CAJ | 학술논문

目的分析骨质疏松性椎体压缩骨折(OVCF)患者行经皮穿刺椎体后凸成形术(PKP)后发生继发性椎体骨折的情况及相关危险因素.方法对2005年7月至2007年10月行PKP手术治疗的95例OVCF患者(135个椎体),动态监测其术后状态及正常椎体继发骨折与否;对其临床相关参数如性别、骨质疏松原因、骨折部位、矢状面成角、骨水泥注入量、骨水泥椎间隙渗漏、椎体高度恢复、术后支具佩戴、抗骨质疏松治疗及原发骨折类型进行统计学分析,以筛选出发生继发性骨折的相关危险因素.结果所有患者术后随访10～35个月(平均18个月);其中19例(20.0%)患者25个(18.5%)正常椎体(22个位于手术节段邻近上下椎体)术后发生继发性骨折;其中12例患者的继发骨折在术后3个月内发生.继发性骨质疏松骨折、骨水泥椎间隙渗漏及新鲜椎体骨折是PKP治疗OVCF后发生继发性椎体骨折的危险因素(P＜0.05).结论 OVCF进行PKP手术后部分患者可能在术后早期发生继发性椎体骨折,其发生与骨质疏松原因、术中骨水泥椎间隙渗漏及新鲜椎体骨折相关.
목적 분석골질소송성추체압축골절(OVCF)환자행경피천자추체후철성형술(PKP)후발생계발성추체골절적정황급상관위험인소.방법 대2005년7월지2007년10월행PKP수술치료적95례OVCF환자(135개추체),동태감측기술후상태급정상추체계발골절여부;대기림상상관삼수여성별、골질소송원인、골절부위、시상면성각、골수니주입량、골수니추간극삼루、추체고도회복、술후지구패대、항골질소송치료급원발골절류형진행통계학분석,이사선출발생계발성골절적상관위험인소.결과 소유환자술후수방10～35개월(평균18개월);기중19례(20.0%)환자25개(18.5%)정상추체(22개위우수술절단린근상하추체)술후발생계발성골절;기중12례환자적계발골절재술후3개월내발생.계발성골질소송골절、골수니추간극삼루급신선추체골절시PKP치료OVCF후발생계발성추체골절적위험인소(P＜0.05).결론 OVCF진행PKP수술후부분환자가능재술후조기발생계발성추체골절,기발생여골질소송원인、술중골수니추간극삼루급신선추체골절상관.
Objective To evaluate the risk factors for subsequent vertebral fractures after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods The 95 OVCF patients who had undergone PKP from July 2005 to October 2007 were followed up to observe the incidence of subsequent vertebral fracture. Altogether 135 levels of vertebrae were involved. Statistical analyses were done to screen the risk factors associated with subsequent vertebral fractures in this group.Results The follow-ups ranged from10 to 35 months, averaging 18 months. Over the follow-up period, 19 patients (20. 0% ) sustained 25 subsequent fractures ( 18. 5% ). Twelve patients had fractures within 3 months after the operation. Secondary osteoporosis, intraoperative leakage of bone cement and fresh bone fracture were found to be correlated with subsequent vertebral fracture. Conclusions The subsequent vertebral fracture may occur in OVCF patients undergoing PKP, especially in the early postoperative months. Secondary osteoporosis, intraoperative leakage of bone cement and fresh bone fracture may be the risk factors.