Yong-Xian Li1,2,3, Dan-Qing Guo2,3, Shun-Cong Zhang4,5,6, Kai Yuan2,3, Guo-Ye Mo1,2,3, Da-Xing Li1,2,3, Hui-Zhi Guo1,2,3, Yongchao Tang2,3, Pei-Jie Luo1,3. 1. The First Clinical Academy, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. 2. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510407, China. 3. Laboratory Affiliated to National Key Discipline of Orthopedic and Traumatology of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. 4. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510407, China. spinezsc@126.com. 5. Laboratory Affiliated to National Key Discipline of Orthopedic and Traumatology of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. spinezsc@126.com. 6. First School of Clinical Medicine, Guangzhou University of Chinese Medicine, 12 Airport Road, Baiyun District, Guangzhou, 510405, Guangdong, People's Republic of China. spinezsc@126.com.
Abstract
PURPOSE: Re-collapse of cemented vertebrae occasionally occurs after percutaneous augmentation. However, the potential risks still remain unclear. Several articles have reported some possible risk factors which were not consistent or comprehensive. This study aimed to make a retrospective review on patients with osteoporotic vertebral compression fracture (OVCF) after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) and to further analyse the risk factors for treated vertebral refracture. METHODS: All patients receiving the PKP/PVP with bilateral approach were retrospectively reviewed from January 2014 to January 2016, among whom 230 patients with single level augmentation (30 in refracture group and 200 in the non-refracture group) were enrolled according to inclusion criteria. The following covariates were reviewed: gender, age, height, weight, body mass index (BMI), bone mineral density (BMD), serum bone turnover markers, surgical parameters including approach, cement volume, anterior height, and Cobb angle restoration. Binary logistic regression analysis was used to determine the relative risk of re-collapse of cemented vertebrae. RESULTS: Regarding the patient data, weight, BMI, and BMD were of statistical significance in refracture group (P < 0.01), among which only low BMD was a risk factor to cemented vertebral re-collapse (P = 0.022, OR = 4.197). In respect of surgical variables, the better restoration of anterior height and Cobb angle was found in refracture group (P < 0.05), both of which might increase the refracture risk but not be risk factors (P = 0.065, OR = 0.891, and P = 0.937, OR = 0.996, respectively). Besides, less injected cement (3.30 ± 0.84 ml vs 4.46 ± 1.10 ml, P = 0.000, OR = 19.433) and PKP (P = 0.007, OR = 13.332) significantly boosted the potential risk of refracture (P < 0.001). CONCLUSION: Patients with low BMD, or undergoing PKP, or receiving a low volume of injected cement might have a high risk of re-collapse in surgical vertebrae.
PURPOSE: Re-collapse of cemented vertebrae occasionally occurs after percutaneous augmentation. However, the potential risks still remain unclear. Several articles have reported some possible risk factors which were not consistent or comprehensive. This study aimed to make a retrospective review on patients with osteoporotic vertebral compression fracture (OVCF) after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) and to further analyse the risk factors for treated vertebral refracture. METHODS: All patients receiving the PKP/PVP with bilateral approach were retrospectively reviewed from January 2014 to January 2016, among whom 230 patients with single level augmentation (30 in refracture group and 200 in the non-refracture group) were enrolled according to inclusion criteria. The following covariates were reviewed: gender, age, height, weight, body mass index (BMI), bone mineral density (BMD), serum bone turnover markers, surgical parameters including approach, cement volume, anterior height, and Cobb angle restoration. Binary logistic regression analysis was used to determine the relative risk of re-collapse of cemented vertebrae. RESULTS: Regarding the patient data, weight, BMI, and BMD were of statistical significance in refracture group (P < 0.01), among which only low BMD was a risk factor to cemented vertebral re-collapse (P = 0.022, OR = 4.197). In respect of surgical variables, the better restoration of anterior height and Cobb angle was found in refracture group (P < 0.05), both of which might increase the refracture risk but not be risk factors (P = 0.065, OR = 0.891, and P = 0.937, OR = 0.996, respectively). Besides, less injected cement (3.30 ± 0.84 ml vs 4.46 ± 1.10 ml, P = 0.000, OR = 19.433) and PKP (P = 0.007, OR = 13.332) significantly boosted the potential risk of refracture (P < 0.001). CONCLUSION:Patients with low BMD, or undergoing PKP, or receiving a low volume of injected cement might have a high risk of re-collapse in surgical vertebrae.
Authors: C A H Klazen; A Venmans; J de Vries; W J van Rooij; F H Jansen; M C Blonk; P N M Lohle; J R Juttmann; E Buskens; K J van Everdingen; A Muller; H Fransen; O E Elgersma; W P Th M Mali; H J J Verhaar Journal: AJNR Am J Neuroradiol Date: 2010-07-22 Impact factor: 3.825
Authors: John R Gaughen; Mary E Jensen; Patricia A Schweickert; William F Marx; David F Kallmes Journal: AJNR Am J Neuroradiol Date: 2002 Nov-Dec Impact factor: 3.825
Authors: A S Mudano; J Bian; J U Cope; J R Curtis; T P Gross; J J Allison; Y Kim; D Briggs; M E Melton; J Xi; K G Saag Journal: Osteoporos Int Date: 2008-09-17 Impact factor: 4.507