Komemushi Atsushi, Tanigawa Noboru, Kariya Shuji, Kojima Hiroyuki, Shomura Yuzo, Komemushi Sadao, Sawada Satoshi
Department of Radiology, Kansai Medical University, 10-15 Fumizono, Moriguchi, Osaka, 570-8507, Japan.
Cardiovasc Intervent Radiol. 2006 Jul-Aug;29(4):580-5. doi: 10.1007/s00270-005-0138-5.
To investigate the risk factors and relative risk of new compression fractures following vertebroplasty.
Initially, we enrolled 104 consecutive patients with vertebral compression fractures caused by osteoporosis. A total of 83 of the 104 patients visited our hospital for follow-up examinations for more than 4 weeks after vertebroplasty. Logistic regression analysis of the data obtained from these 83 patients was used to determine relative risks of recurrent compression fractures, using 13 different factors.
We identified 59 new fractures in 30 of the 83 patients: 41 new fractures in vertebrae adjacent to treated vertebrae; and 18 new fractures in vertebrae not adjacent to treated vertebrae. New fractures occurred in vertebrae adjacent to treated vertebrae significantly more frequently than in vertebrae not adjacent to treated vertebrae. Only cement leakage into the disk was a significant predictor of new vertebral body fracture after vertebroplasty (odds ratio = 4.633). None of the following covariates were associated with increased risk of new fracture: age, gender, bone mineral density, the number of vertebroplasty procedures, the number of vertebrae treated per procedure, the cumulative number of vertebrae treated, the presence of a single untreated vertebra between treated vertebrae, the presence of multiple untreated vertebrae between treated vertebrae, the amount of bone cement injected per procedure, the cumulative amount of bone cement injected, cement leakage into the soft tissue around the vertebra, and cement leakage into the vein.
探讨椎体成形术后新发压缩性骨折的危险因素及相对风险。
最初，我们纳入了104例因骨质疏松导致椎体压缩性骨折的连续患者。104例患者中有83例在椎体成形术后4周以上到我院进行随访检查。对这83例患者的数据进行逻辑回归分析，使用13个不同因素来确定复发性压缩性骨折的相对风险。
我们在83例患者中的30例中发现了59处新骨折：41处新骨折发生在治疗椎体相邻的椎体；18处新骨折发生在与治疗椎体不相邻的椎体。治疗椎体相邻椎体的新骨折发生率明显高于与治疗椎体不相邻的椎体。椎体成形术后，仅骨水泥渗漏至椎间盘是椎体新骨折的显著预测因素（比值比=4.633）。以下协变量均与新骨折风险增加无关：年龄、性别、骨密度、椎体成形术的次数、每次手术治疗的椎体数量、累计治疗的椎体数量、治疗椎体之间存在单个未治疗椎体、治疗椎体之间存在多个未治疗椎体、每次手术注入的骨水泥量、累计注入的骨水泥量、骨水泥渗漏至椎体周围软组织以及骨水泥渗漏至静脉。
