Risk Factors And Prevention Of Recurrent Fracture After PVP For The Osteoporotic Vertebral Compression Fracture

Objective: To study and analyze the risk factors and prevention strategies of recurrent fracture after PVP for osteoporotic vertebral compression fracture,so as to provide basis for the prevention and treatment of surgical vertebral fracture after PVP.Methods: 186 patients with OVCF who underwent PVP from April 2015 to April 2018 were divided into group A(recurrent fracture group)35cases and group B(non-recurrent fracture group)151 cases.The clinical data of the patients were retrospectively analyzed,including gender,age,body mass index,bone mineral density,bone cement injection volume,preoperative VAS score,past medical history(including smoking history,alcoholism history,coronary heart disease,diabetes mellifluous,hypertension),vertebral fracture classification,number of vertebral fracture,surgical approach,bone cement leakage,anti-osteoporosis treatment.Univariate and multivariate logistic regression analysis was used to analyze the factors that may affect the operative vertebral re-fracture after operation.Results:(1)Comparing the basic data of the two groups,the results showed that the bone mineral density of group A was significantly lowerthan that of group B(P<0.05),but there was no significant difference in gender,age,body mass index and past history between the two groups(P>0.05).(2)The results showed that there were significant differences in the amount of bone cement injection,the leakage of bone cement and the treatment of anti-osteoporosis between the two groups(P<0.05),while there were no significant differences in VAS score,vertebral fracture classification,the number of fracture pyramids and surgical approach between the two groups(P>0.05).(3)Logistic regression analysis was used to analyze the statistical significance of the above factors.The results showed that anti-osteoporosis treatment,bone cement leakage and bone mineral density entered the regression model(P<0.05),which were independent risk factors for operative vertebral refracture after PVP.(4)In this paper,35 patients with vertebral refracture after operation of osteoporotic vertebral body were treated conservatively in 11 cases,and the others were treated with PVP again which were treated with collateral pedicure approach of previous operation.During the operation,5 patients had a small amount of leakage of bone cement,mainly considering the existence of fissures with the refracture vertebral body.The patients were treated with PVP again.There were no symptoms of nerve injury after treatment,and satisfactory results could be obtained.Conclusion: Continuous progress of osteoporosis,secondary trauma and uneven distribution of bone cement are independent risk factors for vertebral re-fracture in patients with osteoporotic vertebral compression fracture after PVP surgery,and anti-osteoporosis treatment is the protective factor for vertebral refracture after surgery.For the prevention and treatment of patients after operation,we need to pay attention to the anti-osteoporosis treatment,improve the bone mineral density of patients,and pay attention to the prevention of secondary trauma and uneven distribution of bone cement.