Predictive value of posterior convex Cobb's angle,BMD,and P1NP on the risk of recurrent fracture after PKP in pa-tients with osteoporotic vertebral compression fracture
Objective To investigate the predictive value of posterior convexity Cobb's angle,bone mineral density(BMD),and pre-collagen type I amino-terminal pre-peptide(PⅠNP)on the risk of recurrent fracture in osteoporotic verte-bral compression fracture(OVCF)patients following balloon dilatation vertebral kyphoplasty(PKP).Methods One hundred and ten OVCF patients who underwent PKP admitted to the Department of Orthopedics of Shijiazhuang People's Hospital from December 2018 to June 2020 were selected as study subjects for 2-year follow-up,and were categorized into 28 cases in the recurrent fracture group and 82 cases in the non-recurrent fracture group according to whether new fractures ap-peared in the follow-up process.Comparing the general data and postoperative indexes of patients in the 2 groups,Coxana-lyzed the risk factors affecting the recurrent fracture after PKP,and drew ROC curve to analyze the predictive value of pos-terior convex Cobb's angle,BMD,and P1NP on the recurrent fracture after PKP in patients with OVCF.Results There were 28 cases of newfractures during the follow-up period,and the fracture recurrence rate was 25.45%(28/110).The Cobb's an-gle of posterior convexity and P1NP of the recurrent fracture group were higher than that of the non-recurrent fracture group,and the BMD was lower than that of the non-recurrent fracture group,and the differences were statistically signifi-cant(t/P=4.678/＜0.001,4.591/＜0.001,4.784/＜0.001);Cox analysis showed that increased posterior convex Cobb's angle,decreased BMD,and elevated P1NP were all risk factors for recurrent fracture after PKP[OR(95%CI)=1.394(1.135-1.712),1.910(1.127-3.236),2.140(1.084-4.225),P＜0.05];ROCcurve analysis showed that posteriorconvex Cobb's angle≥5.87°,BMD value≤-3.38 SD,and PⅠNP≤50.67 μg/Lwere the cut-offs,and the posterior convex Cobb's angle,BMD,PⅠNP predicted the AUC of 0.725,0.846,and 0.836 for postoperative recurrent fractures after PKP in patients with OVCF,respec-tively,and the combined AUC of the 3 items was 0.899,which was higher than that of the single test(Z/P=8.129/＜0.001,7.195/＜0.001,and 7.695/＜0.001).Conclusion Regular monitoring of posterior convex Cobb's angle,BMD,and P1NP levels can predict the risk of recurrent fracture after PKP in patients with OVCF at an early stage so that timely intervention can be given.
Vertebral compression fracture,osteoporoticBalloon dilatation vertebral kyphoplastyRisk of recurrent fractureKyphotic Cobb's angleBone mineral densityType I precollagen amino-terminal pre-peptidePredictive value
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