Analysis on the associated factors of non-surgical vertebral fracture secondary to percutaneous kyphoplasty for osteoporotic vertebral compression fracture

English Keywords:Osteoporotic vertebral compression fracture  Percutaneous kyphoplasty  Non-surgical vertebral fracture

English Abstract:

  【Abstract】 Objectives: To investigate the associated factors of non-surgical vertebral fracture after percutaneous kyphoplasty(PKP). Methods: The clinical data and follow-up results of 102 patients who underwent PKP due to osteoporotic vertebral compression fracture(OVCF) from January 2005 to December 2009 in our center were retrospectively studied. According to the follow-up results, the patients were divided into fracture group and non-fracture group(control group) by onset of a new fracture. The differences between the two groups in general information(sex, age, BMD, number of vertebral fractures, degree of compression, scoliosis, Cobb angle of kyphosis), operating factors(number of bone cement augmented vertebrae, approach, bone cement filling volume, bone cement leakage, restoration of vertebral height), history of trauma and long-term use of glucocorticoids were analyzed. One-way analysis of variance(ANOVA) and chi-square test were used to analyze the correlation between the above mentioned factors and non-surgical vertebral fracture. All the relevant factors were introduced to Logistic Regression Analysis to analyze the main factors of non-surgical vertebral fracture. Results: All patients were followed up for over 24 months, 20 cases suffered from a new fracture, with the fracture rate of 19.6%. ANOVA showed that bone mineral density, number of pre-existing fractured vertebrae, number of augmentation vertebrae, degree of preoperative vertebral compression, disc leakage of bone cement and long-term use of glucocorticoids were significantly related to non-surgical vertebral fracture(P＜0.05), while age, sex, injury history, volume of bone cement filling, restoration of vertebral height, scoliosis, kyphosis angle showed no relationship with onset fracture(P＞0.05). All the relevant factors logistic analysis showed severe degree of osteoporosis, more augmented vertebrae and long-term use of glucocorticoids were high risk factors associate with non-surgical vertebrae fracture, with the OR value of 0.090, 9.682, 9.584 respectively. Conclusions: A severe degree of osteoporosis, more augmented vertebras and long-term use of glucocorticoids are the high risk factors of non-surgical vertebral re-fracture secondary to percutaneous kyphoplasty.