经皮椎体成形术后手术椎体再发骨折因素剖析.docVIP

经皮椎体成形术后手术椎体再发骨折因素剖析 　　【摘要】 目的：分析经皮椎体成形（PVP）术后手术椎体再发骨折的危险因素，为采取预见性干预措施提供参考。方法：本院2013年1月-2014年6月收治的149例（212个椎体）行椎体压缩性骨折患者均行PVP术治疗，术后随访3～12个月，其中21例（29个椎体）术后再发骨折，分析再发骨折的原因。结果：填充材料、术后平均后凸角矫正度数大、胸腰椎活动度大、骨密度（T值）低、初始骨折节段为T11～L2、未接受抗骨质疏松治疗是PVP手术椎体再骨折的影响因素（P0.05）。多因素Logistic回归分析，骨密度、胸腰椎活动度、术后平均后凸角矫正度数大、初始骨折节段T11～L2是PVP手术椎体骨折的主要影响因素，而抗骨质疏松治疗是手术椎体再骨折的保护因素（P0.05）。结论：影响PVP术后手术椎体再发骨折的危险因素较多，有患者自身因素，也有医源性因素。因此建议后凸角矫正度数应根据患者骨密度情况，避免过度矫正，骨密度低的患者应减少胸腰椎活动度，并坚持抗骨质疏松药物治疗，以阻止或延长椎体再发骨折的周期。 　　【关键词】 经皮椎体成形术； 手术椎体； 再发骨折； 因素 　　【Abstract】 Objective：To analyze the risk factors of surgical vertebral recurrent fractures after percutaneous vertebroplasty（PVP），and to provide reference for the intervention measures.Method：149 patients（212 vertebral bodies） with vertebral compression fractures were treated with percutaneous vertebroplasty（PVP） in our hospital from January 2013 to June 2014 and followed up for 3-12 months，21 patients（29 vertebral bodies） were postoperative recurrence of fracture，the causes of recurrent fractures were analyzed.Result：The filling materials，postoperative average angle correction of high degree，activity of thoracic lumbar spine，low bone mineral density （T value），the initial fracture segments to T11-L2，did not receive the osteoporosis treatment were the influencing factors of PVP surgical vertebral recurrent fractures（P0.05）.Multivariate Logistic regression analysis showed that bone mineral density，thoracic and lumbar activity，postoperative average angle correction degree，initial fracture segment T11-L2 were the main influence factors of PVP for the treatment of vertebral fracture，and anti osteoporosis treatment was surgical vertebral fracture protective factor（P0.05）.Conclusion：There are many risk factors of postoperative vertebral fractures in patients wth PVP，such as the patients’ own factors，also have medical source factors.Therefore recommended angle correction cycle should be the degree according to patients with bone mineral density and avoid excessive correctio