骨水泥体积/椎体体积比值与椎体成形术后相邻椎体压缩性骨折的相关性分析。

Correlation analysis of larger side bone cement volume/vertebral body volume ratio with adjacent vertebral compression fractures during vertebroplasty.

机构信息

Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

Graduate School of Xuzhou Medical University, Xuzhou, Jiangsu, China.

出版信息

Front Endocrinol (Lausanne). 2023 Mar 23;14:1072087. doi: 10.3389/fendo.2023.1072087. eCollection 2023.

OBJECTIVE

To investigate the correlation analysis of larger side bone cement volume/vertebral body volume ratio (LSBCV/VBV%) with adjacent vertebral compression fracture (AVCF) in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).

METHODS

A retrospective analysis of 245 OVCF patients who underwent PVP treatment from February 2017 to February 2021, including 85 males and 160 females. The age ranged from 60 to 92 years, with a mean of (70.72 ± 7.03) years. According to whether AVCF occurred after surgery, they were divided into 38 cases in the AVCF group (fracture group) and 207 cases in the no AVCF group (non-fracture group). The correlation between gender, age, bone mineral density (BMD), body mass index (BMI), thoracolumbar segment fracture, bone cement disc leakage, LSBCV, bone cement volume (BCV), VBV, LSBCV/VBV ratio (LSBCV/VBV%), and BCV/VBV% and AVCF were analyzed in both groups. Risk factors for AVCF after PVP were analyzed by multifactorial logistic regression, and then the receiver operating characteristic curves (ROC curves) were plotted to identify the critical value of LSBCV/VBV%.

RESULTS

38 patients (15.5%) developed AVCF postoperatively. Univariate analysis showed that BMD, bone cement disc leakage, LSBCV, and LSBCV/VBV% were risk factors for AVCF after PVP (P<0.05), while gender, age, BMI, thoracolumbar segment fracture, BCV, VBV, and BCV/VBV% were not significantly different in both groups (P>0.05). Multifactorial logistic regression analysis revealed that BMD, bone cement disc leakage, and LSBCV/VBV% were independent risk factors for AVCF after PVP (P<0.05). According to the ROC curve, the LSBCV/VBV% had an area under the curve of 71.6%, a sensitivity and specificity of 89.5% and 51.7%, respectively, and a critical value of 13.82%.

CONCLUSION

BMD, bone cement disc leakage and LSBCV/VBV% are independent risk factors for AVCF after PVP. With LSBCV/VBV at 13.82%, the incidence of AVCF significantly increased.

目的

探讨经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折（OVCF）时，较大侧骨水泥体积/椎体体积比（LSBCV/VBV%）与相邻椎体骨折（AVCF）的相关性分析。

方法

回顾性分析 2017 年 2 月至 2021 年 2 月期间 245 例接受 PVP 治疗的 OVCF 患者的临床资料，其中男 85 例，女 160 例；年龄 60~92 岁，平均（70.72±7.03）岁。根据术后是否发生 AVCF，将患者分为 AVCF 组（骨折组）38 例和无 AVCF 组（非骨折组）207 例。分析两组患者的性别、年龄、骨密度（BMD）、体质量指数（BMI）、胸腰椎段骨折、骨水泥弥散、LSBCV、骨水泥体积（BCV）、VBV、LSBCV/VBV 比值（LSBCV/VBV%）、BCV/VBV%与 AVCF 的相关性。多因素 logistic 回归分析 PVP 后 AVCF 的危险因素，绘制受试者工作特征曲线（ROC 曲线），确定 LSBCV/VBV%的临界值。

结果

38 例患者（15.5%）术后发生 AVCF。单因素分析显示，BMD、骨水泥弥散、LSBCV 及 LSBCV/VBV%是 PVP 后发生 AVCF 的危险因素（P<0.05），而两组患者的性别、年龄、BMI、胸腰椎段骨折、BCV、VBV、BCV/VBV%比较，差异均无统计学意义（P>0.05）。多因素 logistic 回归分析显示，BMD、骨水泥弥散、LSBCV/VBV%是 PVP 后发生 AVCF 的独立危险因素（P<0.05）。根据 ROC 曲线，LSBCV/VBV%的曲线下面积为 71.6%，灵敏度和特异度分别为 89.5%和 51.7%，临界值为 13.82%。