经皮椎体成形术后椎体再骨折生存率及危险因素分析轩冲,汪红亮,周涛∗(安徽医科大学马鞍山临床学院,马鞍山市人民医院,安徽马鞍山２４３０００)摘要:目的确定椎体成形术后新发椎体骨折的自然病程,并分析危险因素,探究相邻椎体骨折(adjacentvertebralfracture,AVF)和远端椎体骨折(remotevertebralfracture,RVF)的发生率及其相关性.方法回顾分析马鞍山市人民医院２０１８年１月至２０２１年１月２６０例接受经皮椎体成形术患者的临床资料,男７５例,女１８５例;年龄６２~８１岁,平均(６７．３４±７．２１)岁.根据术后至少２年的随访期内有无椎体骨折,将患者分为骨折组和对照组,然后按照骨折椎体与手术椎体的位置关系,将骨折组分为AVF组和RVF组,通过生存分析和各危险因素回归分析,探究AVF和RVF之间发生时间、危险因素是否存在差异.结果２６０例患者中新发椎体骨折５５例,４２例发生相邻椎体骨折,发病时间为(６．２±２．４)个月;１３例发生远端骨折,发病时间为(１２．３±１．６)个月.在单因素及多因素Cox回归分析中,CT值、抗骨质疏松药物的治疗、矢状面的失衡为AVF的危险因素(P＜０．０５);CT值为RVF的危险因素(P＜０．０５).结论患者在椎体成形术后,邻近椎体骨折的发生时间明显早于远端椎体骨折,CT值、抗骨质疏松药物的治疗、矢状面的失衡是AVF发生的独立危险因素,AVF和RVF发生的公共危险因素是CT值的大小.关键词:椎体压缩性骨折;经皮椎体成形术;新发椎体骨折;危险因素AnalysisoftheSurvivalRateandRiskFactorsofVertebralBodyRefractureAfterPercutaneousVertebroplastyXuanChong,WangHongliang,ZhouTao∗(MaanshanClinicalCollege,AnhuiMedicalUniversity,MaanshanPeople’sHospital,Maanshan２４３００,China)Abstract:ObjectiveTodeterminethenaturalcourseofnewvertebralfracturesaftervertebroplasty,analyzetheassociatedriskfactors,andinvestigatetheincidenceandcorrelationbetweenadjacentvertebralfracture(AVF)andremotevertebralfracture(RVF)．MethodsAretrospectiveanalysiswasconductedontheclinicaldataof２６０patientswhounderwentpercutaneousvertebroplastyaugmentationsurgeryinMa＇anshanPeople’sHospitalfromJanuary２０１８toJanuary２０２１．７５patientsweremaleand１８５patientswerefemale,withanagerangeof６２~８１yearsandameanageof(６７．３４±７．２１)years．Patientsweredividedintofracturegroupandcontrol...
