【摘要】 目的 探讨经皮椎体后凸成形术(percutaneous kyphoplasty, PKP)治疗下腰椎骨质疏松椎体压缩性骨折(osteoporotic vertebral compression fracture, OVCF)合并腰椎椎管狭窄症(lumbar spinal stenosis, LSS)过程中改善下肢神经症状的因素。方法 回顾性分析滨州医学院附属医院2020年1月至2022年12月行PKP治疗的109例OVCF合并LSS患者。按术后下肢神经症状改善情况分成改善组与未改善组，改善组共24例，未改善组85例，采用单项因素比较和二元多因素逻辑回归探讨影响PKP术后改善下肢神经症状的因素。结果 所有患者均顺利完成手术，均无严重并发症。单因素比较，两组在年龄、性别、骨密度、椎体压缩度、骨折节段、腰痛病程、手术时间、骨水泥注入量、术后下地时间及完全负重时间差异均无统计学意义。与改善组相比，未改善组的下肢神经症状病程显著延长(P<0.05),腰椎椎管狭窄程度显著加重(P<0.05)。二元多因素逻辑回归表明，腰椎椎管狭窄程度轻(OR=0.036,P<0.05)与下肢神经症状病程短OR=0.593,P<0.05)是影响PKP术后下肢神经症状改善的独立影响因素。结论 腰椎椎管狭窄程度轻和下肢神经症状病程短是影响PKP术后下肢神经症状改善的独立影响因素，更严重的腰椎椎管狭窄程度和更长下肢症状病程，会降低术后下肢症状改善的几率。对于下肢症状未改善的患者，应继续治疗腰椎椎管狭窄症。更多还原

【Abstract】 Objective To investigate factors that improve lower extremity neurological symptoms during the treatment of lower lumbar vertebral osteoporotic compression fracture(OVCF) combined with lumbar spinal stenosis(LSS) by percutaneous kyphoplasty(PKP).Methods A retrospective analysis was performed on 109 patients with OVCF combined with LSS who received PKP treatment in Binzhou Medical University Hospital from January 2020 to December 2022. According to the improvement of lower extremity nerve symptoms after the surgery, the patients were divided into the improved group and the non-improved group, with 24 cases in the improved group and 85 cases in the non-improved group. Univariate comparison and binary multifactor logistic regression were used to investigate the factors affecting the improvement of lower extremity neurological symptoms after PKP.Results All patients were successfully operated on without serious complications. In term of univariate comparison, there were no significant differences between the two groups in age, gender, bone mineral density, vertebral compression, fracture stage, low back pain course, operation time, bone cement injection amount, postoperative time of getting off the bed and complete weight bearing time. Compared with that in the improved group, the course of lower limb nerve symptoms in the non-improved group was significantly prolonged(P<0.05), and the degree of lumbar spinal canal stenosis was significantly aggravated(P<0.05). As results of binary multifactor logistic regression, a mild degree of lumbar spinal stenosis(OR=0.036, P<0.05), and a short course of lower extremity neurological symptoms(OR=0.593, P<0.05) were independent risk factors improving lower extremity neurological symptoms after PKP.Conclusion The mild degree of lumbar spinal stenosis and the short course of lower extremity neurological symptoms are independent influencing factors the improvement of lower extremity neurological symptoms after PKP. A more severe degree of lumbar spinal stenosis and a longer course of lower extremity symptoms can reduce the likelihood of postoperative improvement. The treatment for lumbar spinal stenosis should be continued for patients whose symptoms do not improve.更多还原