Clinical Observation On The Curative Effect Of Percutaneous Kyphoplasty And Analysis The Associated Factors Of Non-surgical Vertebral Re-fracture On Follow Up

Objective: To investigate clinical observation on the curative effect of percutaneous kyphoplasty ofosteoporotic vertebral compression fracture (OVCF) and the associated factors of non-surgicalvertebral re-fracture.Method: The clinical data of102patients who underwent PKP for osteoporoticvertebral compression fracture from January2005to December2009in our center wereretrospectively studied. The changes of visual analogue scale of pain (VAS), vertebral height andCobb angle were observed on X ray before and3days after the operation. The complications such ascement ledge were record. Observation the follow-up results, the patients were divided into fracturegroup and non-fracture group (control group) by whether there was a new fracture. The differencesbetween the two groups in general information(sex, age, bone mineral density, number of preexistingfracture, degree of vertebral compression, existence of scoliosis and Cobb angel), operatingfactors(augmentation number of vertebral, operative approach, cement volume, Disc cement leakage,degree of vertebral height restoration), history of trauma and long-term use of glucocorticoids wereanalyzed. One-way analysis of variance (ANOVA) and chi-square test was used to analyze thecorrelation between the above factors and non-surgical vertebral fracture. All relevant factors wereintroduced to Logistic Regression Analysis to analyze the main factors of non-surgical vertebralfracture. Result: operations were carried out successfully for all patients. The average surgery timewas45min (30-55min).133vertebras were performed by pkp,110vertebras were performed inunilateral approach and23vertebras were performed in bilateral approach.3.86ml (2.5-8.0ml)bone cement was injected. VAS decreased from Pre-OP （7.8±0.4）points to3days after Post-OP(2.8±0.6)point（sp＜0.05）；Cobb angles decreased from Pre-OP (24.5±4.0)°to Post-OP（18.0±3.8）°（p＜0.05）, height of fractured vertebral body increased from Pre-OP （15.23±2.4）mm to Post-OP（22.91±3.2）mm°（p＜0.05），Leakage of bone cement from DISC was found in18cases, no bonecement leakage to spine cord. no serious complications occurred.All Patients were followed up for over24months,20cases were suffered a new fracture, there-fracture rate was19.6%. ANOVA showed that bone mineral density, numbers of pre-existingfractured vertebra, numbers of augmentation vertebral, degree of preoperative vertebral compression,disc leakage of bone cement and long-term use of glucocorticoids were significantly related tonon-surgical vertebral fracture(p＜0.05). All relevant factors logistic analysis showed severe degree of osteoporosis, more augmented vertebras and long-term use of glucocorticoids was high riskfactors associate with non-surgical vertebral fracture. Conclusion: Percutaneous kyphoplasty canrelieve the pain, recover spinal morphous and reduce the rate of leakage of Disc cement; it was aeffective technology of cure osteoporotic vertebral compression fracture. There were many factorsrelatived to the re-fracture in the long-term follow up. A severe degree of osteoporosis, moreaugmented vertebras and long-term use of glucocorticoids may be the high risk factors ofnon-surgical vertebral re-fracture following percutaneous kyphoplasty.