The Clinical Analysis Of Adjacent Vertebral Body Fractures After Vertebroplasty For Single Vertebral Osteoporotic Compression Fractures

Objective: To explore the clinical feature and risk factors of adjacent vertebral body fractures after vertebroplasty for Single vertebral osteoporotic compression fractures.Methods: A retrospectively collected cohort of 136 patients who were underwent PVP surgery for Single vertebral osteoporotic compression fractures in our hospital from March 2015 to October 2016.All of the cases were divided into the no fracture group after operation(group A)113 cases and the adjacent vertebral fracture group after operation(group B)23 cases.The related indicators were recorded and the t-test or ?2-test methods and the COX regression analysis were used and the survival curve was drawn by Kaplan-Meier.Results:1.All of the 136 cases were followed up for an average of 20.41±2.38 months,including 23 cases of adjacent vertebral fractures and the incidence rate was 16.91%.The mean time of the twice fracture interval was 9.17±1.86 months and the postoperative adjacent fracture within 1 month accounted for 30.43%,6 months accounted for 60.87% and 1 year accounted for 73.91%;2.The difference of bone density,anterior edge vertebral height recovery percentage,vertebral kyphotic angle change,bone cement leakage and postoperative regular anti-osteoporosis treatment in the two groups were statistically significant(P < 0.05),while there were no significant difference in gender,age,height,weight,body mass index and bone cement dosage between the two groups(P > 0.05);3.According to the single factor COX regression analysis results,only the bone mineral density(P=0.003),bone cement dosage(P=0.011),anterior edge vertebral height recovery percentage(P=0.015)and the postoperative regular anti-osteoporosis treatment(P=0.000)were significant variables,which may have an effect on the occurrence of AVF;4.The Kaplan-Meier method was used to draw the survival curve of the adjacent vertebral body fracture about whether the postoperative regular anti-osteoporosis treatment was used.The result was that the time of occurrence of AVF with postoperative regular anti-osteoporosis treatment was later than that without postoperative regular anti-osteoporosis treatment and the difference was statistically significant(P < 0.05);5.The COX multivariate regression analysis showed that bone mineral density(P = 0.05,HR=0.237)and the postoperative regular anti-osteoporosis treatment(P < 0.05,HR=0.016)were protective factors of adjacent vertebral fractures,anterior edge vertebral height recovery percentage was an independent risk factor of AVF(P < 0.05,HR=1.318),but AVF had no correlation with bone cement dosage(P > 0.05).Conclusion:1.The adjacent vertebral body fractures after PVP surgery for the single vertebral osteoporotic compression fractures always occur within the postoperative 6 months and the incidence was 16.91%;2.There are many factors affecting the adjacent vertebral body fracture.Bone mineral density and the regular anti-osteoporosis measures are the protection factors for the adjacent vertebral body fracture and the recovery percentage of height of anterior edge vertebral body is the independent risk factor for AVF after the PVP operation.