摘要
目的探讨脊柱-骨盆矢状位参数对骨质疏松性椎体压缩骨折患者行非手术治疗后骨折愈合情况的影响。方法纳入2016年7月-2018年7月采用非手术治疗的骨质疏松性椎体压缩骨折患者79例,治疗前均测量其骨盆入射角(pelvic incidence,PI)、骨盆倾斜角(pelvic tilt,PT)、腰椎前凸角(lumbar lordosis,LL)、胸椎后凸角(thoracic kyphosis angle,TKA)、脊柱矢状轴(sagittal axis of spine,SAS)和C_(7)椎体中心到骨折椎体中心的垂直线距离(DSVA)、腰椎骨盆匹配值(PI-LL)等指标。治疗6个月后,依据骨折愈合情况分为两组:骨折愈合组和不愈合组。对两组患者的人口学资料和脊柱-骨盆矢状位参数进行比较,并采用多因素Logistic回归分析探讨非手术治疗后骨折不愈合的独立危险因素。结果79例中,12例治疗6个月后出现骨不连,发生率为15.2%,均纳入不愈合组。不愈合组患者的年龄显著高于愈合组(P<0.001);两组性别、骨密度值和骨折椎体分布均无组间明显差异。愈合组患者的SVA(P=0.000)、DSVA(P=0.000)和PI-LL值(P=0.000)均显著低于不愈合组,而PI、PT、LL、TKA等参数差异无统计学意义。经多因素Logistic回归分析,DSVA>6.7 cm(OR=1.792)、PI-LL>31°(OR=2.651)是骨折不愈合的独立风险因素。结论治疗前的脊柱-骨盆矢状位参数对OVCF患者非手术治疗后的骨愈合结局有明显影响,尤其是PI-LL>31°和DSVA>6.7 cm将显著增加骨不连的风险。
Objective To investigate the influence of sagittal parameters of spine pelvis on the healing of osteoporotic vertebral compression fractures(OVCF)after conservative treatment.Methods From July 2016 to July 2018,79 patients with OVCF were included in the study.Before treatment,the pelvic incidence angle(PI),pelvic tilt angle(PT),lumbar lordosis angle(LL),thoracic kyphosis angle(TKA),sagittal axis of spine(SAS)and C_(7) vertebral body center vertical distance to the center of the vertebral body fracture(DSVA),lumbar vertebra pelvis matching value(PI-LL),and other indicators were measured.After 6 months of treatment,according to the fracture healing,the patients were divided into two groups:the fracture healing group and the nonunion group.The demographic data and spine-pelvic sagittal parameters of the two groups were compared,and the independent risk factors for fracture nonunion after conservative treatment were investigated by multivariate Logistic regression analysis.Results Among the 79 cases,12 cases developed nonunion after 6 months of treatment,and the incidence rate was 15.2%.The age of patients in the nonunion group was significantly higher than that in the union group(P<0.001).There were no significant differences between the two groups in gender,bone mineral density and vertebral body distribution.The values of SVA(P=0.000),DSVA(P=0.000)and PI-LL(P=0.000)in the healing group were significantly lower than those in the nonunion group,while the differences in parameters such as PI,PT,LL and TKA were not statistically significant.According to multivariate Logistic regression analysis,DSVA>6.7 cm(OR=1.792)and PI-LL>31°(OR=2.651)were independent risk factors for fracture nonunion.Conclusion Spain-pelvic sagittal parameters have significant influence on the outcome of bone healing after conservative treatment in patients with OVCF,especially PI-LL>31°and DSVA>6.7 cm,which significantly increase the risk of bone nonunion.
作者
张鑫
张艳锋
ZHANG Xin;ZHANG Yan-feng(Department of Orthopedics,the Second People's Hospital of Nanyang,Nanyang,Henan 473000,China)
出处
《颈腰痛杂志》
2022年第1期60-63,共4页
The Journal of Cervicodynia and Lumbodynia
关键词
骨质疏松
椎体压缩骨折
脊柱-骨盆矢状位参数
骨不连
PI-LL
osteoporosis
vertebral compression fracture
spinepelvis sagittal position parameters
bone nonunion
PI-LL
