胸腰椎骨折复位术后椎体“空壳现象”的相关因素分析

Analysis of influencing factors for "shell" phenomenon in centrum after thoracolumbar fracture reduction

中文关键词:  胸腰椎骨折  空壳现象  相关因素

英文关键词:Thoracolumbar fractures  "Shell" phenomenon  Influencing factor

中文摘要:

  【摘要】 目的：探讨胸腰椎骨折复位术后椎体“空壳现象”的相关因素。方法：对2013年1月～2015年12月我科行后路椎弓根钉棒系统复位内固定术治疗的116例胸腰椎单节段骨折患者进行回顾性分析。分别记录患者的年龄、性别、病程、术前椎体压缩程度、术前矢状面Cobb角、骨折类型、骨密度、伤椎置钉、骨折撑开复位情况、椎体复位程度、螺钉位置等相关因素，观察患者术后椎体“空壳现象”的发生情况，应用单因素和多因素Logistic回归分析研究各因素与椎体“空壳现象”发生的相互关系。结果：116例患者中有72例患者术后发生椎体“空壳现象”，发生率为62.1％。单因素分析结果显示患者骨折撑开复位情况、椎体复位程度、术前椎体压缩程度及骨密度与术后椎体“空壳现象”的发生有明显的相关性（P<0．05），而患者的年龄、性别、病程、骨折类型、术前矢状面Cobb角、伤椎置钉情况、螺钉位置与术后椎体“空壳现象”的发生无相关性（P>0．05）。多因素分析结果显示患者术前椎体压缩程度及骨密度是影响术后椎体“空壳现象”发生的独立危险因素。结论：胸腰椎骨折复位术后出现椎体“空壳现象”受多种因素影响，其中椎体压缩程度和骨密度可能是造成上述问题的主要原因。

英文摘要:

  【Abstract】 Objectives: To investigate the influencing factors for the "shell" phenomenon after thoracolumbar fracture reduction. Methods: A retrospective analysis was conducted in 116 patients with single-segment thoracolumbar fracture who received posterior pedicle screw reduction and internal fixation in our department from January 2013 to December 2015. Their detailed information was recorded, including age, gender, course of disease, degree of preoperative spinal compression, preoperative sagittal Cobb angle, fracture type, bone density, screw placement in diseased spinal segment, distraction and reduction of fracture, degree of reduction, and screw position. The incidence of the "shell" phenomenon was observed. Single-factor analysis and multiple-factor logistic regression analysis were used to study the correlation between these factors and the incidence of the "shell" phenomenon. Results: The "shell" phenomenon in centrum occurred in the 72 of 116 patients, with an incidence of 62.1%. Single-factor analysis showed that the "shell" phenomenon was significantly correlated with distraction and reduction of fracture, degree of reduction, degree of preoperative spinal compression, and bone density(P<0.05), but not related to age, gender, course of disease, fracture type, preoperative sagittal Cobb angle, screw setting in diseased spinal segment, and screw position(P>0.05). Multiple-factor Logistic regression analysis showed that bone density and degree of preoperative spinal compression were major risk factors for "shell" phenomenon. Conclusions: The "shell" phenomenon after thoracolumbar fracture reduction is influenced by many factors, the degree of preoperative vertebral compression and bone density may be the major risk factors of the problem.