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经皮椎体成形术后骨水泥剂量对手术椎体及邻近椎体再发骨折的影响
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Abstract:
背景：单侧入路经皮椎体成形术后新发相邻椎体骨折的危险因素是多方面的，但这方面的相关研究较少。目的：探讨经皮椎体成形术(PVP)在治疗骨质疏松性胸腰椎椎体压缩性骨折(OVCF)中注入不同聚甲基丙烯酸甲酯骨水泥剂量后对手术椎体及邻近椎体再发骨折的影响。方法：连续性选择新疆医科大学第六附属医院微创脊柱外科2019年01月至2022年12月进行PVP的患者122例，分为骨折组(n = 15)和未骨折组(n = 107)。回顾两组患者以下变量：患者年龄、性别、手术时间、体重指数(BMI)、骨密度T值、PVP节段、既往史、术前腰痛评分、骨水泥渗漏和骨水泥剂量等，并进行统计分析。结果：本研究共纳入122例患者，比较骨折组和未骨折组之间的参数。骨折组15例(年龄72.72 ± 9.93)，未骨折组107例(年龄72.14 ± 8.13)。① 单因素分析显示，经皮椎体成形术后，椎体再发骨折与右侧股骨骨密度T值(P = 0.012)、骨水泥量(P = 0.015)等因素相关，差异具有统计学意义(P < 0.05)。② 二元Logistic回归分析显示，骨水泥剂量(P = 0.010)是PVP术后手术椎体及邻近椎体再发骨折的危险因素；与2.1~4.0 mL、4.1~5.0 mL、5.1~6.0 mL和8.1~10.0 mL相比，骨水泥剂量6.1~8.0 mL的再发骨折风险较高(OR = 1, P = 0.047)。结论：骨水泥剂量是椎体再发骨折的独立危险因素。当骨水泥剂量达到6.1~8.0 ml时，最容易发生手术椎体及邻近椎体再发骨折，因此需要根据患者情况制定相关治疗方案。
Background: The risk factors for new adjacent vertebral fractures after unilateral approach percutaneous vertebroplasty may differ, but there are few studies in this area. Objective: This paper aims to investigate the effects of percutaneous vertebroplasty (PVP) on recurrent fractures of the surgically treated vertebrae and adjacent vertebrae after injection of different doses of polymethyl methacrylate bone cement in the treatment of osteoporotic thoracolumbar vertebral compression fractures (OVCF). Methods: According to the inclusion criteria, 122 patients who underwent unilateral approach PVP surgery in the Sixth Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2022 were retrospectively and continuously screened. According to whether repeated compression fractures were observed during the follow-up period, the patients were divided into two groups: fracture group (n = 15) and non-fracture group (n = 107). Both groups of patients were reviewed for the following variables: The patient’s age, gender, body mass index (BMI), operation time, bone mineral density T value, PVP segment, previous history, preoperative low back pain score, bone cement dose and intervertebral disc cement leakage were analyzed by univariate analysis. Results: A total of 122 patients were included in the study and parameters were compared between the fracture group and the non-fracture group. There were 15 patients in fracture group (age 72.72 ± 9.93) and 107 patients in non-fracture group (age 72.14 ± 8.13). ① Univariate analysis showed that recurrent vertebral fractures after percutaneous vertebroplasty were correlated with bone mineral density T (P = 0.012) and bone cement volume (P = 0.015),
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