Risk Factors For Recurrent Fracture Of Adjacent Vertebrae After PVP For Single-Segment Osteoporotic Vertebral Compression Fractures Of The Lumbar Spine

Objective: To investigate the risk factors for recurrent fracture of adjacent vertebrae after percutaneous vertebroplasty(PVP)for single-segment osteoporotic vertebral compression fractures of the lumbar spine,to provide a theoretical reference for the early prevention of re-fracture of adjacent vertebrae after PVP in clinical practice,and to provide a basis for further in-depth studies.Methods: A total of 197 patients diagnosed with single-segment osteoporotic vertebral compression fractures of the lumbar spine treated by PVP in our outpatient and inpatient departments between 01/01/2021 and 31/12/2022,meeting the criteria,were included,and the imaging data of all patients were read and followed up regularly.The patients’ gender,ethnicity,age,body mass index,bone mineral density,preoperative Cobb angle,postoperative Cobb angle,vertebral height recovery rate,cemented disc leakage,type of cement distribution,fracture distribution segment,anti-osteoporosis treatment,and other factors were selected for univariate and multi-factor logistic regression analysis.Results: A total of 197 patients with single-segment osteoporotic vertebral compression fractures of the lumbar spine after PVP were included in this study.spine 42 patients(21.3%)were finally screened for postoperative re-fractures,of which 27(13.7%)were adjacent vertebral re-fractures,8males and 19 females,with a mean age of 78.78±7.66 years;155(78.7%)were in the no re-fracture group,38 males and 117 cases,mean age73.43±8.23 years.There were no statistically significant differences between the re-fracture and non-re-fracture groups in terms of gender,ethnicity,preoperative Cobb angle,anti-osteoporosis treatment,disc leakage of bone cement,and fracture distribution segments(P > 0.05),while there were statistically significant differences between the two groups in terms of age,body mass index,bone mineral density,postoperative Cobb angle,vertebral height recovery rate,and type of bone cement distribution(P < 0.05).Further logistic regression analysis of the factors that were statistically significant in the univariate analysis above showed that age,bone density,vertebral height recovery rate and type of cement distribution were independent risk factors for re-fracture of the adjacent vertebral body after PVP(P < 0.05).Conclusion(s): This study derived from univariate and multifactorial analyses that age(OR= 1.063,95% CI [1.002 to 1.128]),bone mineral density(OR= 0.974,95% CI [0.949 to 0.999]),vertebral height recovery rate(OR=1.056,95% CI [1.000 to 1.114])and type of bone cement distribution(OR=1.385,95% CI [1.017 to 1.885])were independent risk factors for the occurrence of adjacent vertebral re-fracture after PVP.In elderly patients with OVCF,in addition to strict mastery of surgical indications and operating techniques to prevent uneven distribution of bone cement within the vertebral body and avoid excessive postoperative vertebral height recovery rates,standardised,rational and effective postoperative anti-osteoporotic treatment should be enhanced to improve bone mineral density,prevent continued bone loss and reduce the incidence of re-fracture of adjacent vertebral bodies after PVP.