| Objective To observe the treatment of OVCF patients with PVP,to follow up the study subjects for 1years,to see whether non-surgical vertebral fractures occurred during the follow-up period,to record and analyze the factors that may cause non-surgical vertebral fracture,and to explore the influencing factors of non-surgical vertebral fracture after PVP operation.Methods From January 2017 to January 2018,the Hospital of North China Polytechnic University and the orthopaedic hospital affiliated to North China University of Technology were selected to diagnose OVCF parallel PVP patients,and a total of 94 cases were included according to the inclusion criteria and exclusion criteria,and all patients were retrospectively studied for a period of 1 years follow-up.According to whether the apparent pain of the lumbar back was repeated during the followup period and the MRI confirmed that it was a fresh fracture,the positive patients were determined to be the re-fracture group,and no corresponding symptoms were identified as the control group.To collect all the biological parameters(age,sex,BMD,severity of fracture,previous fracture)and surgical parameters(symmetry of bone cement distribution,bone cement dosage,CL,bone cement distribution position),the differences between the two groups were compared,P<0.05 is statistically significant for the difference;with the fracture as the cause variable,In single factor analysis,P<0.05 parameters are independent variables,and multivariate Logistic logic regression analysis is carried out,P<0.05 is statistically significant for the difference.Results 94 patients had non-surgical vertebral fracture during the 1-year follow-up period,and no non-surgical vertebral fracture occurred in the remaining 75 patients.In the case of fracture,11 cases of adjacent vertebral fractures(57.89,11/19),8 cases of non-adjacent vertebral fractures(42.11,8/19),adjacent vertebral fractures occurred within June after operation,and only 2 cases(25.00,2/8)of nonadjacent vertebral fractures occurred within June years after operation,The fracture of non-adjacent vertebral body was isolated from one vertebral body.The previous history of thoracolumbar fractures,severe osteoporosis,asymmetric distribution of bone cement,>4.5ml of bone cement injection and non-distribution of bone cement in the middle of the vertebral body are risk factors for non-surgical vertebral fractures(P<0.05),while gender,age,degree of vertebral body compression,There is no correlation between CL and non-surgical vertebral fracture(P>0.05).In the non-conditional Logistic regression analysis,the previous history of Thoracolumbar fracture was a risk factor(OR value>1)for non-surgical vertebral fracture after PVP operation,low bone density value,small amount of bonecement,The symmetrical distribution of bone cement and the distribution of bone cement in the middle of the vertebral body are the protective factors of non-surgical vertebral fracture after PVP operation(OR<1).Conclusion The previous history of thoracolumbar fracture and low BMD value can increase the incidence of non-surgical vertebral fracture after operation,which is related to the recurrence of spinal kyphosis after thoracolumbar fracture,and severe OP will cause spinal sagittal deformity,which will also cause non-surgical vertebral fracture after PVP operation.In the course of PVP operation,the surgeon should master the direction and depth of the puncture needle as far as possible,choose the appropriate bone cement cooling time and injection speed to achieve the uniform distribution of bone cement in the vertebral body,for patients with severe osteoporosis and incomplete vertebral cortex,the amount of bone cement injection should be small and choose high viscosity bone cement.Pay attention to the treatment of OP,especially in the presence of spinal sagittal malformation,should be systematically treated with anti-osteoporosis.Figure7;Table9;Reference 230... |
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