Risk Factors Associated With Osteoporotic Compression Fractures After Percutaneous Vertebroplasty Re-fracture Analysis

Objective: Through analysis and comparison of Percutaneous Vertebroplasty in the treatment of Osteoporosis vertebral compression fracture in patients with clinical data,to find the postoperative non-injured vertebral fractures related factors,which provides the basis for clinical work.Methods: Clinical data of 297 patients undergoing Percutaneous Vertebroplasty(PVP)surgical treatment of Osteoporosis vertebral compression fracture(OVCF)were enrolled in the Department of Spinal surgery,Affiliated Hospital of Yan'an University from October 2012 to October 2017.The basic data of the patients(Gender,age,height,weight),Cases,Surgery,Imaging,etc.Patients were divided into group A(re-fracture group)and group B(non-fracture group)according to whether or not non-injured vertrbral fractures occurred after Percutaneous Vertebroplasty.Comparison of measurement data(age,bone cement injection volume,correction of vertebral bodies' local sagittal angle etc)using t-test.?2-Test was?applied?to?enumeration?data(sex,Operation vertebral segmentsetc,Bone cement extravasation,The degree of osteoporosis etc).Compare factors related to non-injured vertrbral fractures by Logistic regression model at the Same time Calculate OR and 95%CI.Results:In this study,there are 297 patients were successfully completed the surgery,there was no serious complications,such as spinal cord injury and pulmonary embolism.There are 76 males and 211 females with an average age of 72.67±6.31.The average patients' BMI was 20.91±3.15(Kg/m2).75 patient had bone cement extravasation with the incidence of 25.3%.The average bone cement injection volume was 3.13±0.76 ml.Before the surgery,the average vertebral bodies' local sagittal angle was 10.97°±10.66°.After the surgery,the average vertebral bodies' local sagittal angle was 7.47°±10.52°.The average correction of vertebral bodies' local sagittal angle was 2.56°±2.09°.There are 266 patients accepted antiosteoporotic therapy with the rate of 89.7%.The patients' average T-score was-(2.86±0.44).There are 28 fractures occurred on T5-T10.There are 239 fractures occurred on T11-L2.There are 30 fractures occurred on L3-L4.Group A: There are 12 males and 30 females with an average age of 73.32±5.41.The average patients' BMI was 20.62±2.90(Kg/m2).28 patient had bone cement extravasation with the incidence of 66.7%.The average bone cement injection volume was 3.16±0.71 ml.Before the surgery,the average vertebral bodies' local sagittal angle was 10.97°±10.53°.After the surgery,the average vertebral bodies' local sagittal angle was 7.52°±11.17°.The average correction of vertebral bodies' local sagittal angle was 2.58°±1.98°.There are 29 patients accepted antiosteoporotic therapy with the rate of 69.0%.The patients' average T-score was-(3.14±0.23).There are 4 fractures occurred on T5-T10.There are 35 fractures occurred on T11-L2.There are 3 fractures occurred on L3-L4.Group B: There are 64 males and 191 females with an average age of 72.48±6.97.The average patients' BMI was 21.05±3.27(Kg/m2).47 patient had bone cement extravasation with the incidence of 18.4%.The average bone cement injection volume was 3.12±0.91 ml.Before the surgery,the average vertebral bodies' local sagittal angle was 11.02°±11.04°.After the surgery,the average vertebral bodies' local sagittal angle was 7.38°±10.17°.The average correction of vertebral bodies' local sagittal angle was 2.54°±2.17°.There are 237 patients accepted antiosteoporotic therapy with the rate of 92.9%.The patients' average T-score was-(2.32±0.76).There are 24 fractures occurred on T5-T10.There are 204 fractures occurred on T11-L2.There are 27 fractures occurred on L3-L4.Conclusion:This study shows us that excessive correction of vertebral bodies' local sagittal angle and bone cement extravasation can significantly increase the incidence of new fractures.At the same time,accepting antiosteoporotic therapy can help preventing new vertebral fractures.Age,sex,BMI,bone cement injection volume,the vertebral bodies' local sagittal angle,The correction of vertebral bodies' local sagittal angle,T-score,fractured segments are not related of new fractures.It is essential to treat patients with antiosteoporotic therapy and to avoid bone cement extravasation.