CAJ | 학술논문

目的探讨椎体强化术后夹心椎体骨折的相关因素.方法 2006年1月至2010年10月行经皮椎体成形术或经皮椎体后凸成形术治疗且资料随访完整的患者有449例,对其中存在夹心椎现象的41例(41节)骨质疏松性椎体压缩骨折患者的临床资料进行回顾性分析,男9例,女32例;年龄54 ～85岁,平均71.1岁.根据症状、体格检查及影像学资料判断夹心椎是否骨折；以夹心椎是否骨折作为二分类因变量,选取性别、年龄、身高、体质量、体质量指数、夹心椎是否位于胸腰段、累计手术椎体节段数、夹心椎两侧强化椎体骨水泥注射入路(单侧或双侧椎弓根)、手术方式、骨水泥注射量、骨水泥椎间盘渗漏及术前、术后夹心椎局部后凸角等作为自变量进行统计学分析.结果 41例患者术后获9～44个月(平均21.6个月)随访.41例(41节)夹心椎中,9例(9节)夹心椎发生骨折.手术前、后夹心椎局部后凸角骨折组非骨折组比较差异有统计学意义(P＜0.05)；进一步分析结果显示仅术前夹心椎局部后凸角是夹心椎骨折的危险因素(P=0.024).结论术前脊柱后凸畸形严重程度对椎体骨水泥强化术后邻近椎体骨折有影响,后凸畸形越严重,骨折风险越高.
목적 탐토추체강화술후협심추체골절적상관인소.방법 2006년1월지2010년10월행경피추체성형술혹경피추체후철성형술치료차자료수방완정적환자유449례,대기중존재협심추현상적41례(41절)골질소송성추체압축골절환자적림상자료진행회고성분석,남9례,녀32례;년령54 ～85세,평균71.1세.근거증상、체격검사급영상학자료판단협심추시부골절；이협심추시부골절작위이분류인변량,선취성별、년령、신고、체질량、체질량지수、협심추시부위우흉요단、루계수술추체절단수、협심추량측강화추체골수니주사입로(단측혹쌍측추궁근)、수술방식、골수니주사량、골수니추간반삼루급술전、술후협심추국부후철각등작위자변량진행통계학분석.결과 41례환자술후획9～44개월(평균21.6개월)수방.41례(41절)협심추중,9례(9절)협심추발생골절.수술전、후협심추국부후철각골절조비골절조비교차이유통계학의의(P＜0.05)；진일보분석결과현시부술전협심추국부후철각시협심추골절적위험인소(P=0.024).결론 술전척주후철기형엄중정도대추체골수니강화술후린근추체골절유영향,후철기형월엄중,골절풍험월고.
Objective To investigate potential risks of sandwich vertebral fracture after cement augmentation of the 2 adjacent vertebral bodies.Methods A series of 41 patients with 41 sandwich vertebral levels who had undergone percutaneous vertebroplasty or percntaneous kyphoplasty from January 2006to October 2010 for osteoporotic vertebral compression fracture (OVCF) were reviewed by this study.They were 32females and 9 males,aged from 54 to 85 years (mean,71.1years).Sandwich vertebral fraeture was identified by a hybrid method combining physical and image examinations A database was created containing the demographic characteristics and surgical variables.The incidence of sandwich vertebral fracture was calculated and multiple logistic regression analysis was conducted to identify risk factors of the fracture.Results All the patients had a mean follow-up of 21.6 months (range,9 to 44 months).Nine of 41 sandwich levels developed vertebral fractures.The pre- and postoperative local kyphotic angulations were found to make a statistical difference for the fracture( P ＜ 0.05).Only the preoperative kyphotic angulation at the sandwich region was positively associated with the subsequent fracture of the sandwich vertebral body(P=0.024).Conclusions Thepreoperative spinal kyphotic deformity has an effect on the sandwich vertebral fracture after cement augmentation of the 2 adjacent vertebral bodies.The more serious the kyphosis,the more likely the fracture.