Analysis of risk factors for adjacent vertebral fractures in conservative treatment of osteoporotic vertebral compression fractures in elderly women
老年女性骨质疏松性椎体压缩骨折保守治疗邻近椎体骨折危险因素分析

摘要

目的 探讨老年女性骨质疏松性椎体压缩骨折（OVCF）患者保守治疗后邻近椎体骨折的危险因素。方法 选取147例老年女性OVCF保守治疗患者，根据是否发生邻近椎体骨折分为骨折组（36例）与无骨折组（111例），采用单因素分析比较两组临床资料差异，将有意义因素纳入多因素Logistic回归分析筛选危险因素。结果 单因素分析显示，两组骨折压缩程度、复诊骨密度T值、骨密度变化T值、唑来膦酸盐及甲状旁腺素类似物使用情况差异有统计学意义（P<0.05）；多因素Logistic回归分析显示，骨折压缩程度、骨密度变化、使用甲状旁腺素类似物是邻近椎体骨折的独立危险因素。结论 骨折压缩程度、骨密度变化及甲状旁腺素类似物使用情况与老年女性OVCF保守治疗后邻近椎体骨折密切相关，临床需针对性干预以降低骨折风险。

Abstract

Objective To explore the risk factors of adjacent vertebral fractures in elderly female patients with osteoporotic vertebral compression fractures (OVCF) after conservative treatment.
Methods A total of 147 elderly female patients with OVCF undergoing conservative treatment were selected and divided into the fracture group (36 cases) and the non-fracture group (111 cases) based on whether adjacent vertebral fractures occurred. Univariate analysis was used to compare the differences in clinical data between the two groups, and meaningful factors were included in multivariate Logistic regression analysis to screen for risk factors.
Results Univariate analysis showed that there were statistically significant differences between the two groups in terms of fracture compression degree, T-value of bone mineral density at follow-up visit, T-value of bone mineral density change, and the use of zoledronic acid and parathyroid hormone analogues (P<0.05). Multivariate Logistic regression analysis showed that the degree of fracture compression, changes in bone mineral density, and the use of parathyroid hormone analogues were independent risk factors for adjacent vertebral fractures.
Conclusion   The degree of fracture compression, changes in bone mineral density, and the use of parathyroid hormone analogues are closely related to adjacent vertebral fractures after conservative treatment of OVCF in elderly women. Targeted clinical intervention is needed to reduce the risk of fractures.