFs and more augmented vertebrae were noted.The age，gender，bone mineral density，severity of prevalent vertebral fractures，average amount of bone cement injected and cement leakage showed no statistical difference between groups A and B.Patients receiving PVP had a higher incidence of new fractures compared with PKP.Conclusion：The number of preexisting VCFs and augmented vertebrae are risk factors associated with new onset compression fractures.Compared with PVP，patients undergoing PKP are more apt to develop new VCFs.