Incidence And Risk Factors Of Vertebral Refracture After Percutaneous Vertebroplasty

Objective: This retrospective study aimed to investigate and analyze the incidence and risk factors of vertebral refracture after percutaneous vertebroplasty for osteoporotic vertebral compression fractures(OVCFs).Methods: The retrospective study included a consecutive series of 168 patients with OVCFs in Department of spinal surgery,the third affiliated hospital of Hebei Medical University from March 2016 to December 2017.Fifty-three patients were excluded for various reasons.Finally,115 patients were included in our study.According to the last follow-up whether the occurrence of new vertebral fracture,36 patients were divided into Fracture group and 79 patients were divided into the Fracture-free group.Basic data including age,recovery rate of vertebral height(RRVH)sex,body mass index(BMI),follow-up time,discal cement leakage,smoking status,local kyphosis(LK)and pelvic parameters(PI,PT,SS)were collected for statistical analysis.Independent t test,chi-square test and multivariate logistic regression analysis with adjusted odds ratio(OR)and 95% confidence interval(CI)were used.The sensitivity,specificity and area under the curve(AUC)of BMD were evaluated by receiver operating characteristic curve(ROC),and the Cutoff value of BMD was obtained at the same time.Results: 36(31.3%)patients were included in the fracture group,and 79(58.7%)patients were included in the fracture-free group.There were no significant differences in PI,PT,SS,LK,age,discal cement leakage,gender,follow-up time,smoking status or BMI between the two groups.RRVH(P=0.016)and BMD(P < 0.001)were statistically significant.By multivariate logistic regression analysis,only BMD(P =0.001)was highly correlated with vertebral refracture after PVP.The receiver operating characteristic(ROC)curve and Jordan index were used to calculate the cutoff value of BMD as-2.85 SD.Conclusion: In this study,the age,gender,BMI,follow-up time,pelvic parameters,RRVH,discal cement leakage,LK and smoking status were not correlated with OVCFs after PVP.Low preoperative BMD is a high risk factor for vertebral refracture after PVP,especially when the preoperative BMD is less than-2.85 SD.