[1]邓文军,余绍金,谢剑龙.胸腰椎骨质疏松压缩性骨折术后再发骨折的影响因素分析[J].中华老年骨科与康复电子杂志,2022,(03):140-146.[doi:10.3877/cma.j.issn.2096-0263.2022.03.003]
　Deng Wenjun,Yu Shaojin,Xie Jianlong..Analysis of influencing factors of osteoporotic compression fractures of thoracolumbar vertebrae after PVP and recurrent fractures after PKP[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(03):140-146.[doi:10.3877/cma.j.issn.2096-0263.2022.03.003]
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胸腰椎骨质疏松压缩性骨折术后再发骨折的影响因素分析()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2022年03期
页码:
140-146
栏目:
脊柱专题
出版日期:
2022-06-05

文章信息/Info

Title:
Analysis of influencing factors of osteoporotic compression fractures of thoracolumbar vertebrae after PVP and recurrent fractures after PKP
作者:
邓文军; 余绍金; 谢剑龙
516006 中信惠州医院骨外科
Author(s):
Deng Wenjun;  Yu Shaojin;  Xie Jianlong.
Department of Orthopedics, ZhongXin Huizhou Hospital, Huizhou, Guangdong 516000, China
关键词:
胸腰椎骨质疏松压缩性骨折;  椎体成形术;  椎体后凸成形术;  再发性骨折
Keywords:
Osteoporotic vertebral compression fracture;  Percutaneous vertebroplasty;  percutaneous kyphoplasty;  Refractures
DOI:
10.3877/cma.j.issn.2096-0263.2022.03.003
文献标志码:
A
摘要:
目的 探讨骨质疏松性胸腰椎压缩骨折（OVCF）经皮椎体成形术（PVP）与经皮椎体后凸成形术（PKP）术后近期再发骨折的危险因素。方法 回顾性分析2017年9月至2021年9月于中信惠州医院因胸腰椎骨质疏松压缩性骨折行PVP或PKP术的562例患者的临床资料，男192例，女370例，平均年龄（76±8）岁，分为再发骨折组（n=72）与未再发骨折组（n=490）。将患者性别、年龄、体重、身高、体质指数（BMI）、骨密度QCT值、椎体后凸角（Cobb）、手术方式、既往有无骨折病史、骨水泥注入量、穿刺方法、是否规律使用抗骨质疏松药物治疗、骨水泥是否渗漏等变量纳入术后再发性骨折的危险因素分析。结果 562例患者获得随访，随访率95.90%，随访时间（14±4）月。1年内再骨折发生率为12.81%（72/562），3个月内再发骨折的人数占总发生率的15.28%（11/72）。单因素分析示，年龄、性别、QCT值、既往有无骨折病史、是否规律使用抗骨质疏松药物治疗以及骨水泥是否渗漏与PVP或PKP术后再骨折有关（P＜0.05）；多因素Logistic回归分析示，高龄（OR=1.095，95% CI：1.079，1.111）、既往其他骨折病史（OR=1.311，95% CI：1.082，1.633）与骨水泥渗漏（OR=1.756，95% CI：1.112，2.797）是胸腰椎OVCF患者行PVP或PKP术后近期再骨折的主要危险因素，规律使用抗骨质疏松药物治疗（OR=0.130，95% CI：0.012，0.347）为术后近期再骨折的保护因素（P＜0.05）。结论 胸腰椎OVCF患者行PVP或PKP术后再骨折的主要危险因素为高龄、既往存在其他骨折病史与骨水泥渗漏。建议患者术后合理补充钙剂，规律服用抗骨质疏松药物。
Abstract:
Objective To investigate the risk factors of recent recurrence of osteoporotic thoracolumbar compression fractures (OVCF) after percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). Methods The clinical data of 562 patients who underwent PVP or PKP for thoracolumbar osteoporotic compression fractures in CITIC Huizhou Hospital from September 2017 to September 2021 were retrospectively analyzed, including 192 males and 370 females with an average age (76±8) years old, divided into recurrent fracture group (n=72) and non-recurrent fracture group (n=490). The patient’s gender, age, weight, height, body mass index (BMI), bone mineral density QCT value, kyphosis angle (Cobb), surgical method, previous history of fracture, bone cement injection volume, puncture method, and regular use Variables such as anti-osteoporosis drug treatment and bone cement leakage were included in the risk factor analysis of postoperative recurrent fractures. Results 562 patients were followed up, the follow-up rate was 95.90%, and the follow-up time was (14±4) months. The incidence of refracture within 1 year was 12.81% (72/562), and the number of refracture within 3 months accounted for 15.28% (11/72) of the total incidence. Univariate analysis showed that age, gender, QCT value, history of fracture, regular use of anti-osteoporosis drugs, and bone cement leakage were associated with refracture after PVP or PKP (P<0.05); multivariate Logistic regression analysis showed that advanced age (OR=1.095, 95% CI: 1.079, 1.111), other history of other fractures (OR=1.311, 95% CI: 1.082, 1.633) and bone cement leakage (OR=1.756, 95% CI: 1.112, 2.797) was the main risk factor for recent refracture after PVP or PKP in patients with thoracolumbar OVCF, and regular use of anti-osteoporosis drugs (OR=0.130, 95% CI: 0.012, 0.347) was the protective factor for recent refracture after surgery (P<0.05). Conclusion The main risk factors for re-fracture in patients with thoracolumbar OVCF undergoing PVP or PKP are advanced age, previous history of other fractures, and bone cement leakage. It is recommended that patients take reasonable calcium supplements and take anti-osteoporosis drugs regularly.

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备注/Memo

备注/Memo:
基金项目：惠州市科技局项目（210521114570622）
更新日期/Last Update: 2022-08-03