A Retrospective Study On The Influencing Factors Of Osteoporotic Thoracolumbar Fracture And Secondary Fracture

Objective:Analyze the correlation between the second fracture and the first fracture and the influencing factors,and to guide the clinical application of anti-osteoporosis drugs and the prevention of the second fracture through the statistics of gender,age,secondary fracture and other information of the patients who were diagnosed with osteoporotic thoracolumbar fracture in the hospital of Traditional Chinese Medicine of Jiangsu Province in recent 5 years.Methods:According to the patients for patients diagnosis vertebra fracture in Traditional Chinese Medicine of Jiangsu Province,lumbar vertebral fracture,statistics the hospital number,name,gender,age,telephone,segmental fracture,fracture history,basic disease history,history of alcohol,tobacco,syndrome classification,secondary fractures,presence of anti osteoporosis treatment,treatment methods,such as a secondary fracture statistics its fracture area,is apart from the previous fractures in time treatment,secondary fracture,syndrome classification and fracture have to improve the way of life,for the first time,according to the data were retrospectively study and telephone return visit to the patient's quality of life(see appendix),SPSS22.0 statistical software was used for data statistical analysis to analyze the relationship between the first fracture and the second fracture,and to evaluate the effectiveness of the current anti-osteoporosis program.Results:1.There are more female patients with osteoporotic thoracolumbar fractures than male patients,with a male to female ratio of 1:3.5.The age distribution was between 29 and 94 years,with an average age of(70.7±12.1)years.The most common age is over 60 years old.A total of 53.99%of osteoporotic thoracolumbar fractures occurred in the T12 and L1 segments.2.Among the patients with osteoporotic thoracolumbar fractures,30%received conservative treatment and 70%received surgical treatment.The mean age of patients receiving conservative treatment was(66.34±14.30)years,the mean age of patients receiving PVP treatment was(74.49±8.46)years,the mean age of patients receiving PKP treatment was(71.98±10.51)years,and the mean age of patients receiving open surgery was(50.1±7.89)years.There were statistically significant differences in the age of different treatment methods(P<0.05).After treatment,a total of 193 patients received anti-osteoporosis treatment.3.Among the TCM syndromes of osteoporotic thoracolumbar fracture,there were 13 cases of qi stagnation and blood stasis,66 cases of liver and kidney insufficiency,54 cases of kidney Yang deficiency,and 193 cases of spleen and kidney deficiency.Patients<50 years old were mostly qi stagnation and blood stasis and deficiency of liver and kidney;patients aged 51-70 years old were mostly deficiency of liver and kidney,deficiency of kidney Yang and deficiency of spleen and kidney;patients aged>71 years old were mostly deficiency of spleen and kidney,and the distribution age of different syndromes was statistically different(P<0.05).4.The incidence of osteoporotic thoracolumbar secondary fractures was as high as 24.85%.Secondary fractures occur in more women than men,with a male to female ratio of about 1:5.The age range of patients with secondary fractures ranged from 54 to 94 years,with an average age of(75.60±8.19)years.Patients with secondary fractures were significantly older than those without secondary fractures(P<0.05).Multiple fractures were more likely to cause secondary fractures,accounting for 40.96%of patients with multiple fractures.T12-L2 vertebral bodies had the highest number of secondary fractures.5.In addition to secondary fractures of adjacent vertebral bodies,fractures of the upper thoracic vertebra are more likely to occur again after thoracolumbar fractures above T10;Secondary fractures of T12 and T10 vertebral bodies are more likely to occur after L2 vertebral body fracture.After L4 vertebral body fracture,L1 vertebral body is prone to secondary fracture.Secondary fractures of L2 vertebral bodies are more likely to occur after L5 vertebral fractures.The hip is also a high incidence of secondary fractures.Secondary fractures tend to occur about 2 years after the first fracture.6.Patients receiving PVP for the first fracture were more likely to have secondary fractures,and patients receiving anti-osteoporosis treatment and lifestyle adjustment after the first fracture were less likely to have secondary fractures,with statistically significant differences(P<0.05).7.Among the TCM syndromes of patients with secondary osteoporotic thoracolumbar fractures,there were 9 cases of liver and kidney insufficiency,16 cases of kidney Yang deficiency,and 59 cases of spleen and kidney deficiency,with statistical differences in the age of different syndromes(P<0.01).Conclusion:Old age and female are the risk factors for osteoporotic thoracolumbar fracture.T12 and L1 are the high frequency segments of osteoporotic thoracolumbar fractures.According to the clinical symptoms,the patients were divided into qi stagnation and blood stasis type,liver and kidney insufficiency type,kidney Yang deficiency type and spleen and kidney deficiency type.The incidence of osteoporotic thoracolumbar secondary fractures was 24.85%,with an average age of(75.60±8.19)years.High age,no anti-osteoporosis treatment,no lifestyle improvement,and PVP for the first fracture were risk factors for secondary fractures.