Analysis of the incidence and risk factors of postoperative refractures in elderly patients with thoracolumbar vertebral osteoporotic compression fractures after PVP
10.3969/j.issn.1005-6483.20240039
- VernacularTitle:老年胸腰椎骨质疏松性压缩骨折经皮穿刺椎体成形术后再骨折危险因素分析
- Author:
Haifeng BI
1
;
Ke WANG
;
Chuan WANG
Author Information
1. 255300 山东省淄博一四八医院骨科一区
- Keywords:
osteoporotic vertebral compression fracture;
vertebroplasty;
refracture;
intravertebral cleft sign
- From:
Journal of Clinical Surgery
2024;32(11):1196-1200
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of postoperative vertebral body refracture after percutaneous vertebroplasty(PVP)in the treatment of thoracolumbar osteoporotic compression fracture.Methods The radiological and clinical data of 1258 patients who underwent single-level PVP surgery for thoracolumbar vertebral compression fracture in our hospital from January 1,2015 to December 31,2020 were retrospectively analyzed.Gender,age,body mass index(BMI),bone mineral density(BMD),surgical approach,injection amount of cement,diffusion state of,leakage,vertebral height restores,kyphotic angle reduction,wedge angle reduction of vertebral body,postoperative anti-osteoporosis drug application and other radiological and clinical data of patients were collected and analyzed by univariate and multivariate analysis.The differences of these parameters in the refracture group and the non-refracture group were compared to evaluate the correlation between these factors and postoperative vertebral refracture.Results A total of 247 patients were included in this study.The incidence of refracture was 3.90％in 49 patients.Univariate analysis showed that large kyphotic angle,intravertebral cleft sign,endplate cortical disruption,small injection amount of bone cement,non-contact between bone cement and endplate,and high reduction rate of vertebral body were risk factors for vertebral refracture after PVP.Multivariate analysis of these factors showed that large injection amount of bone cement(OR=0.37,95％CI:0.19-0.55,P=0.018)was a protective factor for vertebral refracture after PVP,and preoperative endplate cortical disruption(OR=2.86,95％CI:1.14-7.53,P=0.026),preoperative intravertebral cleft sign(OR=18.15,95％CI:3.07-44.79,P=0.003),large vertebral reduction rate(OR=3.58,95％CI:1.38-8.40,P=0.007),and poor contact between bone cement and endplate(OR=3.01,95％CI:1.92-10.65,P=0.004)were independent risk factors for vertebral refracture after PVP.Conclusion In this study,it was found that small injection amount of bone cement,endplate cortical disruption before surgery,intravertebral cleft sign,large vertebral reduction rate,and poor contact between bone cement and endplate were independent risk factors for postoperative refracture after PVP treatment of osteoporotic compression fractures in the elderly thoracolumbar spine.
