Hu Hao, Cao Kai-Xue, Huang Pan, Huang Chuan-Wen, Wan Ling-Ling, Yi Li-Yan, Pu Fei-Fei
Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei, China.
Zhongguo Gu Shang. 2022 Aug 25;35(8):710-4. doi: 10.12200/j.issn.1003-0034.2022.08.002.
To analyze the risk factors for refracture of adjacent vertebrae after percutaneous vertebroplasty (PVP) in super-old patients with osteoporotic vertebral compression fractures(OVCFs).
A retrospective analysis was performed on 40 patients(age≥90 years) with OVCFs who underwent PVP between June 2012 and June 2019. There were 7 males and 33 females, age from 90 to 101 years old with an average of (94.6±1.6) years. Patients were divided into two groups according to whether adjacent vertebral refracture occurred after PVP. Among them, 20 patients occurred refracture after PVP (refracture group) and 20 patients did not occur it(control group). The general information, radiological data and pelvic parameters of the two groups were collected. The items included age, gender, body mass index (BMI), fracture site and bone mineral density(BMD) T-value, fracture to operation time, compression degree of injured vertebra, recovery degree of anterior edge of injured vertebra, bone cement injection amount, bone cement leakage, pelvic index(PI), pelvic tilt angle (PT), sacral angle(SS), et al. Factors that may be related to refracture were included in the single-factor study, and multivariate Logistic regression analysis was performed on the risk factors with statistical significance in the single-factor analysis to further clarify the independent risk factors for refracture of adjacent vertebral bodies after PVP.
There were no significant differences in age, gender, fracture site, fracture to operation time, compression degree of injured vertebra and recovery degree of anterior edge of injured vertebra between two groups (>0.05). There were significant differences in BMI, BMD T-value, bone cement injection amount and bone cement leakage rate between two groups(<0.05). The PI and PT values of the refracture group were higher than those of the control group(<0.05). There was no significant difference in SS between two groups (>0.05). Multivariate Logistic regression analysis showed that decreased BMD T-value, bone cement leakage, increased PT and PI values increased the risk of recurrence of adjacent vertebral fractures in OVCFs (<0.05).
There are many risk factors for the recurrence of adjacent vertebral fractures in super-old patients with OVCFs. Patients with high PI and PT values may be one of the risk factors.
分析超高龄骨质疏松性椎体压缩骨折（OVCFs）患者经皮椎体成形术（PVP）后相邻椎体再骨折的危险因素。
回顾性分析2012年6月至2019年6月期间接受PVP治疗的40例年龄≥90岁的OVCFs患者。其中男性7例，女性33例，年龄90～101岁，平均（94.6±1.6）岁。根据PVP术后是否发生相邻椎体再骨折将患者分为两组。其中，20例患者PVP术后发生再骨折（再骨折组），20例患者未发生再骨折（对照组）。收集两组患者的一般资料、影像学资料及骨盆参数。项目包括年龄、性别、体重指数（BMI）、骨折部位及骨密度（BMD）T值、骨折至手术时间、伤椎压缩程度、伤椎前缘恢复程度、骨水泥注入量、骨水泥渗漏、骨盆指数（PI）、骨盆倾斜角（PT）、骶骨角（SS）等。将可能与再骨折相关的因素纳入单因素研究，并对单因素分析中有统计学意义的危险因素进行多因素Logistic回归分析，以进一步明确PVP术后相邻椎体再骨折的独立危险因素。
两组患者在年龄、性别、骨折部位、骨折至手术时间、伤椎压缩程度及伤椎前缘恢复程度方面比较，差异均无统计学意义（>0.05）。两组患者在BMI、BMD T值、骨水泥注入量及骨水泥渗漏率方面比较，差异有统计学意义（<0.05）。再骨折组的PI和PT值高于对照组（<0.05）。两组患者的SS比较，差异无统计学意义（>0.05）。多因素Logistic回归分析显示，BMD T值降低、骨水泥渗漏、PT及PI值升高增加了OVCFs患者相邻椎体骨折复发的风险（<0.05）。
超高龄OVCFs患者相邻椎体骨折复发的危险因素较多。PI和PT值高的患者可能是危险因素之一。
