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[经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折后二次骨折的相关因素]

[Correlative factors of secondary fracture after percutaneous kyphoplasty for osteoporotic vertebral compression fracture].

作者信息

Zhou Jianwei, Ma Huasong, Zou Dewei, Tan Rong, Wang Dong, Zheng Rui

机构信息

Chinese PLA Postgraduate Medical School, PLA General Hospital, Beijing 100853, PR China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Oct;25(10):1180-3.

Abstract

OBJECTIVE

To analyse the correlative factors of secondary vertebral fracture after percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral compression fracture (OVCF) at different levels (adjacent and/or nonadjacent levels).

METHODS

Between December 2002 and May 2008, 84 patients with OVCF were treated with PKP, and the clinical data were analysed retrospectively. There were 11 males and 73 females with an average age of 70.1 years (range, 55-90 years). All patients were followed up 24-96 months (mean, 38 months). Secondary vertebral fracture occurred in 12 cases at 3-52 months after PKP (secondary fracture group), no secondary fracture in 72 cases (control group) at over 24 months. The preoperative bone mineral density, postoperative vertebral height compression rate, postoperative Cobb angle, amount of injected bone cement per vertebra, puncture pathway (uni- or bilateral puncture), age, gender, number of fracture segment, and cement intradiscal leakage were compared between 2 groups to find correlative factors of secondary vertebral fractures.

RESULTS

There was no significant difference in preoperative bone mineral density, postoperative vertebral height compression rate, postoperative Cobb angle, amount of injected bone cement per vertebra, puncture pathway, age, gender, and number of fracture segment between 2 groups (P > 0.05). But the incidence of cement intradiscal leakage was much higher in secondary fracture group than in control group (chi2 = 5.294, P = 0.032).

CONCLUSION

Cement intradiscal leakage may be the correlative factor of secondary vertebral fracture after PKP in OVCF.

摘要

目的

分析经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)后不同节段(相邻和/或非相邻节段)发生继发性椎体骨折的相关因素。

方法

回顾性分析2002年12月至2008年5月期间采用PKP治疗的84例OVCF患者的临床资料。其中男性11例,女性73例,平均年龄70.1岁(55 - 90岁)。所有患者随访24 - 96个月(平均38个月)。PKP术后3 - 52个月有12例发生继发性椎体骨折(继发性骨折组),72例术后超过24个月未发生继发性骨折(对照组)。比较两组患者术前骨密度、术后椎体高度压缩率、术后Cobb角、每个椎体注入骨水泥量、穿刺路径(单侧或双侧穿刺)、年龄、性别、骨折节段数及骨水泥椎间盘内渗漏情况,以找出继发性椎体骨折的相关因素。

结果

两组患者术前骨密度、术后椎体高度压缩率、术后Cobb角、每个椎体注入骨水泥量、穿刺路径、年龄、性别及骨折节段数比较,差异均无统计学意义(P > 0.05)。但继发性骨折组骨水泥椎间盘内渗漏发生率明显高于对照组(χ2 = 5.294,P = 0.032)。

结论

骨水泥椎间盘内渗漏可能是OVCF患者PKP术后继发性椎体骨折的相关因素。

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