Analysis of the influencing factors of new fractures of other vertebrae after percutaneous kyphoplasty for single-level thoracolumbar osteoporotic vertebral compression fractures

English Keywords:Osteoporotic vertebral compression fractures  Percutaneous kyphoplasty  Other vertebral fractures  Refracture  Influencing factors

English Abstract:

  【Abstract】 Objectives: To analyze the influencing factors of new fractures of other vertebral bodies(non-operative) after percutaneous kyphoplasty(PKP) in patients with single-level thoracolumbar osteoporotic vertebral compression fractures(OVCFs). Methods: The data of a total of 258 patients with single-level thoracolumbar OVCFs who underwent PKP in our hospital from January 2018 to December 2019 were retrospectively analyzed. There were 35 males and 223 females. The age of the patients ranged from 49 to 92 years(70.3±9.3 years). The fracture segments were: T6-T8 in 9 cases, T9-T11 in 33 cases, T12-L2 in 180 cases, and L3-L5 in 36 cases. The patients were followed up for 36.4±6.7 months(24-48 months) and they were divided into refracture group and non-refracture group according to whether presenting with new fractures of other vertebral bodies at the last follow-up. The clinical and imaging data such as gender, age, injured vertebral segment, with or without diabetes mellitus, preoperative bone mineral density(BMD), preoperative blood calcium, blood phosphorus, albumin, with or without scoliosis, bone cement injection volume, whether presenting with bone cement leakage, and standardized postoperative anti-osteoporosis treatment were analyzed and compared between the two groups. The parameters with statistical differences were analyzed by multivariate Logistic regression. Results: Among the 258 patients, 21 patients(8.14%) had new fracture of other vertebral bodies(refracture group) and 237 patients did not have refracture(non-refracture group) at the last follow-up. 18 cases(85.71%) in the refracture group were still single-segment fractures, involving thoracic(T10 and above) in 8 cases(38.10%), thoracolumbar(T11-L2) in 7 cases(33.33%) , and lumbar(L3 and below) in 3 cases(14.29%), and the other 3 cases(14.29%) were two-segment fractures. There was no significant difference in gender, age, injured vertebral segment, with or without diabetes mellitus, preoperative BMD, preoperative blood calcium, blood phosphorus, albumin, bone cement injection volume, and with or without standardized postoperative anti-osteoporosis treatment between the two groups(P>0.05). Significant differences were noticed in whether with scoliosis and presenting with bone cement leakage(P<0.05). Logistic regression analysis showed that scoliosis[odds ratio(OR)=1.135, 95% confidence interval(CI) 1.005-1.296, P=0.015] and bone cement leakage(OR=1.258, 95%CI 1.085-1.727, P=0.023) were the risk factors for new fractures of other vertebrae after PKP. Conclusions: Patients with single segment thoracolumbar osteoporotic compression fracture combined with scoliosis or bone cement leakage are prone to develop new fractures of other vertebrae after PKP.