中国组织工程研究2024，Vol.28Issue(29)：4657-4662,6.DOI:10.12307/2024.813
经皮椎体成形术中骨水泥分布对手术及邻近椎体再发骨折的影响
Influence of bone cement distribution on surgical and adjacent vertebral refractures in percutaneous vertebroplasty
摘要
Abstract
BACKGROUND:Studies have shown that good bone cement distribution during percutaneous vertebroplasty reduces postoperative secondary vertebral fractures and helps improve prognosis.However,how to get a good distribution of bone cement is a problem for spine surgeons. OBJECTIVE:To analyze the correlation of bone cement distribution with surgical and adjacent vertebral refractures after percutaneous vertebroplasty. METHODS:A total of 193 patients with thoracolumbar compression fracture(≤2 fractured vertebrae)admitted to Xinjiang Uygur Autonomous Region Orthopedic Hospital from January 2018 to December 2022 were selected.They underwent percutaneous vertebroplasty via unilateral approach and were followed up after surgery.They were divided into fracture group(n=30)and non-fracture group(n=163)based on whether the surgical and adjacent vertebral fractures were observed during the follow-up period(more than 6 months).The basic data of the two groups were analyzed by univariate analysis.Statistically significant factors were replaced with binary logistic regression model to explore the correlation with recompression fracture of surgical and adjacent vertebrae after percutaneous vertebroplasty. RESULTS AND CONCLUSION:(1)Univariate analysis showed that there was no significant difference between the two groups in gender,body mass index,menopause age of female patients,bone cement dose,previous history,smoking history,drinking history,operation segment,operation time,and hospital stay(P>0.05).There were significant differences in age,bone mineral density T value,bone cement leakage,and bone cement distribution between the two groups(P<0.05).(2)Binary logistic regression analysis showed that age(95%CI:1.016-1.167,P=0.016),bone cement leakage(95%CI:0.080-0.582,P=0.002),bone mineral density T value(95%CI:1.214-22.602,P=0.026),and bone cement distribution(P=0.007)were risk factors for recurrent fractures after percutaneous vertebroplasty and adjacent vertebroplasty.Patients with type I bone cement distribution(which did not touch the upper and lower endplates of the vertebral body)had a higher risk of recurrent fractures of surgical and adjacent vertebrae after percutaneous vertebroplasty.(3)The results of this study show that refracture of surgical and adjacent vertebrae is caused by the interaction of various risk factors.Age,bone cement leakage,T value of bone mineral density and bone cement distribution are independent risk factors for surgical and adjacent vertebral refracture.Refracture of surgical and adjacent vertebrae can easily occur when bone cement is distributed type I.关键词
骨质疏松性椎体压缩骨折/经皮椎体成形术/骨水泥分布/相邻椎体骨折/手术椎体再次骨折/危险因素Key words
osteoporotic vertebral compression fracture/percutaneous vertebroplasty/bone cement distribution/adjacent vertebral fracture/surgical vertebral refracture/risk factor分类
医药卫生引用本文复制引用
阿卜杜吾普尔·海比尔,阿里木江·玉素甫,林航,吐尔洪江·阿布都热西提..经皮椎体成形术中骨水泥分布对手术及邻近椎体再发骨折的影响[J].中国组织工程研究,2024,28(29):4657-4662,6.基金项目
新疆维吾尔自治区科学技术厅项目,自然科学基金青年项目(2022D01C821),项目参与人:阿卜杜吾普尔·海比尔 a grant from Department of Science and Technology of Xinjiang Uygur Autonomous Region,Youth Program of Natural Science Foundation of China,No.2022D01C821(to AH) （2022D01C821）
