椎体成形术治疗骨质疏松压缩性骨折后再发骨折的临床分析-clinical analysis of vertebroplasty in the treatment of recurrent fractures after osteoporotic compression fractures.docxVIP

椎体成形术治疗骨质疏松压缩性骨折后再发骨折的临床 研究 中 文 摘 要 目 的 ：研究经皮穿刺椎体成形术（percutaneous vertebroplasty，PVP） 在治疗骨质疏松性脊柱压缩性骨折（osteoporosis vertebral compression fracture，OVCF）后再发骨折的相关危险因素。 方法： 回顾性分析行经皮穿刺椎体成形术在治疗骨质疏松压缩性 骨折例 264 例（394 个椎体）的患者，分为 A 组（再发骨折组）30 例， B 组（未再发骨折组）234 例。随访时间平均（26.50±5.50）个月，记 录术后再发骨折的时间、发生率、部位，记录患者的性别、年龄、穿刺 方法、骨水泥量、QCT 值、原发椎体平均数目、椎体高度恢复率、骨水 泥渗漏、手术前后 VAS 评分、椎体后凸角等因素并对以上因素进行分析。 结果：所有患者均成功完成手术，椎体成形术后的首次再发骨折的 发生率为 7%，时间为（9.34±8.34）个月，第 2、3 次再次发生骨折在 3 个月内。骨水泥渗漏率为 9%，渗漏后无临床症状发生。性别、年龄、穿 刺方法、骨水泥量、骨水泥渗漏、原发椎体平均数目、椎体后凸角度 （Cobb）、椎体高度恢复率等因素在 A 组和 B 组间差异均无统计学意义 （P0.05）；术前及术后第 3 天 VAS 评分在 A 组、B 组两组内比较有显 著意义 （P0.05 ），终末随访 VAS 评分在两组间对比有统计学意义 （P0.05）；QCT 值在 A 组和 B 组两间统计学有显著意义（P0.05）。 结论： 老年人骨质疏松性脊柱压缩性骨折的患者行椎体成形术治 疗后，能够取得很满意的临床治疗效果，术后再发骨折发好于术后 9 个 月内，骨密度是 PVP 后再发骨折的一个危险因素。 关键词： 椎体成形术，骨质疏松症，脊柱骨折，再发骨折 Clinical study of refractures factors of osteoporot- ic vertebral compression fractures treated by per- cutaneous vertebroplasty ABSTRACT Objective: To investigate the associated risk factors of percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCF) following fracture. Methods: By retrospective analysis,264 cases(394 vertebrae)patients of osteoporotic compression fractures treated by percutaneous vertebroplasty,w- ere divided into 21 cases as A group (refracture group), while the other 243 cases(no refracture group) were termed as group B.The follow-up time averaged (16.50 ± 6.50) months,factors such as time,location and incidence rate of refracture,and patients age,gender,puncture methods, the amount of bone cement,the average numbers of primary centrum,QCT value,leakage of bone cement,the recovery rates of vertebral height,VAS scores before and after operation,kyphosis angle,were recorded and analyzed. Results: All patients were successfully completed the operation, the incidence rate of the first-refracture was 7%,the time was (9.34 ± 8.34) months,while the second and the third was occurred in 3 months.The rate of bone cemen