摘要
Abstract
Objective To explore the related factors of fracture recurrence after percutaneous vertebroplas-ty(PVP)in the patients with osteoporotic vertebral compression fracture(OVCF),and to construct a risk predictive model.Methods A retrospective analysis was conducted on 345 cases of OVCF received the treat-ment in this hospital from January 2017 to November 2020.All selected patients underwent the PVP treat-ment and were followed up for at least 2 years.The patients were divided into the non-fracture group(289 ca-ses)and re-fracture group(56 cases)according to the postoperative fracture recurrence.The related indicators were collected and compared between the two groups,including age,gender,body mass index(BMI),fracture segment,history of diabetes,bone mineral density,surgical conditions and postoperative anti-osteoporosis treatment situation.The multivariate Logistic regression was adopted to analyze the independent influencing factors for the recurrent fracture occurrence after PVP in the patients with OVCF and the risk predictive mod-el was constructed on this basis.The receiver operating characteristic(ROC)curve was used to test the pre-dictive effect of the risk predictive model on recurrent fractures after PVP treatment in OVCF patients,and the Hosmer-Lemeshow test was used to judge the goodness of fit of the model.Results There were statisti-cally significant differences in the age,bone mineral density,bone cement leakage,number of vertebral bodies in initial fracture and bisphosphonates medication between the two groups(P＜0.05),while there were no statistically significant differences in the gender,BMI,fracture segment,history of diabetes,Cobb angle,punc-ture mode,PVP for the first time and the amount of bone cement injection between the two groups(P＞0.05).The multivariate Logistic regression analysis showed that the bone mineral density value,cement leak-age,number of first fractured vertebrae and administration of bisphosphonates were the independent influen-cing factors for postoperative fracture recurrence of the patients(P＜0.05);the risk predictive model:Logit(P)=-21.635+2.697 × X bone density+0.948 × X leakage of bone cement+2.419 × X number of vertebral bodies in initial fracture+1.156 × X bisphosphate medication.The area under the curve(AUC)of the risk predictive model for predicting recurrent fracture after PVP in OVCF patients was 0.921(95％CI:0.874-0.967),with a sensitivity of 76.80％and a specifici-ty of 94.80％.The Hosmer-Lemeshow test showed that x2=7.157,P=0.520,the model had the good fitting validity and high predictive value.Conclusion The BMD value,bone cement leakage,number of vertebra in primary fracture and bisphosphonates medication all are the independent influencing factors for the recurrence of fractures after PVP in OVCF patients.The constructed risk predictive model for postoperative recurrence fracture after PVP in OVCF patients has good predictive efficacy,which can evaluate the risk of postoperative recurrence fracture recurrence after PVP in OVCF patients,could be used to evaluate the fracture recurrence risk after PVP in OVCF patients and provide the guidance for clinically formulating the interventional meas-ures in postoperative fracture recurrence.关键词
骨质疏松性骨折/压缩骨折/再发骨折/影响因素Key words
osteoporotic fracture/compression fracture/recurrent fracture/influencing factor分类
医药卫生
