Volume 20 Issue 4
Apr.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(4): 591-593
AN Zhong-cheng, CHEN Chen, DONG Li-qiang, WU Lian-guo, ZHU Yu-chen, WEI Hao. Risk factors for adjacent segment refracture after percutaneous kyphoplasty[J]. Chinese Journal of General Practice, 2022, 20(4): 591-593. doi: 10.16766/j.cnki.issn.1674-4152.002407
Citation: AN Zhong-cheng, CHEN Chen, DONG Li-qiang, WU Lian-guo, ZHU Yu-chen, WEI Hao. Risk factors for adjacent segment refracture after percutaneous kyphoplasty[J]. Chinese Journal of General Practice, 2022, 20(4): 591-593. doi: 10.16766/j.cnki.issn.1674-4152.002407
shu

Risk factors for adjacent segment refracture after percutaneous kyphoplasty

doi: 10.16766/j.cnki.issn.1674-4152.002407

  • Department of Orthopedics, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310005, China

Funds:

 2020-JDXK-ZC01

 2021ZX009

 浙卫办中医〔2019〕1号

  • Received Date: 2021-06-16
    Available Online: 2022-08-20
    Abstract
  •   Objective  To analyze the risk factors for adjacent segment refracture after percutaneous kyphoplasty (PKP), so as to reduce the incidence of adjacent segmental refracture in patients with osteoporotic vertebral compression fracture (OVCF) after PKP.  Methods  Total 438 patients with single-segment OVCF treated by PKP in the Department of Orthopedics of the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2016 to December 2017 were collected and analyzed retrospectively. The patients were divided into refracture group (32 cases) and non-fracture group (257 cases) according to the occurrence of adjacent segment fracture after PKP. The age, gender, body mass index (BMI), proportion of injured vertebrae in thoracolumbar segment, bone mineral density, bone cement injection volume, recovery rate of vertebral height, bone cement leakage, trauma during follow-up and bone mineral density during refracture in the two groups were analyzed by univariate analysis. The statistically significant factors were put into logistic regression to analyze their correlation with adjacent segment refractures after PKP.  Results  The follow-up data of 289 patients were complete and included in this study, the postoperative follow-up was 12 to 24 (13.5±0.9) months. Up to the last follow-up, 32 patients had new adjacent vertebral fractures. Univariate analysis showed that the refracture of adjacent segments was correlated with bone mineral density at the time of refracture and trauma during follow-up (P < 0.05). Multivariate logistic regression analysis showed that the bone mineral density at the time of refracture (OR=0.225) was the influencing factor of postoperative adjacent segment refracture (P < 0.01). Minor trauma during follow-up (OR=5.254) might be an important external factor leading to the occurrence of adjacent segment refracture (P < 0.01).  Conclusion  The main causes of adjacent segment refracture after PKP are severe osteoporosis and trauma during follow-up. Therefore, early postoperative waist protection, effective anti-osteoporosis treatment and avoidance of trauma are essential.

     

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