| ObjectiveTo investigate the relationship between adjacent vertebral fractures after percutaneous vertebroplasty for thoracolumbar osteoporotic vertebral compression fractures and degeneration of septal intervertebral discsMethodsUsing a non matched case-control study method,we conducted a retrospective analysis on 211 patients who underwent percutaneous vertebroplasty(PVP)for thoracolumbar vertebral compression fractures.due to osteoporosis from January 2016 to December 2020 in our hosp ital,with complete relevant data.The case group(n=73)was a group of patients who experienced adjacent vertebral fractures after PVP surgery during the follow-up period,while the control group(n=138)was a group of patients who did not experience adjacent vertebral fractures after PVP surgery during the follow-up period,Age,gender,bone mineral density,body mass index,the penetration of bone cement into intervertebral disc,the height of intervertebral discs,the MRI index of intervertebral discs,and the signal level of intervertebral discs were observed and recorded in both groups(according to the improved Pfirmmann grading system).Divide intervertebral disc degeneration into severe degeneration group,mild degeneration group,and no degeneration group according to the signal level of the intervertebral disc.Use the x2 test to compare whether there.is a significant difference in the incidence of adjacent vertebral fractures after PVP surgery among three groups with different degrees of intervertebral disc degeneration,and estimate the OR value for the severity of intervertebral disc degeneration.Apply univariate and multivariate logistic regression analysis to study the correlation between various factors and adjacent vertebral fractures after PVP surgery,and calculate the exposure ratio OR value of each influencing factor.Draw ROC curves for different intervertebral disc indicators,use the maximum Yoden index as the positive judgment value,analyze the corresponding sensitivity,specificity,and Yoden index table to estimate the risk threshold of intervertebral disc degen eration for adjacent vertebral fractures after PVP surgery.ResultsThere was no significant difference in age,gender,and body mass index between the case group and the control group(P>0.05)，but there was a significant difference in bone density,bone cement infiltration into the intervertebral disc,intervertebral disc height,intervertebral disc MRI index,and intervertebral disc signal level(P<0.05);The x2 test showed that the exposure ratio of intervertebral disc degeneration between the case group and the control group[OR=3.985，95%CI(1.686,9.422)]and the exposure ratio of severe intervertebral disc degeneration[OR=9.567,95%CI(3.807,24.038)]were statistically significant(P<0.05);The results of univariate logistic regression analysis showe d that age,gender,bone density,and body mass index were not the influencing factors for postoperative adjacent vertebral fractures(P>0.05),while bone cement infiltration into the intervertebral disc,severe disc degeneration,mild disc degeneration,MRI index of the intervertebral disc,and disc height were the influencing factors for postoperative adjacent vertebral fractures(P<0.05);The results of multivariate logistic regression analysis showed that the intervertebral disc degeneration was severe[OR=10.941,95%CI(2.109,56.751)],and bone cement infiltrated into the intervertebral disc[OR=10.835;95%CI(1.887,62.228)and a decrease in intervertebral disc height[OR=0.487;95%CI(0.316,0.752)and decreased intervertebral disc MRI index(OR=0.999,95%CI(0.999,1))are risk factors for adjacent vertebral fractures after PVP surgery(P<0.05);ROC analysis showed that the height of the intervertebral disc less than 6.070mm(sensitivity=99.28%,specificity=58.9%;area under the curve=0.7991;Jordan index=0.5818),and the MRI index of the intervertebral disc less than 27628mm2× GY,(sensitivity=89.65%,specificity=79.45%;area under the curve=0.9265;Jordan index=0.6931),the intervertebral disc signal level more than V level(sensitivity=78.1%,specificity=70%;area under the curve = 0.7212;Jordan index=0.481),are the risk threshold for predicting adjacent vertebral fractures after PVP surgery(P<0.0001).Conclusion1.There is a correlation between adjacent vertebral fractures after percutaneous vertebroplasty for thoracolumbar osteoporotic fractures and septal intervertebral disc degeneration.2.The severe degeneration of intervertebral disc(the signal level of intervertebral disc more than V),the decreased MRI index of intervertebral disc(the MRI index of intervertebral disc less than 27628mm2×GY),the decreased height of intervertebral disc(the height of intervertebral disc less than 6.070mm)and the infiltration of bone cement into intervertebral disc are the risk factors for adjacent vertebral fractures after percutaneous vertebroplasty for thoracolumbar osteoporotic vertebral compression fractures... |
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