BACKGROUND:Osteoporotic vertebral compression fractures have a high rate of recurrent fractures in adjacent vertebrae after percutaneous vertebroplasty,but the cause of their occurrence is still controversial. OBJECTIVE:To explore the influencing factors of adjacent vertebral re-fractures after percutaneous vertebroplasty in patients with single-segment osteoporotic vertebral compression fractures. METHODS:A retrospective analysis was performed in 210 patients admitted to the Fifth Hospital of Wuhan City,Second Affiliated Hospital of Jianghan University from June 2016 to June 2020,who had been diagnosed with new single-segment osteoporotic vertebral compression fractures by X-ray and MRI examinations,and received percutaneous vertebroplasty.The patients were followed up for more than 18 months.The general preoperative data and postoperative indicators were collected.The general preoperative data included age,sex,body mass index,fracture segment location,fracture days,fracture cause,whether accompanied by diabetes mellitus,whether accompanied by renal and thyroid dysfunction,and visual analogue scale score on admission.The postoperative indicators included recovery rate of anterior edge of the vertebral body after operation,degree of dispersion of bone cement,leakage of bone cement,use of bone material,single or bilateral injection of bone cement,recovery rate of the injured vertebral mid-column after operation,local Cobb angle of the injured vertebra after operation.According to their real conditions,the patients were divided into a group without adjacent vertebral re-fractures(n=190)and a group with adjacent vertebral re-fractures(n=20).The presence or absence of postoperative re-fracture of the adjacent vertebrae of the injured spine was used as the dependent variable and the categorical variables such as preoperative general data and postoperative indicators were used as independent variables for statistical analysis. RESULTS AND CONCLUSION:After percutaneous vertebroplasty,patients with adjacent vertebral re-fractures showed significant differences in age,body mass index,postoperative vertebral body anterior edge recovery rate,degree of cement dispersion,and cement leakage from those without adjacent vertebral re-fractures(P<0.05).However,sex,time of fracture,cause of fracture,presence of diabetes or kidney disease or thyroid disease,location of the initial vertebral fracture segment,mode of cement injection,local Cobb angle of the injured vertebra,recovery rate of the injured vertebral mid-column,and use of bone tissue were not statistically significant in relation to re-fracture of the adjacent vertebra after percutaneous vertebroplasty(P>0.05).Multivariate Logistic regression analysis showed that age,vertebral body anterior edge recovery rate and cement leakage were independent risk factors for re-fractures of the adjacent vertebra after percutaneous vertebroplasty.To conclude,age,vertebral body anterior edge recovery rate and leakage of bone cement are the influencing factors of adjacent vertebral re-fractures after percutaneous vertebroplasty.However,factors such as the degree of bone cement dispersion and the local Cobb angle of the injured vertebra were not correlated with adjacent vertebral re-fractures after percutaneous vertebroplasty.

Objective:To evaluate the intervention effect of Naikan cognitive therapy (NCT)on psychosomatic symptoms of female compulsory drug addicts.Methods:Seventy drug addicts who met the inclusion criteria and volunteered to participate in the study were selected and randomly divided into intervention group( n=35) and control group( n=35) with random number table method.The intervention group received 10 consecutive days of NCT, while the control group received the same period of mental health education.Before and after treatment, the two groups were assessed with symptoms check list-90(SCL-90), preceived social support scale(PSSS), simple coping style scale(SCSQ) and inclination of relapse questionnaire of drug rehabilitated addicts. Results:There was no significant difference between the two groups before the intervention (all P>0.05). Compared with pre-intervention, the total score of SCL-90((176.49±40.85) vs (152.60±31.17)), somatization, compulsion, interpersonal sensitivity, depression, anxiety, terror, paranoid and psychiatric factors were significantly decreased and the total scores of PSSS((59.09±14.60) vs (64.43±10.42)) family support, friend support and other support subscales increased significantly post-NCT intervention in the intervention group (all P<0.05). Compared with control group, the scores of positive coping((25.54±6.09) vs (22.37±7.04)) increased significantly, and the tendency of negative coping((8.20±3.59) vs (10.17±4.03)) and relapse((15.66±9.57) vs (22.11±10.18)) decreased significantly (all P<0.05) after intervention in the intervention group.There was no significant difference in the scores of all scales in the control group (all P>0.05). Conclusion:Naikan cognitive therapy can significantly improve the psychosomatic symptoms perceive social support and positive coping styles, and reduce the tendency of negative coping and relapse of female compulsory drug addicts.