【摘要】 目的分析脊柱-骨盆矢状面平衡状态对骨质疏松性椎体压缩性骨折经皮椎体成形术(peicutaneous vertebroplasty,PVP)后继发骨折的影响。方法收集2016年10月至2018年10月郴州市第一人民医院脊柱外科收治的90例行PVP治疗的骨质疏松性椎体压缩性骨折患者的病历资料,根据术后是否出现继发骨折将其分为继发组(26例)与非继发组(64例),对比两组患者矢状面偏移距离(sagittal vertical axis,SVA)、胸椎后凸角(thoracic kyphosis,TK)、腰椎前凸角(lumbar lordosis,LL)、骶骨倾斜角(sacral slope,SS)、骨盆倾斜角(pelvic tilt,PT)、骨盆入射角(pelvic incidence,PI)等脊柱-骨盆矢状面平衡参数,分析其对患者继发骨折的影响。结果继发组患者SVA明显长于非继发组(t=4.236,P=0.000),TK明显大于非继发组(t=3.213,P=0.002),LL、SS、PT、PI明显小于非继发组(t=3.834、3.455、2.423、2.722,P=0.000、0.001、0.017、0.008)。结论脊柱-骨盆矢状面平衡状态越差,骨质疏松性椎体压缩性骨折PVP术后继发骨折的风险越高,术前及术后均应高度重视脊柱-骨盆矢状面平衡参数,以指导防治方案,提高患者预后。更多还原

【Abstract】 Objective To analyze the effect of spine-pelvic sagittal balance on the secondary fractures after percutaneous vertebroplasty(PVP) for osteoporotic vertebral compression fractures.Methods Medical records of 90 patients with osteoporotic vertebral compression fracture,admitted to Department of Spinal Surgery of Chenzhou No.1 people’s Hospital from October 2016 to October 2018 and treated with PVP,were collected.Based on the occurrence of secondary fractures after the surgery,the patients were divided into a secondary fracture group(26 cases) and a non-secondary fracture group(64 cases).Spinal-pelvic sagittal balance parameters,such as sagittal vertical axis(SVA),thoracic kyphosis(TK),lumbar lordosis(LL),sacral slope(SS),pelvic tilt(PT),and pelvic incidence(PI) were compared between the two groups to analyze their effect on patients’ secondary fracture.Results Compared with the non-secondary fracture group,the SVA in the secondary fracture group was significantly longer(t=4.236,P=0.000),TK was significantly greater(t=3.213,P=0.002),and LL,SS,PT,and PI were significantly smaller(t=3.834,3.455,2.423 and 2.722 respectively,P=0.000,0.001,0.017 and 0.008 respectively).Conclusion The more imbalanced the spin-pelvis sagittal plane is,the higher the risk of having secondary fracture after PVP for osteoporotic vertebral compression fracture is.Before and after the PVP operation,great attention should be paid to the parameters of spin-pelvis sagittal plane balance,which can offer guidance for the prevention and treatment scheme to improve the prognosis of patients.更多还原