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[1]李格,梅偉,劉沛霖,等.骨質(zhì)疏松性椎體壓縮骨折經(jīng)皮椎體成形術(shù)后鄰近椎體再骨折的危險因素探討[J].中醫(yī)正骨,2016,28(06):18-20.
　LI Ge,MEI Wei,LIU Peilin,et al.Investigation on risk factors for adjacent vertebral refractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(06):18-20.
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骨質(zhì)疏松性椎體壓縮骨折經(jīng)皮椎體成形術(shù)后鄰近椎體再骨折的危險因素探討()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年06期
頁碼:
18-20
欄目:
臨床研究
出版日期:
2016-06-20

文章信息/Info

Title:
Investigation on risk factors for adjacent vertebral refractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures
作者:
李格1; 梅偉2; 劉沛霖2; 毛克政2
1.河南省中醫(yī)院,河南 鄭州 450002;
2.河南省鄭州市骨科醫(yī)院,河南 鄭州 450052
Author(s):
LI Ge1; MEI Wei2; LIU Peilin2; MAO Kezheng2
1.Henan Provincial Hospital of TCM,Zhengzhou 450002,Henan,China
2.Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,Henan,China
關(guān)鍵詞:
脊柱骨折;  骨質(zhì)疏松性骨折;  骨折; 壓縮性;  椎體成形術(shù);  手術(shù)后并發(fā)癥;  再骨折;  危險因素;  臨床試驗
Keywords:
spinal fractures;  osteoporotic fractures;  fractures; compression;  vertebroplasty;  postoperative complications;  refractures;  risk factors;  clinical trail
摘要:
目的:探討骨質(zhì)疏松性椎體壓縮骨折經(jīng)皮椎體成形術(shù)(percutaneous vertebroplasty,PVP)后鄰近椎體再骨折的危險因素。方法:收集采用PVP治療的225例骨質(zhì)疏松性椎體壓縮骨折患者的病例資料。按照PVP術(shù)后是否發(fā)生鄰近椎體骨折,將患者分為再骨折組和未再骨折組。統(tǒng)計分析患者的性別、年齡、初次骨折椎體數(shù)量、術(shù)前椎體骨密度降低值、單個椎體骨水泥注射量、骨水泥椎間盤滲漏率和再骨折發(fā)生時間。結(jié)果:再骨折組31例,未再骨折組194例。再骨折組鄰近椎體再骨折時間為PVP術(shù)后10 d至48個月,中位數(shù)13個月。再骨折組男8例、女23例,未再骨折組男39例、女155例; 2組患者的性別比較,差異無統(tǒng)計學意義(χ2=0.171,P=0.679)。再骨折組初次骨折椎體數(shù)量<3椎27例、≥3椎4例,未再骨折組初次骨折椎體數(shù)量<3椎183例、≥3椎11例; 2組患者初次骨折椎體數(shù)量比較,差異無統(tǒng)計學意義(χ2=1.235,P=0.266)。2組患者單個椎體骨水泥注射量比較,差異無統(tǒng)計學意義[(3.59±1.45)mL,(4.97±1.06)mL,t=0.624,P=0.542]。再骨折組的患者年齡大于未再骨折組[(75.34 ± 4.79)歲,(72.59 ± 6.67)歲,t=1.216,P=0.000],術(shù)前椎體骨密度降低值大于未再骨折組[(2.92±0.25)SD,(2.75±0.38)SD,t=1.127,P=0.031]。再骨折組骨水泥椎間盤滲漏12例,未再骨折組骨水泥椎間盤滲漏15例,再骨折組的骨水泥椎間盤滲漏率高于未再骨折組(χ2=21.444,P=0.000)。結(jié)論:高齡、骨水泥椎間盤滲漏及椎體骨密度降低可能是導(dǎo)致骨質(zhì)疏松性椎體壓縮骨折PVP術(shù)后鄰近椎體再骨折的危險因素。
Abstract:
Objective:To explore the risk factors for adjacent vertebral refractures after percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fractures.Methods:The medical records of 225 patients with osteoporotic vertebral compression fractures who were treated with PVP were collected.The patients were divided into refracture group(31 cases)and non-refracture group(194 cases)according to whether the adjacent vertebral fractures happened after PVP.The gender,age,number of initial fractured vertebral bodies,decreased value of preoperative vertebral bone mineral density,consumption of bone cements that were injected into single vertebral body,incidence rate of leakage of bone cements into intervertebral disc and the occurrence time of refractures were analyzed.Results:The occurrence time of adjacent vertebral refractures ranged from 10 days to 48 months(Median=13 months)after PVP in refracture group.The patients consisted of 8 males and 23 females in refracture group and the patients consisted of 39 males and 155 females in non-refracture group.There was no statistical difference in constituent ratio of gender between the 2 groups(χ2=0.171,P=0.679).The number of initial fractured vertebral bodies was<3 in 27 cases and≥3 in 4 cases in refracture group,while it was<3 in 183 cases and≥3 in 11 cases in non-refracture group.There was no statistical difference in the number of initial fractured vertebral bodies between the 2 groups(χ2=1.235,P=0.266).There was no statistical difference in consumption of bone cements that were injected into single vertebral body between the 2 groups(3.59+/-1.45 vs 4.97+/-1.06 ml,t=0.624,P=0.542).The patients were older and the decreased values of preoperative vertebral bone mineral density were greater in refracture group compared to non-refracture group(75.34+/-4.79 vs 72.59+/-6.67 yrs, t=1.216,P=0.000; 2.92+/-0.25 vs 2.75+/-0.38 SD,t=1.127,P=0.031).The leakage of bone cements into intervertebral disc was found in refracture group(12 cases)and non-refracture group(15 cases),and the incidence rate of leakage of bone cements into intervertebral disc was higher in refracture group compared to non-refracture group(χ2=21.444,P=0.000).Conclusion:Great age,leakage of bone cements into intervertebral disc and decrease in vertebral bone mineral density may be the risk factors which lead to the adjacent vertebral refractures after PVP in patients with osteoporotic vertebral compression fractures.

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通訊作者:梅偉 E-mail:[email protected]
更新日期/Last Update: 2016-06-30