脊柱不稳定性预测评分系统对OVCF 患者 椎体强化术后再发骨折的预测价值

Predictive value of spine instability score system for recurrent bone fracture in postoperative patients with OVCF

摘要:

目的 探究脊柱不稳定性预测评分系统对骨质疏松性椎体压缩性骨折患者（OVCF）椎体强化术后 骨折再发的预测效果。方法 选取2015 年6 月-2017 年6 月该院行椎体强化术的OVCF 患者，收集其一般情况 和影像学资料，以及随访过程中再发骨折情况和视觉疼痛评分，利用Logistic 回归分析骨折再发的危险因素，并 对其赋分，构建脊柱不稳定性预测评分系统，计算似然比检测该系统的准确性。结果 共纳入342 例患者，2 例 失访，142 例患者再发骨折。再发骨折的危险因素包括脊柱后凸角度、椎体后凸角度、椎体高度、强化椎体的 数量、骨密度以及骨折部位。根据预测评分系统评分将所有患者分为4 组，总体评分<5 分组似然比为0.10，总 体评分≥ 15 分组似然比为5.84。结论 脊柱不稳定性预测评分系统较为准确地预测椎体强化术后OVCF 患者 的骨折再发风险，可为骨折再发的预防提供理论依据，值得临床深入探究。

Abstract:

Objective To investigate the predictive effect of spinal instability predictive scoring system for subsequent bone fractures in postoperative patients with osteoporotic vertebral compression fractures (OVCF). Methods OVCF patients receiving bone cement augmentation admitted into our hospital from June 2015 to June 2017 were involved in this study. Clinical characteristics and imaging data of patients were collected. Subsequent fractures and the visual analogue were recorded. Logistic regression analysis was performed to identify risk factors of subsequent fractures. Spinal instability predictive scoring system was established based on risk factors for prediction of recurrent bone fracture. Results A total of 342 patients were included, of which 2 were lost to follow up and 142 patients suffered subsequent fractures. Risk factors of subsequent fractures included spinal kyphotic angle, vertebral kyphotic angle, vertebral height, the number of vertebral augmentation level, bone marrow density, and fracture site. All patients were divided into four groups according to the score of predictive scoring system. The likelihood ratio of the group with score < 5 was 0.10 while that in group with score ≥ 15 was 5.84. Conclusions The spine instability predictive scoring system can accurately predict the risk of subsequent fractures in patients with OVCF after bone cement augmentation, which can provide theoretical basis for the prevention of subsequent fractures.