Risk factors of adjacent vertebral fractures after percutaneous kyphoplasty with percutaneous balloon dilatation for patients with osteoporosis

Abstract

Objective To investigate the risk factors of the re-fracture of adjacent vertebral body after percutaneous kyphoplasty with percutaneous balloon dilatation for patients with osteoporosis. Methods The clinical data of 298 patients with osteoporotic vertebral compression fractures treated at our hospital from June, 2014 to June, 2017 were retrospectively collected. The patients were divided into a re-fracture group and a non-re-fracture group according to the adjacent vertebral fracture after PKP. The gender, age, body mass index (BMI), operative site, the injection method of bone cement, the preoperative intravertebral cleft, height restoration of anterior vertebral body, preoperative bone mineral density (BMD), the amount of bone cement injection, bone cement leakage, and changes of kyphotic angle before and after operation were compared between these two groups. Results In this study, the 298 patients were followed up for (28.74±4.81) months. It was found that 37 patients had re-fracture of the adjacent vertebral body after operation, with an incidence of 12.42%. Univariate analysis showed that there were no statistical differences in gender, BMI, operative site, the injection method of bone cement, the combination of fracture-like changes in the vertebral body before the operation, and the recovery rate of the anterior edge of the vertebral body (all P>0.05), but were in age, BMD, amount of bone cement injection, bone cement leakage, and kyphotic angle changes between the re-fracture group and the non-re-fracture group (all P<0.05). Multivariate logistic regression analysis showed that BMD, bone cement injection, and the cement leakage were risk factors of re-fracture (all P<0.05). Conclusions Osteoporotic patients after PKP have certain risk of adjacent vertebral body re-fracture; the changes such as BMD, bone cement injection, cement leakage in these patients should be paid more attention clinically; and the targeted intervention should be given, so as to reduce the incidence of re-fracture after PKP. Key words: Osteoporosis; Percutaneous kyphoplasty; Re-fracture; Risk factors