Correlation Between Sagittal Parameters Of Spine Pelvis And Re Fracture And Curative Effect Of Osteoporotic Vertebral Compression Fracture After PVP

Objective : To study the correlation between spinal pelvic sagittal parameters and postoperative re fracture and curative effect of osteoporotic vertebral compression fracture（OVCF）treated with percutaneous vertebroplasty（PVP）.Methods:The clinical data of 62 patients with OVCF treated with PVP from December2018 to December 2020 were analyzed retrospectively.All patients used bone densitometer to measure the bone mineral density of lumbar spine and record the T value before operation.The body mass index（BMI）of patients was measured and calculated by weight height measuring instrument.The lateral films of thoracolumbar spine and pelvis were taken in standing position within 2-3 days after operation.The patients with postoperative（within 1 year）re fracture were taken as the fracture group（31 cases）.The patients without postoperative re fracture whose general baseline data such as gender,age,body mass index（BMI）,bone mineral density（BMD）,bone cement dosage and surgical segments were similar to those of the fracture group were selected as the control group（31 cases）.The spinal pelvic sagittal parameters [including thoracic kyphosis（TK）,thoracolumbar kyphosis（TLK）,lumbar lordosis（LL）,sacral slope（SS）,pelvic tilt（PT）,pelvic incidence（PI）] and curative effect [according to Visual Analogue Scale（VAS）,Activities of Daily Living（ADL）,Berg Balance Scale（BBS）] were compared between the two groups.Results:（1）There was no significant difference between the fracture group and the control group in gender,age,BMI value,bone mineral density t value,bone cement dosage and surgical segments（P > 0.05）.（2）The thoracic kyphosis（TK）in the fracture group was greater than that in the control group,and the lumbar lordosis（LL）,sacral slope（SS）and pelvic incidence（PI）in the fracture group were less than those in the control group（P < 0.05）.There was no significant difference in thoracolumbar kyphosis（TLK）and pelvic tilt（PT）between the two groups（P > 0.05）.（3）Taking thoracic kyphosis（TK）,lumbar lordosis（LL）,sacral inclination angle（SS）and pelvic incidence angle（PI）as independent variables and OVCF as dependent variables,logistic regression analysis showed that thoracic kyphosis angle（TK）,lumbar lordosis angle（LL）,sacral slope（SS）and pelvic incidence（PI）were related to re fracture after PVP.（4）There was no significant difference in VAS score and ADL score between the two groups before operation（P > 0.05）.The patients were followed up for 12 ～ 18 months,with an average of 14.6 months.The curative effect of postoperative fracture group was significantly lower than that of control group（P < 0.05）.Conclusion:TK is positively correlated with the probability of re fracture after PVP in patients with OVCF and negatively correlated with the curative effect;The values of LL,SS and PI were negatively correlated with the probability of re fracture after PVP in patients with OVCF and positively correlated with the curative effect.