[Objective]To explore the risk factors related to adjacent segment degeneration(ASD)after percutaneous kyphoplasty(PKP).[Methods]A total of 162 patients who received PKP in our hospital from January 2020 to September 2021 were included in this study.They were divided into a ASD group and a non-ASD group based on whether adjacent segment degeneration happened 2 years after the primary PKP.Multivariate logistic regression analyses were conducted to identify the risk factors for degeneration.A predictive model was constructed using logistic regression,and the predictive performance was evaluated using ROC curves.[Results]Among 162 patients,25 cases(15.4％)experienced ASD 2 years after PKP surgery.As for univariate comparison,the ASD cohort proved significantly greater than the non-ASD group in terms of age[(73.0±6.6)years vs(67.9±7.9)years,P=0.003],proportion of smoking history[yes/no,(17/8)vs(62/75),P=0.036],proportion of previous ASD before surgery[yes/no,(9/16)vs(24/113),P=0.035],amount of bone cement injected[(4.1±1.0)ml vs(3.1±0.9)ml,P＜0.001],proportion of bone cement leakage[yes/no,(10/15)vs(23/114),P=0.008],Cobb angle immediately after surgery,[(11.5±2.7)° vs(9.8±2.1)]and recovery rate of vertebral height[(12.0±2.6)％vs(8.2±2.3)％,P＜0.001],whereas the former had significant-ly lower preoperative BMD than the latter[T value,(-3.2±0.8)vs(-2.6±0.5),P＜0.001].As results of multivariate logistic regression analysis,more amount of bone cement injected(OR=2.653,P=0.044),higher vertebral height recovery rate(OR=2.045,P＜0.001),and older age(OR=1.199,P=0.016)were the independent risk factors for ASD,while the greater BMD(OR=0.279,P=0.035)was a protective factor.The ROC areas under curve(AUCs)predicting ASD by independent factor were of 0.804 by age,0.753 by BMD,0.761 with bone cement volume in-jected,and 0.878 by vertebral height recovery rate,in contrast,of 0.960 by the prediction equation.[Conclusion]Advanced age,low bone density,large amount of bone cement injection,and excessive recovery of vertebral height are risk factors for ASD after PKP surgery,which should be highly valued and treated accordingly in clinical practice.
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