Analysis of risk factors for recurrent collapse in patients with osteoporotic vertebral compression fractures after percutaneous kyphoplasty
Objective To explore the risk factors and preventive measures for recurrent vertebral collapse in patients with osteoporotic compression fractures(OVCF)undergoing percutaneous kyphoplasty(PKP)treatment.Methods A retrospective analysis was conducted on 33 OVCF patients who received PKP treatment at the Chengdu Bayi Orthopedic Hospital from May 2020 to May 2022 and experienced recurrent vertebral collapse within one year after surgery,as the collapse group.A total of 67 OVCF patients who received PKP treatment during the same period and did not experience recurrent collapse after surgery were selected as the control group.The general information,bone density,surgical treatment indicators,and postoperative imaging indicators of the two groups of patients were compared and analyzed.Multivariate model analysis was used to screen the risk factors for recurrent collapse in OVCF patients after PKP surgery.Results Among the 33 patients selected for PKP surgery,the time of recurrent vertebral collapse was 4-12(8.3±1.7)months after surgery,including 6 patients with mild collapse,24 patients with moderate collapse,2 patients with severe collapse,and 1 patient with extremely severe collapse.The age of patients in the collapse group was higher than that of the control group,and the difference was statistically significant(P＜0.05).There was no statistically significant difference in body mass index(BMI),smoking,alcohol consumption,gender,and comorbidities between the collapse group and the control group(all P＞0.05).The lumbar spine bone density T value of the collapse group patients was lower than that of the control group,and the incidence of postoperative bone cement leakage,the proportion of bone cement with a dense distribution were all higher than those of the control group,and the use of anti-osteoporosis drugs was lower than that of the control group,with statistically significant differences(all P＜0.05).There was no statistically significant difference in the fracture site,bone cement injection volume,postoperative convexity angle,postoperative kyphosis deformity angle,postoperative vertebral height recovery rate,and postoperative Oswestry Disability Index(ODI)value between the collapse group and the control group patients(P＞0.05).The results of logistic regression model analysis showed that increasing age,occurrence of bone cement leakage,and dense distribution of vertebral bone cement were independent risk factors for recurrent collapse after PKP surgery in OVCF patients(all P＜0.05).High bone density T value and use of anti-osteoporosis drugs can effectively reduce the risk of recurrent collapse after PKP surgery in OVCF patients(all P＜0.05).Conclusions There are many risk factors for recurrent collapse in OVCF patients after PKP surgery,including advanced age,more severe osteoporosis,occurrence of bone cement leakage,and dense distribution of bone cement,which increase the risk of recurrent collapse of the injured vertebrae.The use of anti-osteoporosis drugs can reduce the risk of recurrent collapse of the injured vertebrae.
NETL
NSTL
万方数据
