【作者】 李军；

【导师】 郝延科；

【作者基本信息】 山东中医药大学 ， 中医骨伤科学（专业学位）， 2015， 硕士

【摘要】 目的:探讨经皮椎体成形术后再发椎体骨折的危险因素分析。方法:收集2011年12月至2012年12月山东中医药大学附属医院脊柱骨科收治的行椎体骨质疏松性压缩骨折经皮穿刺椎体成形术(PVP)治疗的骨质疏松椎体压缩性骨折(OVCFs)患者126例,随访期间记录再发椎体骨折情况,根据是否发生骨折分为骨折组(n=50)和非骨折组(n=76)。再发骨折的患者根据是否为邻近骨折分为邻近骨折组(n=31)和非邻近骨折组(n=19)。比较分析各组的影响因素差异性,并采用Logistic多因素分析,以了解其独立危险因素。结果:骨折组糖皮质激素使用、BMD的T值≤-2.5SD、手术部位在T10-L2、椎体裂隙征、骨水泥椎间盘内渗漏的比例明显高于非骨折组(P<0.05),BMD、椎体高度恢复率明显低于非骨折组(P<0.05)。患者年龄、手术部位、骨密度、糖皮质激素使用、椎体裂隙征、骨水泥椎间盘内渗漏是PVP术后新发骨折的独立危险因素(P<0.05)。邻近椎体骨折组的BMD明显低于非邻近椎体骨折组,椎体裂隙征、骨水泥椎间盘内渗漏的比例明显高于非邻近椎体骨折组(P<0.05)。患者手术部位、BMD、椎体裂隙征、骨水泥椎间盘内渗漏是PVP术后新发骨折的独立危险因素(P<0.05)。结论:行PVP术治疗的OVCFs患者发生术后再发椎体骨折和邻近椎体骨折与骨质疏松程度密切相关,随着年龄的增加、骨密度值的降低,再发骨折及邻近椎体骨折的发生率也明显增大,而糖皮质激素的长期应用也会增加骨折的风险。更多还原

【Abstract】 Objective: to analyze risk factors of percutaneous vertebroplasty new vertebral f racture.Methods: 126 patients with osteoporotic vertebral compression fracture(OVCF s) who were treated with PVP in orthopedics depart ofour hospital from Dec,2011 t o Dec,2012 were selected,they were followed up and recorded new vertebral fracture s conditions, they were divided into fracture group(n=50) and non fracture group(n=76)according to whether fracture.New fracture patients were divided into adjacent fractu res group(n=31) and non contiguous fracture group(n=19) according to whether adja cent fractures.the influence factors’ s difference were comparied,Logistic multi factor analysis were done in order to find out independent risk factors.Results: the ratio of glucocorticoid use, BMD T ≤-2.5SD, operation site at T10-L2, vertebral cleft, bone cement intradiscal leakage in fracture group were significantl y higher than those of non fracture group(P <0.05), BMD, vertebral height restorati on rate were significantly lower than those in non fracture group(P < 0.05). The pati entage, operationsite, bonemineraldensity, glucocorticoid use, vertebralfracture syndrom e, bone cement intradiscal leakage were independent risk factor for postoperative PV P new fracture(P<0.05). the BMD of adjacent vertebral fracture group were signifi cantly lower than that of non adjacent vertebral fracture group, the ratio of vertebra l fracture syndrome, bone cementintradiscal leakage were significantly higher thanthose in non adjacent vertebral fracture group(P<0.05).Operation site, BMD,vertebral cleftsyndrome,bone cement intradiscal leakage were independent risk factors for PVP po stoperative new fracture(P<0.05).Conclusion: New vertebral fractures and adjacent vertebral fractures in OVCF s patients who has done PVP operation are closely related to osteoporosis, with agedecreasing, bone density reducing, the new fractures and adjacent vertebral fracturesare also significantly increased, long term application of glucocorticoids may increa se the fracture risk.更多还原