Risk Factors For Height Loss Of The Augmented Vertebrae After Percutaneous Vertebroplasty For Treatment Of Painful Osteoporotic Vertebral Compression Fractures

Objective To evaluate the long-term height loss of the augmented vertebrae after percutaneous vertebroplasty(PVP)in patients with painful osteoporotic vertebral compression fractures and to analyze the related risk factors.Methods Patients with fresh painful osteoporotic vertebral compression fractures,treated by percutaneous vertebroplasty,were selected in the Department of Interventional Radiology in Zhong-DA hospital from January 2007 to December 2016,and with complete information recorded more than one year follow-up.The anterior height of objective vertebrae was measured in the midsagittal plane of the reformatted images at CT before and 3 days,1 year,3 years and more than 5 years after surgery.Patients were classified into height-loss group and non-height-loss group by whether the height of the augmented vertebrae 3 days after surgery was more than 1 mm in the follow-up time of 1 year.The univariate and multiple linear regression statistical analysis was used with the software of SPSS 23.0.Results A total of 88 patients with 192 vertebral bodies were included in the study,with a follow-up time of 12-74 months,33 ± 10.5 months on average.26.56%(51/192)of augmented vertebral bodies with 23 patients occurred height-loss after PVP.The factors of gender,age,body mass index(BMI),bone density,the position of augmented vertebrae,puncture route,intravertebral vacuum cleft sign,the distribution and shape of bone cement,bone cement dose and preoperative vertebral compression degree were analyzed by univariate analysis.All factors except gender,age,body mass index and bone cement dose were statistically significant(P<0.05).Then multivariate logistic regression was used,and the bone density,the position of augmented vertebrae,intravertebral vacuum cleft sign,the distribution and shape of bone cement,and preoperative vertebral compression degree were the independent risk factors of the loss of augmented vertebral height(P<0.05).Conclusion 26.56%(51/192)of augmented vertebral bodies occurred height-loss after PVP in patients with painful osteoporotic vertebral compression fractures.The bone density,the position of augmented vertebrae,intravertebral vacuum cleft sign,the distribution and shape of bone cement,and the preoperative vertebral compression degree were the independent risk factors of the loss of augmented vertebral height.