经皮椎体成形术后非手术椎体骨折的危险因素分析

目的:探讨骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCFs)患者经皮椎体成形术(percutaneous vertebroplasty,PVP)后非手术椎体骨折的危险因素.方法:对2009年8月至2011年9月126例行单节段PVP治疗的OVCFs患者进行回顾性分析,术后平均随访13.6个月.根据是否发生非手术椎体骨折分为骨折组和未骨折组,其中骨折组32例,男14例,女18例,年龄54～82岁,平均(67.63±7.28)岁；未骨折组94例,男40例,女54例,年龄55～76岁,平均(66.26±6.79)岁再将骨折组按部位分为邻近椎体骨折组20例和非邻近椎体骨折组12例.记录患者年龄、性别、骨密度值(bone mineral density,BMD)、骨水泥注入量、椎体高度恢复率及矢状位后凸纠正度数,分析引起非手术椎体骨折的相关危险因素.结果:骨折组与未骨折组比较,年龄、性别、BMD值、骨水泥注入量及矢状位后凸纠正角度差异无统计学意义(P＞0.05),伤椎高度恢复率差异有统计学意义(P＜0.05).邻近椎体骨折组与未骨折组比较,BMD值、矢状位后凸纠正角度差异无统计学意义(P＞0.05),骨水泥注入量及伤椎高度恢复率差异有统计学意义(P＜0.05).非邻近椎体骨折组与未骨折组比较,BMD值、骨水泥注入量、伤椎高度恢复率及矢状位后凸纠正角度差异均无统计学意义(P＞0.05).结论:椎体高度的恢复增加可能预示着OVCFs患者PVP术后非手术椎体再发骨折的风险增大,而邻近椎体骨折可能跟骨水泥注入量及椎体高度恢复均有关.

Analysis of correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures

Objective: To investigate the correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures(OVCFs). Methods: From August 2009 to September 2011,126 patients who underwent single-level PVP for OVCFs were included in this study. They were followed up with an average time of 13.6 months,divided into the refracture group and non-refracture group according to the onset of non-surgical vertebral fractures or not. In refracture group,there were 14 males and 18 females with an average age of(67.63±7.28) years(ranged,54 to 82);and in non-refracture group,there were 40 males and 54 females with an average age of (66.26±6.79) years (ranged,55 to 76). The refracture group was divided again into adjacent vertebral fracture(AVF) group (7 males and 13 females) and remote vertebral fracture(RVF) group (4 males and 8 females). The age,sex,bone mineral density(BMD),injecting bone cement volume,the recovery rate of vertebral body height,kyphosis corrected degree were recorded and the correlative factors of non-surgical vertebral fractures were analyzed. Results: There was no statistically significant differences in age,sex,BMD,injecting bone cement volume and kyphosis corrected degree between refracture group and non-refracture group(P>0.05),and there was statistically significant difference in the recovery rate of vertebral body height (P<0.05). There was no statistically significant difference in BMD,kyphosis corrected degree between adjacent vertebral fracture group and non-refracture group(P>0.05);and there was statistically significant difference in injecting bone cement volume,recovery rate of vertebral body height(P<0.05). There was no statistically significant difference in BMD,injecting bone cement volume,recovery rate of vertebral body height,kyphosis corrected degree between remote vertebral fracture group and non-refracture group(P>0.05). Conclusion: Recovery of vertebral body height may prefigure increasing risk of refracture in non-surgical vertebral body for the patient with OVCFs after PVP,and the adjacent vertebral fracture maybe concerned with injecting bone cement volume and recovery rate of vertebral body height.