Risk Factors Of Vertebral Refracture After Vertebroplasty For Osteoporotic Vertebral Compression Fractures

Objective:Analysis of osteoporosis vertebral compression fracture?OVCF?in patients with percutaneous vertebroplasty?PVP?after vertebral fracture risk factors for recurrence.Methods:A retrospective analysis was conducted on OVCF patients with single vertebral body who underwent PVP in orthopedics department of the third affiliated hospital of guangzhou medical university from October 2014 to October 2018.According to inclusion and exclusion criteria,192 cases of OVCF patients receiving PVP treatment were selected,among which 15 patients were diagnosed as postoperative vertebral refracture according to clinical symptoms and imaging examination during postoperative follow-up.The patients included in the analysis were divided into the refracture group and the control group according to the occurrence of postoperative intraoperative vertebral refracture.Statistics of two groups of patient's age,gender,preoperative bone mineral density T value,fracture vertebral segment section,preoperative vertebral posterior lobe,vertebral front high recovery rate,bone cement dosage,intervertebral disc bone cement leakage situation,operation by single and double side piercing and vertebral X-ray is a side as the classification and classification on the basis of the two kinds of bone cement.Single-factor independent sample t test and chi-square test were used to analyze whether the differences in the above indicators between the two groups were statistically significant.The indicators with statistical differences between the two groups were taken as independent variables,and the postoperative refracture of the vertebral was taken as dependent variables for multivariate Logistic regression analysis.Results:?1?There was no statistically significant difference between the two groups in age,gender,fracture vertebral segment,preoperative vertebral kyphosis Angle,bone cement disc leakage,and surgical single and bilateral puncture?P>0.05?.?2?univariate analysis results showed statistically significant differences in preoperative bone mineral density T value,operative vertebral height recovery rate,different distribution types of orthotopic bone cement,and different distribution types of lateral bone cement between the two groups?P<0.05?.?3?comparative analysis was conducted on three types of bone cement classification in positive position and three types of bone cement classification in lateral position,respectively.The results showed that the middle and lateral type of positive position classification was more prone to refracture than the symmetrical type in midline?P<0.05/3?.In the lateral classification,no endplate contact type was more likely to cause refracture than both upper and lower endplate contact type?P<0.05/3?.?4?The preoperative t-value of bone mineral density?OR₁=0.258?and the midline symmetrical distribution of bone cement?OR=0.166?were the protective factors for postoperative vertebral refracture after PVP.?5?The results showed that the non-endplate contact distribution of bone cement?OR=8.282?was an independent risk factor for the refracture of the vertebral.Preoperative bone mineral density T value?OR₂=0.244?,AVH?OR=1.149?and bone cement upper and lower endplate contact distribution?OR=0.129?were protective factors for postoperative vertebral refracture after PVP.Conclusions:1.OVCF patients with low bone mineral density T value have a higher incidence of postoperative vertebral refracture after PVP.2.Excessive recovery of intraoperative vertebral height during PVP will increase the risk of postoperative vertebral fracture.3.The bone cement is symmetrically distributed across the midline of the vertebral body in the vertebral body,and it also contacts the upper and lower endplates of the operative vertebra,which can effectively reduce the risk of postoperative vertebral refracture in patients with OVCF after PVP.