Risk Factors Analysis Of Adjacent Vertebral Refracture After PVP Surgery For Osteoporotic Vertebral Compression Fractures In Thoracolumbar Spine

Objective: As one of the common diseases that disturb the health of the elderly,osteoporotic vertebral compression fractures(OVCF)may cause intractable pain and seriously affect the quality of life of patients.At present,there are many treatment options for OVCF,including percutaneous vertebroplasty(PVP),which has the advantages of short operation time,obvious pain relief effect and relatively economical,and is widely recognized.However,the incidence of adjacent vertebral refracture caused by PVP is also gradually increasing.This paper aims to study the risk factors of adjacent vertebral refracture after PVP.Methods : A retrospective analysis was performed on 140 patients with thoracolumbra and lumbar OVCF who received vertebroplasty at the same time and were admitted to the orthopedics Department of Yijishan Hospital,Wannan Medical College from September 2020 to September 2021.There were 115 females and 25 males,aged 73.83 ±6.73 years.According to the occurrence of adjacent vertebral fracture during the follow-up period,the patients were divided into experimental group(refracture)20 cases and control group(no fracture group)120 cases.We collected data on factors that may be associated with the occurrence of refracture,including age,sex,underlying disease,thoracolimbar fracture site,Body Mass Index(BMI),bone cement injection amount,height recovery rate of injured vertebra,change of CObb Angle,anti-osteoporosis treatment,and bone cement leakage.The above data were included in the univariate analysis,and the statistically significant risk factors in the univariate analysis were analyzed by Logistic regression to further identify the independent risk factors for adjacent vertebral refracture after PVP surgery.Results: During the follow-up period(6-12 months),the incidence of refracture of adjacent vertebral body was 14.2%(20/140)in 140 patients treated with PVP.Univariate regression analysis showed that there were no statistically significant differences between the two groups in gender,whether the patients were combined with underlying diseases,BMI,fracture site and bone cement injection amount(P>0.05).There were significant differences in age,bone mineral density T value,Cobb Angle change,recovery rate of injured vertebra height,anti-osteoporosis treatment,and bone cement leakage rate(P<0.05).Multivariate Logistic regression analysis showed that: Age(OR=3.452,P=0.028),bone mineral density(OR=3.279,P=0.017),Cobb Angle(OR=1.874,P=0.023),bone cement leakage(OR=1.843,P=0.037),anti-osteoporosis drug therapy(OR=4.572,P=0.012)and vertebral height recovery rate(OR=1.541,P=0.032)were risk factors for adjacent vertebral refracture after PVP surgery.Conclusions: Age,low bone mineral density,irregular postoperative anti-osteoporosis drug therapy,Cobb Angle,bone cement leakage,and recovery rate of injured vertebral height were risk factors for recurrent fractures of adjacent vertebral body after PVP surgery.