骨质疏松性椎体压缩性骨折椎体强化术后再骨折相关因素研究

目的探讨骨质疏松性椎体骨折椎体强化术(椎体成形PVP和椎体后凸成形PKP)术后椎体再骨折发生的临床特点和危险因素。方法回顾性分析2008年8月～2011年8月在我院行经皮椎体强化术的171例患者,其中再发椎体骨折19例27个椎体(A组),未再发骨折152例作为对照(B组)。所有患者获得随访6～16个月,平均13个月。记录患者临床资料、骨水泥注入量、测量椎体前缘椎体高度及Cobb角变化等并进行多因素Logistic回归分析;记录再次手术前、后第1天及末次随访VAS评分。结果 16个椎体发生在PVP术后相邻椎体(84.2%),其中9个椎体术后2个月内发生;骨水泥向椎间盘渗漏在A、B组间有显著性差异(P<0.05);椎体强化术在再骨折术前、后VAS评分有显著性差异(P<0.05)。结论骨质疏松性椎体再骨折发生具有一定危险因素,椎体强化术可以取得满意的治疗效果,同时应该加强骨质疏松药物治疗。

Study on related factors of refractures after vertebral body augmentation of osteoporotic vertebral compression fractures

Objective To investigate the clinical features and risk factors of refracture after vertebroplasty （PVP）/kyphoplasty （PKP） for osteoporotic vertebral compression fractures. Methods From August 2008 to August 2011, 171 with vertebral fracture patients undergoing percutaneous vertebra! augmentation （PKP/PVP） were analyzed retrospective. The patients were divided two groups： the refracture groups （19 patients, 27 vertebrae, group A） and the non refracture group （152 patients, group B）. The follow-up was got in all cases from 6 to 16 months （average 13 months）. The clinical data, injected volume of bone cement, the height of anterior margin of vertebral column and cobb angle were recorded and muhifactor logistic regression analysis were performed. VAS score of before and after the first day of reoperation and last time of follow-up were recorded. Results Sixteen vertebral fracture occured in neighbouring vertebral body（84%） after PVP and among them, 9 vertebral body refracture occured 2 months after operation. Exudative bone cement into intervertebral disc had significant difference （P〈0.05） between two groups. Vertebral body augmentation in the VSA score of refracture before and after operation had significant difference （P〈0.05）. Conclusion In the occurrence of vertebral body refracture, osteoporosis is one of main risk factors. Vetebral body augmentation would get a satisfactory therapeutic result. At the same time, it is very important to intensify the treatment of anti-osteoporotic drugs.