| Objective: To investigate the risk factors affecting the Sandwich Vertebra after vertebroplasty for osteoporotic vertebral compression fracture and to provide a theoretical basis for the prevention of vertebral fracture.Sandwich vertebral is a special adjacent vertebra after vertebroplasty,It is defined as a vertebra located between two cemented vertebral bodies.Methods: A retrospective analysis was performed to collect the relevant clinical data of patients who underwent PVP in our hospital due to osteoporotic vertebral compression fracture during October 1,2017 solstice December 31,2019,A total of 501 patients were followed up with complete data,Postoperative imaging data of all patients were read,Patients with osteoporotic vertebral compression fracture with the phenomenon of sandwich vertebra were selected as the research object,To regular follow-up,Combined with the clinical signs and symptoms?physical examination and imaging data to determine whether the Sandwich vertebral fracture occurred,and the rate of sandwich vertebral fracture was calculated,A database was selecting containing patient gender,age,height,weight,bone density T value,Sandwich vertebral distribution segment,cement disk leakage,cement amount,cement distribution pattern and whether the reinforced vertebral body cement on both sides of the sandwich vertebra is in contact with the endplate,preoperative and postoperative local kyphosis of the sandwich vertebra.The sandwich vertebra was divided into the fracture group and the non-fracture group and the rate of sandwich vertebral fracture was calculated and multiple logistic regression analysis was executed as well.Results: Among the 501 patients,there were 45 patients with sandwich vertebra.The follow-up time was 6 to 24 months,with an average of 14.04±6.45 months.In 45 patients,a total of 110 vertebral bodies were subjected to vertebroplasty and formed 45 sandwich vertebra.Among them,20 patients(6 males and 14 females)had osteoporotic vertebral compression fracture with an incidence rate of 44.4%(20/45),and 25 patients(7 males and 18females)had no fracture of vertebral compression,Single factor analysis showed no significant difference in gender,age,height,weight,Sandwich vertebral distribution segment,cement amount,cement distribution pattern,whether the reinforced vertebral body cement on both sides of the sandwich vertebra is in contact with the endplate and preoperative and postoperative local kyphosis of the sandwich vertebra between the two groups(P>0.05),There were statistically significant differences between the two groups in bone density T value and whether there was bone cement intervertebral disc leakage in the sandwich area(P < 0.05),and these factors were included in Logistic regression analysis.the results showed that the bone density T value(P <0.05)in the sandwich vertebra fracture group was significantly different from that in the sandwich vertebra non-fracture group(B=1.184,OR=3.269),This suggests that the lower bone density,the more severe the degree of osteoporosis,that is,the more severe the degree of osteoporosis,the higher the risk of fracture of the sandwich vertebra.Intervertebral disc leakage of bone cement in the sandwich area(P >,0.05)showed no statistically significant difference.Conclusion: In this study,it was concluded from single factor and multiple factors that low bone density was an independent risk factor for fracture of the sandwich vertebra.The lower the bone density,the more severe the degree of osteoporosis,and the greater the risk of fracture of the sandwich vertebra.Therefore,the correct and reasonable anti-osteoporosis program should be designed for the patients after vertebroplasty to slow the loss of bone mass.According to the single factor analysis,bone cement intervertebral disc leakage(P < 0.05)was found to be statistically significant,but in the multi-factor analysis(P >0.05),the difference was not statistically significant.Considering that bone cement intervertebral disc leakage may be a potential risk factor affecting the fracture of the embedded vertebra,but not an independent risk factor,so,the occurrence of bone cement disc leakage should be minimized during PVP... |
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