残余疼痛在骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者中的发生情况及其危险因素分析*贾瑞平 李小兵 杨卫可 郭新军 王琳新乡市中心医院(新乡医学院第四临床学院) 新乡453600

The occurrence and risk factors of residual pain in patients with osteoporotic thoracolumbar compression fractures after percutaneous vertebroplasty

摘要:

目的 分析残余疼痛在骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者中的发生情况及其危险因素。方法 将2013年5月~2021年6月我院收治的骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者120例纳入研究,均随访6个月,回顾性收集其临床资料,以术后6个月患者内出现残余疼痛情况为依据,分为残余疼痛组(n=18)和非残余疼痛组(n=102)。分析残余疼痛在骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者中的发生情况,通过单因素和多因素Logistic回归分析法分析骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者残余疼痛发生的危险因素。结果 术后6个月,120例骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者残余疼痛18例,残余疼痛率为15.00%。多因素Logistic分析结果显示,体质量指数(BMI)和邻椎骨折为骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者残余疼痛的危险因素(OR=1.683和10.700,P<0.05),骨水泥弥散至术前骨折线、术后椎体高度恢复率、术后Cobb角改善率、骨密度T值均为骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者残余疼痛的保护因素(OR=6.170、5.797、5.734、9.959,P<0.05)。结论 残余疼痛在骨质疏松性胸腰椎压缩骨折经皮椎体成形术后患者中仍存在,其发生与多种因素息息相关,临床可根据以上指标给予患者针对性治疗,进而降低其发生风险,改善患者预后。

Abstract:

Objective: To analyze the occurrence and risk factors of residual pain in patients with osteoporotic thoracolumbar compression fractures after percutaneous vertebroplasty. Methods: A total of 120 patients with osteoporotic thoracolumbar compression fractures who were treated in our hospital from May 2013 to June 2021 after percutaneous vertebroplasty were included in the study. All patients were followed up for 6 months, and their clinical data were retrospectively collected. The patients were divided into the residual pain group (n=18) and the non-residual pain group (n=102) based on residual pain within 6 months after operation. The occurrence of residual pain in patients with osteoporotic thoracolumbar compression fractures after percutaneous vertebroplasty was analyzed, Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of residual pain in patients with osteoporotic thoracolumbar compression fractures after percutaneous vertebroplasty. Results: 6 months after operation, 18 of 120 patients with osteoporotic thoracolumbar compression fractures had residual pain after percutaneous vertebroplasty, and the residual pain rate was 15.00%. The results of multivariate Logistic analysis showed that body mass indexes (BMI), adjacent vertebral fracture were risk factors for residual pain in patients with osteoporotic thoracolumbar compression fractures after percutaneous vertebroplasty (OR=1.683 and 10.700, P<0.05), bone cement diffuse to the preoperative fracture line, postoperative vertebral height recovery rate, postoperative Cobb angle improvement rate, bone mineral density T value were protective factors for residual pain in patients with osteoporotic thoracolumbar compression fractures after percutaneous vertebroplasty (OR=6.170, 5.797, 5.734, 9.959, P<0.05). Conclusion: Residual pain still exists in patients with osteoporotic thoracolumbar compression fractures after percutaneous vertebroplasty, and its occurrence was associated with many factors, clinically, patients could be given targeted treatment according to the above indicators, thereby reducing the risk of occurrence and improving the prognosis of patients.