Risk factors for refracture after percutaneous kyphoplasty in patients with osteoporotic vertebral compression fracture
Objective To investigate the risk factors for refracture after percutaneous kyphoplasty(PKP)in patients with osteoporotic vertebral compression fracture(OVCF).Methods A retrospective cohort study was conducted on the clinical data of 149 OVCF patients who were admitted to the First Affiliated Hospital of Soochow University from June 2019 to June 2022,including 21 males and 128 females,aged 56-97 years[(73.2±8.7)years].Initial surgical segments included T7 in 1 patient,T8 in 10,T9 in 6,T10 in 6,T11 in 19,T12 in 28,L1 in 38,L2in 18,L3 in 11,L4 in 7 and L,in 5.Patients were divided into refracture group(n=32)and non-refracture group(n=1 17)according to whether they had postoperative refracture after PKP.Refractured surgical segments included T8in 2 patients,T9 in 2,T11 in 4,T12 in 5,L1 in 7,L2 in 4,L3 in 6,and L5 in 2.The age,gender,underlying diseases(hypertension,diabetes),body mass index(BMI),preoperative bone mineral density(BMD),smoking history,drinking history,follow-up time,preoperative visual analogue scale(VAS),and preoperative Oswestry dysfunction index(ODI)of the two groups were recorded.Preoperative paravertebral muscle-related parameters of the two groups were calculated including cross-sectional area of bilateral psoas,bilateral erector spinae,bilateral multifidus,and vertebral bodies,paravertebral muscle mass,and vertebral bone quality(VBQ)score.Univariate analysis was performed to evaluate the correlation between the fore-mentioned indicators and postoperative refracture after PKP in OVCF patients.Multivariate logistic regression analysis was employed to identify the independent risk factors for postoperative refracture after PKP in OVCF patients.Results Univariate analysis revealed that there was certain correlation of BMI,preoperative BMD,cross-sectional area of bilateral psoas,bilateral erector spinae,bilateral multifidus,paravertebral muscle mass and VBQ score with postoperative refracture after PKP in OVCF patients(P＜0.01),while no correlation was found between age,gender,hypertension,diabetes,smoking history,drinking history,follow-up time,preoperative VAS,preoperative ODI,or cross-sectional area of vertebral bodies and postoperative refracture after PKP in OVCF patients(P＞0.05).Multivariate logistic regression analysis showed that preoperative BMD ≤-3.4 SD(OR=0.27,95％CI 0.09,0.80,P＜0.05),paravertebral muscle mass ≤281.2％(OR=0.98,95％CI 0.97,0.99,P＜0.01)and VBQ score ≥4.8 points(OR=4.41,95％CI 1.18,16.44,P＜0.05)were significantly correlated with postoperative refracture after PKP in OVCF patients.Conclusion Preoperative BMD ≤-3.4 SD,paravertebral muscle mass ≤281.2％,and VBQ score ≥4.8 points are the independent risk factors for refracture after PKP in OVCF patients.
Spinal fracturesOsteoporosisKyphoplastyParavertebral muscle mass
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