The Department of Orthopaedics, the First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, Jiangsu, China.
BMC Musculoskelet Disord. 2024 Mar 12;25(1):210. doi: 10.1186/s12891-024-07295-3.
To explore the effect of sarcopenia on recurrent fractures of adjacent vertebra after percutaneous kyphoplasty (PKP).
A total of 376 osteoporotic vertebral compression fractures (OVCFs) patients over 55 years old who were admitted to the Hospital from August 2020 to January 2021 were selected. Among them, 38 patients with recurrent fractures in adjacent vertebra after PKP were selected as the refracture group (RG), and the remaining 338 patients were selected as the non-refracture group (NRG). The age, gender, grip strength, body mass index (BMI), bone mineral density (BMD), visual analogue scale (VAS) of pain before and one month after surgery, Oswestry disability index (ODI) before and one month after surgery and the occurrence of sarcopenia were compared between the two groups. Logistic regression analysis was used to evaluate the effect of related risk factors on refracture after vertebral PKP.
The results of t-test and Chi-square test showed that there were no obvious differences in gender, BMI, preoperative VAS score (t=-0.996, P = 0.320) and ODI (t=-0.424, P = 0.671), one month postoperative VAS score (t=-0.934, P = 0.355) and ODI score (t=-0.461, P = 0.645). while the age and grip strength showed significant differences between the two groups. Logistic regression analysis showed that BMI and gender had no significant effect on refracture after PKP, while sarcopenia and advanced age were independent risk factors for refracture after PKP. Also, increased BMD was a protective factor for refracture after PKP.
Sarcopenia is an independent risk factor for recurrent fractures after PKP in OVCF patients. The screening and diagnosis of sarcopenia should be strengthened. At the same time, anti-sarcopenia treatment should be actively performed after surgery.
探讨肌少症对经皮椎体后凸成形术(PKP)后邻近椎体再骨折的影响。
选取 2020 年 8 月至 2021 年 1 月我院收治的 376 例年龄大于 55 岁的骨质疏松性椎体压缩骨折(OVCF)患者,其中 PKP 后出现相邻椎体再骨折的 38 例患者设为再骨折组(RG),其余 338 例患者为非再骨折组(NRG)。比较两组患者的年龄、性别、握力、体质量指数(BMI)、骨密度(BMD)、术前及术后 1 个月疼痛视觉模拟评分(VAS)、术前及术后 1 个月 Oswestry 功能障碍指数(ODI)及肌少症发生情况。采用 Logistic 回归分析评估相关危险因素对椎体 PKP 后再骨折的影响。
t 检验和卡方检验结果显示,两组患者的性别、BMI、术前 VAS 评分(t=-0.996,P=0.320)和 ODI(t=-0.424,P=0.671)、术后 1 个月 VAS 评分(t=-0.934,P=0.355)和 ODI 评分(t=-0.461,P=0.645)比较差异均无统计学意义,而年龄和握力比较差异有统计学意义。Logistic 回归分析显示,BMI 和性别对 PKP 后再骨折无显著影响,而肌少症和高龄是 PKP 后再骨折的独立危险因素,增加 BMD 是 PKP 后再骨折的保护因素。
肌少症是 OVCF 患者 PKP 后再发骨折的独立危险因素,应加强对肌少症的筛查和诊断,同时术后应积极进行抗肌少症治疗。