CAJ | 학술논문

目的：探讨骨质疏松椎体压缩性骨折（OVCFs）经皮椎体成形术（PVP）后非手术椎体骨折的相关危险因素。方法：对2010年3月～2013年3月收治的76例因OVCFs行PVP患者的临床资料进行回顾性分析，包括患者的一般情况、个人史及既往病史、腰椎骨密度、术中骨水泥注入量、病椎压缩程度、骨折椎体个数及节段、骨水泥椎间盘渗漏情况、术后抗骨质疏松治疗情况；收集患者术后第1、3、6、12、18个月来院复诊时测定的骨代谢相关生化指标数据，包括：血钙、磷、降钙素、Ⅰ型胶原氨基端前肽、甲状旁腺激素、25-羟维生素D[25-（OH） D]。将上述指标作为可能相关因素纳入单因素研究，并通过多因素Logistic回归分析得出术后非手术椎体骨折的相关危险因素。结果：76例原发性OVCFs患者共89节椎体骨折，术后共17例患者19个椎体出现压缩性骨折，单因素分析显示术中骨水泥注入量、骨水泥椎间盘渗漏、术后有无抗骨质疏松治疗、血25-（OH）D水平与术后非手术椎体骨折存在显著相关性（P<0．05），而与患者性别、年龄、体重指数、骨密度值、病椎压缩程度、手术入路等无显著相关性（P>0．05）。多因素分析结果显示骨水泥椎间盘渗漏、术后未进行抗骨质疏松治疗、25-（OH）D水平较低是PVP术后非手术椎体骨折的危险因素（P<0．05）。结论：OCVFs患者PVP术后发生非手术椎体骨折与骨水泥渗漏至椎间盘、术后未抗骨质疏松治疗及低25-（OH）D水平有关。
목적：탐토골질소송추체압축성골절（OVCFs）경피추체성형술（PVP）후비수술추체골절적상관위험인소。방법：대2010년3월～2013년3월수치적76례인OVCFs행PVP환자적림상자료진행회고성분석，포괄환자적일반정황、개인사급기왕병사、요추골밀도、술중골수니주입량、병추압축정도、골절추체개수급절단、골수니추간반삼루정황、술후항골질소송치료정황；수집환자술후제1、3、6、12、18개월래원복진시측정적골대사상관생화지표수거，포괄：혈개、린、강개소、Ⅰ형효원안기단전태、갑상방선격소、25-간유생소D[25-（OH） D]。장상술지표작위가능상관인소납입단인소연구，병통과다인소Logistic회귀분석득출술후비수술추체골절적상관위험인소。결과：76례원발성OVCFs환자공89절추체골절，술후공17례환자19개추체출현압축성골절，단인소분석현시술중골수니주입량、골수니추간반삼루、술후유무항골질소송치료、혈25-（OH）D수평여술후비수술추체골절존재현저상관성（P<0．05），이여환자성별、년령、체중지수、골밀도치、병추압축정도、수술입로등무현저상관성（P>0．05）。다인소분석결과현시골수니추간반삼루、술후미진행항골질소송치료、25-（OH）D수평교저시PVP술후비수술추체골절적위험인소（P<0．05）。결론：OCVFs환자PVP술후발생비수술추체골절여골수니삼루지추간반、술후미항골질소송치료급저25-（OH）D수평유관。
Objectives: To explore the risk factors associated with the onset of vertebral compression frac-tures after percutaneous vertebroplasty(PVP). Methods: A total of 76 patients undergoing PVP due to osteo-porotic vertebral compression fractures(OVCFs) from March 2010 to March 2013 was retrospectively analyzed, the data included age, body mass index, bone mineral density, number of initial vertebral fractures, bone ce-ment leakage into discs, use of antiosteoporotic medications. And the data of their bone metabolistic markers and 25-(OH)D levels of different periods after PVP were also assessed. Results: 17 patients experienced 19 subsequent fractures. Univariate analysis showed that bone cement injection volume, bone cement leakage into discs, use of antiosteoporotic medications and levels of 25-(OH)D were the variables associated with the onset of vertebral fractures (P<0.05). In contrast, age, sex, operation approach, body mass index and bone mineral density showed no significant differences. Multiple-factors logistic regression analysis showed that bone cement leakage into discs, lower level of 25-(OH)D and absence of antiosteoporotic medication were the predominant correlative factors associated with the onset of vertebral fracture. Conclusions: The most important risk factors associated with onset of OVCFs are absence of antiosteoporotic medication and bone cement leakage into discs and low serum 25-(OH)D level.