| Objective:To explore the effect of vertebral cement distribution on the incidence and pain relief of secondary adjacent vertebral fractures after PVP for osteoporotic vertebral compression fractures.Methods:Patients with single OVCF who received PVP treatment in the Second Hospital of Shanxi Medical University from December 2019 to December 2021 were selected as the study objects.Based on the anteroposteric and lateral X-ray images after the operation of the injured vertebra,the diffusion of bone cement in the vertebra in the three directions(transverse,longitudinal and anteroposterical directions)was statistically analyzed.Patients with good distribution in the three directions were classified as the good diffusion group(group A),and the rest were classified as the poor diffusion group(group B),with 36 patients in group A and 84 in group B.Postoperative pain relief and the incidence of secondary adjacent vertebral fractures were compared between the two groups.Results:There were no significant differences in age,gender,BMI(height and weight),preoperative fracture time,bone cement volume,anterior margin compression degree,and anterior margin height recovery rate between the two groups(P > 0.05).VAS scores immediately after surgery and one year after surgery were statistically significant compared with those before surgery(P < 0.05),VAS scores on the day of admission were not statistically significant between the two groups(P > 0.05),VAS scores immediately after surgery and one year after surgery were statistically significant between the two groups(P < 0.05).The probability of secondary adjacent vertebral fracture in group A(8.3%)was lower than that in group B(25.0%),and the difference between the two groups was statistically significant(P < 0.05).The intra-group analysis of group B showed that 11 patients with poor anteroposterical diffusion had adjacent vertebral fracture,accounting for 45.8% of the total number of patients with poor anteroposterical diffusion,which was higher than the probability of adjacent vertebral fracture in patients with good anteroposterical diffusion(16.7%),and the difference was statistically significant(P < 0.05,OR=4.231).There was no correlation between left-right and up-down degree of dispersion and the occurrence of adjacent vertebral fractures(P >0.05).Conclusion:For patients with osteoporotic vertebral compression fractures after PVP,a good distribution of bone cement in the vertebral body can lead to better pain relief,while the incidence of secondary adjacent vertebral fractures is only related to the degree of bone cement diffusion in the anteroposteric direction,which can lead to a lower incidence of secondary adjacent vertebral fractures. |
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