摘要
目的:观察骨质疏松性椎体压缩骨折(OVCFs)患者以经皮椎体成形术(PVP)治疗后的临床疗效,并分析术后邻近椎体骨折的危险因素。方法:选取我院2018年6月~2020年9月期间收治的OVCFs患者180例,给予PVP治疗,观察其治疗效果、骨水泥渗漏情况、术后邻近椎体骨折发生情况,采用单因素及多因素Logistic回归分析术后邻近椎体骨折的危险因素。结果:OVCFs患者术前~术后6个月功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)、活动能力评分(LAS)均呈降低趋势(P<0.05)。随访期间,180例患者中,15例(8.33%)出现了骨水泥渗漏,但均不需要进一步处理。32例(17.78%)出现了术后邻近椎体骨折,148例未出现术后邻近椎体骨折,并以此进行分组。再骨折组、未再骨折组在年龄、骨折病史、骨密度、Cobb角、椎体高度恢复、骨水泥渗漏情况、使用抗骨质疏松药物方面对比有明显差异(P<0.05)。年龄>70岁、骨水泥渗漏、骨密度<-2.5SD、未使用抗骨质疏松药物、Cobb角<15°、椎体高度恢复率>87%均是PVP术后邻近椎体骨折的危险因素(P<0.05)。结论:PVP治疗OVCFs疗效较好,可缓解患者疼痛、减轻功能障碍、改善活动能力,术后邻近椎体骨折的发生受年龄、骨密度、Cobb角等多种因素影响,临床可针对这些因素给予对应的干预措施。
Objective:To observe the clinical effect of percutaneous vertebroplasty(PVP)in the treatment of osteoporosis vertebral compression fracture(OVCFs),and to analyze the risk factors of the adjacent vertebral fracture after operation.Methods:180 OVCFS patients in our hospital from June 2018 to September 2020 were selected,PVP was given to treat them.The therapeutic effect,bone cement leakage condition,and the occurrence of adjacent vertebral fractures were observed.The risk factors of adjacent vertebral fractures were analyzed by multivariate Logistic regression analysis.Results:Disability index(ODI),visual analogue scale(VAS)and locomotor activity scale(LAS)score of OVCFS patients from before operation to 6 months after operation all showed a decreasing trend(P<0.05).During the follow-up,bone cement leakage occurred in 15(8.33%)of 180 patients,but none required further treatment.32 cases(17.78%)had a postoperative adjacent vertebral fracture,and 148 patients had no postoperative adjacent vertebral fracture,and were grouped accordingly.There were statistically significant differences in age,fracture history,bone mineral density,Cobb angle,vertebral height recovery,bone cement leakage condition,and use of anti-osteoporosis drugs between the refracture group and no refracture group(P<0.05).Multivariate Logistic regression analysis showed that age>70 years old,bone cement leakage,bone mineral density<-2.5 SD,no use of anti-osteoporosis drugs,Cobb angle<15°,vertebral height recovery rate>87%were all risk factors for adjacent vertebral fracture after PVP(P<0.05).Conclusion:PVP has a good effect in the treatment of OVCFs,which can relieve pain,reduce dysfunction and improve mobility of patients.The occurrence of vertebral fracture is affected by age,bone density,Cobb angle and so on,and corresponding interventions can be given clinically for these factors.
作者
王强
张骏
王天
刘万舜
谭章勇
WANG Qiang;ZHANG Jun;WANG Tian;LIU Wan-shun;TAN Zhang-yong(Department of Orthopaedics,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu,221000,China;Department of Orthopaedics,Xuzhou Mine Hospital,Xuzhou,Jiangsu,221000,China;Department of Orthopaedics,Jiangsu Provincial People’s Hospital,Nanjing,Jiangsu,210029,China;Department of Orthopaedics,904 Hospital of Joint Service Support Force of Chinese People’s Liberation Army,Wuxi,Jiangsu,214044,China)
出处
《现代生物医学进展》
CAS
2021年第21期4095-4099,共5页
Progress in Modern Biomedicine
基金
江苏省2017年度卫生计生委医学科研项目(H201761)。
关键词
骨质疏松性椎体压缩骨折
邻近椎体骨折
疗效
经皮椎体成形术
危险因素
Osteoporotic vertebral compression fracture
Adjacent vertebral fracture
Curative effect
Percutaneous vertebroplasty
Risk factors
