Systematic Review Of Recurrent Vertebral Fractures After Percutaneous Vertebroplasty

Objective: A systematic retrospective analysis of risk factors for vertebral fracture after percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture(OVCF)in the thoracolumbar spine was performed to clarify the risk factors for vertebral body re-fracture after PVP in patients with OVCF.Methods: Two hundred and thirty-two patients with confirmed new single-segment thoracolumbar osteoporotic vertebral compression fractures seen at the Fifth Hospital of Wuhan City from January 2018 to June 2021 were selected,and the patients’ gender,age,body mass index,admission pain score and 3-day postoperative pain score,whether they had concomitant diabetic underlying disease,number of days of fracture,whether bone powder was added to the bone cement,initial vertebral fracture site,surgical approach(The patients were divided into group A(adjacent vertebral fracture group),group B(non-adjacent vertebral fracture group),and group C(postoperative vertebral fracture group).fracture group).All data were subjected to oneway test,and if P < 0.05,multi-factor logistic regression analysis was performed.Results: The fracture rate of adjacent vertebral body after PVP was 12.3%,the fracture rate of non-adjacent vertebral body was 9.7%,and the total fracture rate of vertebral body after PVP was19.8% in 232 patients.Multi-factor regression analysis showed that age,BMI,cement leakage,and Cobb’s angle of the injured vertebra were independent risk factors for fracture of the adjacent vertebral body after PVP;single-factor analysis showed that BMI,surgical approach,cement leakage,cement dispersion,postoperative vertebral body collapse rate,postoperative mid-column height recovery rate,and postoperative Cobb’s angle were correlated with non-adjacent vertebral fracture after PVP.There was a correlation(P< 0.05)between postoperative non-adjacent vertebral fractures and PVP;multifactorial regression analysis showed that cement leakage,degree of postoperative vertebral collapse,and postoperative mid-column height recovery rate were independent risk factors for postoperative non-adjacent vertebral fractures;vertebral VAS decreased significantly after PVP,and the difference was statistically significant(P< 0.05),but VAS was not related to postoperative vertebral fractures after PVP(P > 0.05).The difference was statistically significant(P< 0.05),but there was no relationship between VAS and vertebral fracture after PVP(P> 0.05).Conclusion:1.age,BMI,cement leakage,and Cobb’s angle of the injured vertebra were independent risk factors for re-fracture of adjacent vertebral bodies after PVP.2.bone cement leakage,degree of postoperative vertebral collapse,and postoperative mid-column height recovery rate were independent risk factors for non-adjacent vertebral body re-fracture after PVP.