Analysis Of Related Factors Of Re-fracture After Osteoporotic Vertebral Body Fracture

Purpose:To investigate the distribution characteristics of syndrome types and the possible risks of re-fractures by revisiting patients with osteoporotic vertebral fractures in Wuxi Hospital of Traditional Chinese Medicine and Jiangsu Provincial Hospital of Traditional Chinese Medicine from January 2017 to March 2021.Factors are screened to provide a reference for the prevention and treatment of re-fractures and reduce the incidence of re-fractures.Methods:Return visits to patients with osteoporotic vertebral fractures in Wuxi Hospital of Traditional Chinese Medicine and Jiangsu Provincial Hospital of Traditional Chinese Medicine to collect their basic information(name,gender,age,phone number),combined underlying diseases,history of tobacco and alcohol,history of fractures,and TCM syndromes Type,bone density,anti-osteoporosis treatment,treatment methods,lifestyle,analyze the collected data,rely on the case observation table to return visits to the patients(see attachment),use SPSS24.0.0.0 statistical software for data Analyze,look for factors related to the occurrence of re-fracture,and guide clinical prevention and treatment of re-fracture.Results:1.Among the patients with vertebral compression fractures collected in this study,56 were males,accounting for 18.5%of the total number,and 246 were females,accounting for 81.5%of the total number.A total of 81 patients suffered re-fractures,and the incidence of re-fractures was 26.8%.Among them,8 were males,the incidence was about 14.3%;73 were females,the incidence was about 29.7%.Among them,the incidence rate is higher in patients over 70 years old,and the age distribution is statistically different.The average bone mineral density T value of the re-fractured group was lower than that of the non-fractured group(P<0.05).2.About 20%of patients in this study chose non-surgical treatment,and 80%of patients chose surgical treatment.Among patients with re-fractures,31 were non-surgically treated,and the incidence of re-fracture was about 50.8%;49 patients who received vertebral enhancement surgery,the incidence of re-fracture was about 20.8%;1 person underwent open reduction surgery Treatment,the incidence of re-fracture was 20%.Through analysis,there is a difference in the incidence of re-fracture between different treatment methods,and the incidence of re-fracture is the highest in patients with non-surgical treatment.3.Among all fracture patients,there were 139 patients with spleen and kidney deficiency,and the incidence of re-fracture was about 40.3%;79 patients with liver and kidney yin deficiency,and the incidence of re-fracture was about 13.9%;77 patients with kidney-yang deficiency,and re-fracture occurred.The rate was about 18.2%;there were 7 people with blood stasis and qi stagnation,and no fracture occurred again.There is a difference in the incidence of re-fracture among the various syndrome types,which is statistically significant(P<0.05),and the spleen and kidney deficiency type is more common,and there is a connection between re-fracture and TCM syndrome types.4.After the first fracture,67.2%(n=203)of patients had lifestyle changes,and the remaining 32.8%(n=99)had no changes.After improving the lifestyle,the incidence of fractures again was about 10.8%;the incidence of fractures again without improving the lifestyle was about 59.6%,there was a difference between the two(P<0.05).49.7%of all patients received anti-osteoporosis treatment,and about 19.3%of them had re-fractures.Compared with patients without anti-osteoporosis treatment,the prevalence of re-fractures was statistically significant.Difference(P<0.05).In addition,the history of hypertension was related to the occurrence of re-fractures(P<0.05),and the history of smoking and drinking was not related to the incidence of re-fractures(P>0.05).5.After Logistic regression analysis,gender,hypertension,bone density,non-surgical treatment after the initial fracture,whether to improve lifestyle and receive anti-osteoporosis treatment,spleen and kidney deficiency are the influencing factors for re-fracture.Conclusion:Gender is a related factor for re-fracture,and it is more common in elderly patients,especially in women.TCM syndromes,hypertension,treatment methods,and bone mineral density are all important factors affecting the occurrence of re-fractures.Among them,patients with spleen and kidney deficiency and non-surgical treatment have a higher risk of re-fracture.Improved lifestyle and anti-osteoporosis treatment can effectively reduce the risk of fracture again.