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南京医科大学学报（自然科学版） 第41卷第10期
·1490 · Journal of Nanjing Medical University（Natural Sciences） 2021年10月

·临床医学·

经皮椎体后凸成形术后骨水泥渗漏的相关危险因素分析

高 畅 ，邹月芬 2
1
南京中医药大学附属医院放射科，江苏 南京 210029；南京医科大学第一附属医院放射科，江苏 南京 210029
1 2

［摘 要］ 目的：探讨经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗骨质疏松性椎体骨折（osteoporotic vertebral
body fracture，OVF）后骨水泥渗漏的相关危险因素。方法：回顾性搜集252例经PKP 治疗且确诊为OVF 的患者临床及影像学
特征，包括年龄、性别等17个因子。利用单因素分析将上述与骨水泥渗漏有关的因子纳入多因素Logistic回归分析，并建立预
测模型。应用受试者工作特征曲线的曲线下面积（area under curve，AUC）评估模型的诊断价值。结果：单因素分析结果显示，
骨密度、骨水泥量、皮质缺损以及椎体内裂隙征与术后骨水泥渗漏有关，多因素Logistic回归分析示皮质缺损（P=0.001）、大剂
量骨水泥量（P=0.047）和较低骨密度值（P=0.002）为术后骨水泥渗漏的独立预测因素，这三者建立的骨水泥渗漏预测模型，
AUC为0.751，灵敏度为61.0%，特异度为82.5%。结论：PKP治疗OVF术后，椎体出现皮质缺损、大剂量骨水泥量和较低骨密度
值为骨水泥渗漏的独立危险因素，其构成的联合模型具有较好的预测效能。
［关键词］ 经皮椎体后凸成形术；骨水泥渗漏；危险因素；皮质缺损
［中图分类号］ R681.5 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）10⁃1490⁃07
doi：10.7655/NYDXBNS20211012

Analysis of risk factors causing cement leakages after percutaneous kyphoplasty for
osteoporotic vertebral fractures
1 2
GAO Chang ，ZOU Yuefen
Department of Radiology，Affiliated Hospital of Nanjing University of Chinese Medicine，Nanjing 210029；
1
2 Department of Radiology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To evaluate risk factors for the occurrence of cement leakages after percutaneous kyphoplasty for osteoporotic
vertebral fractures. Methods：A total of 252 vertebrae with percutaneous kyphoplasty were investigated. The following 17 parameters
were evaluated：patient age，sex，and so on. The influence of possible risk factors affecting cement leakage was assessed using
univariate analysis，and the parameters with statistical significance were incorporated into the multivariate logistic regression model，
and the prediction model was established. The AUC value of ROC was used to evaluate the value of diagnostic tests. Results：The
presence of intravertebral cleft，cortical disruption，large volume of cement and low bone mineral density were selected with statistical
significance by univariate analysis for cement leakage in general. Multivariate logistic regression showed that the presence of cortical
disruption（P=0.001），large volume of cement（P=0.047）and low bone mineral density（P=0.002）were independent predictors for
cement leakage. The combined prediction model of cement leakage was established. The AUC value was 0.751，the sensitivity was
61.0%，and the specificity was 82.5%. Conclusion：The presence of cortical disruption，large volume of cement and low bone mineral
density of treated level are three independent risk factors for cement leakage after percutaneous kyphoplasty for osteoporotic vertebral
fractures，and the combined prediction model has excellent prediction efficiency.
［Key words］ percutaneous kyphoplasty；cement leakage；risk factor；cortical disruption
［J Nanjing Med Univ，2021，41（10）：1490⁃1496］

经皮椎体后凸成形术（percutaneous kyphoplas⁃ 疗，对缓解疼痛、恢复椎体高度及矫正后凸畸形有
ty，PKP）已广泛应用于外伤、骨质疏松、多发骨髓 显著疗效，PKP是在经皮椎体成型术的基础上，通过
瘤、血管瘤和转移瘤所导致的椎体压缩性骨折的治 扩张的球囊恢复椎体高度 ［1-3］ 。但目前一些随访研