Related Factors Of Vertebral Height Loss After Vertebroplasty

Objective: Percutaneous Vertebroplasty(PVP)is the main minimally invasive procedure for the treatment of Osteoporotic Vertebral Compression Fracture(OVCF).The loss of vertebral height after vertebral surgery so that recurrence of back pain is one of the common complications after PVP,and it is difficult to treat such complications.This study analyzed the factors that may cause the loss of vertebral height after PVP,and provided relevant evidence for the clinical use of PVP for the treatment of osteoporotic vertebral fractures,in order to improve the efficacy of surgery and prevent the loss of surgical vertebral height.Methods:A retrospective analysis of patients with osteoporotic vertebral compression fractures treated with percutaneous vertebroplasty from January 2013 to December 2015 in our spine surgery.According to the inclusion criteria and exclusion criteria,wo collected gender,age,body mass index,bone mineral density,whether there were intravertebral vacuum cleft(IVC),single or bilateral injections,injured vertebrae,the volume of bone cement injected,bone cement distribution,the anterior height of the vertebral body and the degree of kyphosis angle and the visual analogue scale(VAS)were performed before operation,1 day after surgery and 12 months after surgery.According to whether there was any loss of the anterior height of the vertebral body at the last follow-up,the subjects were divided into high-loss group and non-loss group,and the factors were statistically analyzed.Results: There were 156 patients who met the inclusion criteria,37 males and 119 females,aged 56-87 years,mean(72.4±4.1)years old.The preoperative bone density T value was-4.9 to-2.6,with an average of(-3.2±0.2).Preoperative imaging examination showed that there were 13 vertebral bodies with intravertebral vacuum cleft.There were 137 cases of bilateral pedicle injection and 19 cases of unilateral pedicle injection.The cement is used in a dose of 2.5-6 ml with an average of 4.3 ml.The follow-up period was 12-36 months,and the average follow-up time was(18±9.8)months.A total of 17 patients had bone cement-enhanced vertebral height loss again,the incidence rate was 10.9%,which usually occurred after 1-10.Months,an average of 4 months.Univariate analysis showed that the patient's age,gender,body mass index,injured vertebra segment,single and double side injection,bone cement injection dose,bone cement contact with endplate,had no significant effect on the height loss of the surgical vertebral body(P > 0.05),The patient's bone mineral density,intravertebral vacuum cleft,vertebral compression correction rate,and vertebral body angle correction were significant factors.Logistic regression analysis was performed on significant factors,showing bone density,intravertebral vacuum cleft,and vertebral body compression correction recovery rate,vertebral kyphosis angle correction is a risk factor for surgical vertebral height loss(P <0.05).Conclusion: Osteoporosis degree,intravertebral vacuum cleft,vertebral body height reconstruction too large,kyphosis angle correction is too large for the risk of vertebral body height loss,select appropriate patients before surgery,pay attention to moderately correct the degree of compression and kyphosis of the injured vertebrae during surgery,surgery Post-active anti-osteoporosis treatment can reduce the incidence of enhanced vertebral height loss after PVP.