摘要
目的分析探讨老年骨质疏松性椎体压缩骨折经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)后新发骨折的危险因素。方法回顾性分析2013年4月—2017年3月于陕西省杨凌示范区医院行PKP的88例老年骨质疏松性椎体压缩骨折患者的临床资料,按术后是否新发骨折分为骨折组(33例)与非骨折组(55例),收集其一般临床资料、既往史、骨折一般情况、手术情况等资料,采用Logistic多因素回归分析筛选老年骨质疏松性椎体压缩骨折患者行PKP后新发骨折的危险因素。结果骨折组长期糖皮质激素使用史、骨密度、术前骨折椎体数、手术椎体数、骨折压缩率、椎体高度恢复率、强化椎体数目、骨水泥椎间盘渗漏所占比例与非骨折组比较差异均有统计学意义(P<0.05);长期糖皮质激素使用史、骨密度、术前骨折椎体数、手术椎体数、强化椎体数目、骨水泥椎间盘渗漏均为导致骨质疏松性椎体压缩骨折PKP后新发骨折的危险因素。结论老年骨质疏松性椎体压缩骨折PKP术后新发骨折与长期应用糖皮质激素、术前骨折椎体数、手术椎体数、强化椎体数及骨水泥椎间盘渗漏有明显的相关性,积极控制上述危险因素,可降低术后再骨折发生风险。
Objective To analyze the risk factors for new fractures after vertebroplasty for osteoporotic vertebral compression fractures in the elderly.Methods The clinical data of88elderly patients with osteoporotic vertebral compression fractures who had undergone vertebroplasty in our hospital between April2013and March2017was analyzedretrospectively.According to the presence of new fractures,the patients were divided into the fracture group(33pepole)and non-fracture group(55pepole).The demographic data,past history,general information on fractures and operations were collected.The risk factors of new fractures after vertebroplasty for osteoporotic vertebral compression fractures in the elderly were screened by Logistic regression analysis.Results Among the88elderly patients with osteoporotic vertebral compression fractures after vertebroplasty,there were33cases with non-operative new vertebral fractures,and the incidence was37.50%.There was significant difference between the fracture group and the non-fracture group in the long-term use of glucocorticoids,bone mineral density,the number of fractured vertebral bodies before surgery,the number of operated vertebral bodies,the fracture compression rate,the recovery rate of vertebral body height,the number of enhanced vertebral bodies and the proportion of bone cement vertebral disc leakage(P<0.05).Long-term use of glucocorticoids,bone mineral density,the number of fractured vertebral bodies before surgery,the number of operated vertebral bodies,the number of enhanced vertebral bodies and bone cement vertebral disc leakage were risk factors for new fractures after vertebroplasty of osteoporotic vertebral compression fractures.Conclusion There is an obvious correlation between new fractures and long-term use of glucocorticoids,the number of fractured vertebral bodies before surgery,the number of enhanced vertebral bodies and bone cement vertebral disc leakage in elderly patients with osteoporotic vertebral compression fractures after percutaneous kyphoplasty(PKP).Positive control of the risk factors can reduce the risk of refracture after surgery.
作者
曹冬子
许正伟
王存良
鲁良
尚伟
孙玉录
CAO Dongzi;XU Zhengwei;WANG Cunliang;LU Liang;SHANG Wei;SUN Yulu(Department of Orthopaedics, Yangling Demonstration Area, Xianyang Shanxi 712100, China)
出处
《空军医学杂志》
2018年第1期41-44,共4页
Medical Journal of Air Force
关键词
骨质疏松性骨折
椎体成形术
新发骨折
骨密度
osteoporotic fracture
vertebroplasty
new fracture
bone mineral density
