PKP治疗骨质疏松性压缩骨折后椎体再骨折的原因分析

Cause analysis of vertebral body re-fracture after PKP treatment of osteoporotic compression fracture

关键词:  经皮椎体后凸成形术  骨质疏松压缩骨折  再骨折

Key words:  percutaneous keratoplasty  osteoporosis compression fractures  the vertebral body fracture again

摘要:

目的　探讨经皮椎体后凸成形术(PKP)治疗骨质疏松压缩骨折(OVCF)后椎体再骨折的原因。方法　收集2013年1月至2015年1月行PKP治疗的OVCF患者206例，共399个椎体。未发生椎体再骨折的作为首次组（185例共364个)；手术后发生椎体再骨折的作为再次组（21例共35个)，都再次行PKP治疗。根据首次及再骨折病例的临床资料、影像特点与随访结果进行分析。结果　再次组骨水泥量（4.08±2.12）mL、伤椎前缘高度恢复程度值(0.58±0.10)均高于首次组［(3.53±1.55)mL和（0.49±0.08）］（P<0.05）；而骨密度T值(-3.89±0.68)低于首次组(-3.16±1.55)（P<0.05）。结论　低骨密度、超量骨水泥注入、伤椎前缘高度过度复位可能是PKP术后继发非手术椎体再骨折的高危因素。

Abstract:

ObjectiveTo investigate the causes of vertebral body re-fracture after percutaneous kyphoplasty (PKP) treatment of osteoporotic vertebral compression fractures (OVCF).MethodsFrom January 2013 to January 2015, 206 patients with OVCF were treated with PKP, with a total of 399 vertebral bodies. The first group (185 cases) had no vertebral fracture after surgery (with a total of 364 vertebral bodies). The patients with vertebral fracture after surgery were divided as the second group (21 patients with a total of 35 vertebral bodies) and were treated with PKP again. Clinical data, imaging characteristics and follow-up results of the first and second fracture cases were analyzed.ResultsIn the second group, the cement content and recovery degree of the anterior height of the injured vertebrae were higher than those in the first group (P<0.05), while the bone mineral density (T) was lower than that in the first group (P< 0.05). ConclusionLow bone mineral density, excessive bone cement injection, and excessive reduction of the height of the injured vertebra are maybe the risk factors of the secondary vertebral fracture after PKP.