Risk Factors For Recollapse Of The Augmented Vertebrae After Percutaneous Vertebral Augmentation

ObjectiveThe study aimed to identify the risk factors for recollapse of the augmented vertebrae after percutaneous vertebral augmentation.MethodsThe study retrospectively analyzed 411 patients who were diagnosed with osteoporotic vertebral compression fracture(OVCF),with follow-up,underwent single level percutaneous vertebral augmentation(PVP or PKP)in our depar-tment from April 2012 to May 2016.They were divided into two groups:collapsed group and non-collapsed group,according to whether the height of the anterior vertebral body in lateral X-ray of the final follow-up that was reduced by≥4mm.Clinical data were collected,including patient’s age,gender,vertebral compression rate,anterior vertebral height recovery rate,preoperative and postoperative kyphotic cobb angle,correction of kyphotic cobb,intravertebral vacuum cleft,number of original fracture vertebra,fracture pattern,the column and the endplate involved by the fracture line or not,perioperative anti-osteoporosis treatment,preoperative use of corticosteroids,surgical intervention time,surgical methods,cement injection volume,distribution of cement in the fracture lines,cement diffusion type,cement distribution area,cement leakage,the type and time of the brace.Univariate and multivariate regression analyses were performed to identify risk factors for recollapse of the augmented vertebrae.ResultsThere were 411patients enrolled in this study,65 males and 346 females,with a mean age of 75.64±7.92 years(53~92ys),the average follow-up time was 17.60±7.28 months(1~37m).There were 59 cases of recollapsed augmented vertebra after operation,352 cases of non-collapse,and the rate of recoll-apsed was 14.36%.According to result of univariate analysis t test orΧ~2 test,anterior vertebral height recovery rate,perioperative anti-osteoporosis treatment,surgical methods,distribution of cement in the fracture lines,cement diffusion type were statistically significant related to the recollapsed(P<0.05),while there were no significant difference in patient’s age,gender,vertebral compression rate,preoperative and postope-rative kyphotic cobb angle,correction of kyphotic cobb,intravertebral vacuum cleft,number of original fracture vertebra,fracture line location,fracture pattern,the column and the endplate involved by the fracture line or not,preoperative use of corticosteroids,surgical intervention time,cement injection volume,cement distribution area,cement leakage,the type and time of the brace of the two groups(P>0.05).The results of the multivariate binary logistic regression analysis showed that higher vertebral height recovery rate,insufficient cement distribution in the fracture lines,solid lump cement,PKP were determined as risk factors for recollapse of the augmented vertebrae after percutaneous vertebral augmentation.The perioperative anti-osteoporosis treatment can reduce the risk of the recollapse of the augmented vertebrae.ConclusionHigher anterior vertebral height recovery rate,insufficient cement distribution in the fracture lines,solid lump cement,and PKP were risk factors for recollapse of the augmented vertebrae after percutaneous vertebral augmentation.The perioperative anti-osteoporosis treatment can reduce the risk of the recollapse of the augmented vertebrae.