The Influence Of Distribution Pattern Of Bone Cement On The Recollapse Of Augmented Vertebrae After OVCF Patients Underwent Percutaneous Vertebroplasty Based On The Theory Of“Bone Impotence”

Objective :To explore the influence of the distribution pattern of bone cement on the recollapse of augmented vertebrae and guide the postoperative treatment of the combination of traditional Chinese medicine and western medicine.Methods: A retrospective analysis was performed on 304 patients with OVCF treated by percutaneous vertebroplasty in our hospital from January 2016 to December 2017,and101 patients were selected in the study.The patients were divided into the recollapse group and non-recollapse group based on the height loss ratio and the change of kyphosis angle during the postoperative follow-up.Age,gender,preoperative bone mineral density(BMD),and postoperative imaging data of patients were collected.Basic anti-osteoporosis drug therapy(Vitamin D,calsium supplement)and Qianggu capsules were treated to patients after the operation,to judge the improvement of traditional Chinese medicine symptoms and the incidence of recollapse.Results : There was no significant difference in age,follow-up time and gender between the recollapse group and the non-recollapse group(P < 0.05).There were significant differences between the recollapse group and the non-recollapse group in bone mineral density and the distribution pattern of bone cement(P < 0.05).In recollapse group,the bone cement didn`t contact the upper and lower endplate in 41.9% patients.In non-recollapse group,the bone cement contact upper and lower endplates in 52.9%patients at the same time.Whether the cement crossed the middle line of vertebrae showed no significant difference between two groups.During follow-up,61 patients were treated with basic anti-osteoporosis drug therapy combined with Qianggu capsules,while 40 were only treated with basic anti-osteoporosis drug.The independent sample T test of the comparison of improvement of traditional Chinese medicine symptoms in the two groups showed P<0.05,indicating significant difference between the two groups.The incidence of recollapse in patients treated with anti-osteoporosis drug therapy combined with Qianggucapsules group is 21.7%,and the other group is 45.0%.The independent sample T test showed P<0.05,indicating significant difference between two groups.Conclusions :1.Bone mineral density(BMD)is an influential factor for the recollapse of the augmented vertebrae after percutaneous vertebroplasty.The recollapse of the augmented vertebrae may be the result of natural course of osteoporosis,which further confirm the impact of the theory of “Bone Impotence”.2.Basic anti-osteoporosis drug therapy combined with Qianggu capsules has a certain effect on improving traditional Chinese medicine symptoms and reducing incidence of recollapse,which shows significant differences in alleviating pain after operation and reducing incidence of recollapse.It is of clinical significance to apply the theory of "bone impotence" of traditional Chinese medicine for further postoperative treatment.3.The distribution pattern of bone cement is related to the recollapse of augmented vertebrae.The distribution of bone cement in solid lumps and away from the vertebral endplate can increase the risk of recollapse of the augmented vertebrae.Sufficient diffusion of bone cement and simultaneous contact with the upper and lower endplates of the augmented vertebrae can effectively maintain the postoperative height of the augmented vertebrae and avoid recollapse.