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Analysis of risk factors of secondary adjacent vertebral fracture after percutaneous kyphoplasty

Objective: To explore the potential risk factors of secondary adjacent vertebral fracture after percutaneous kyphoplasty (PKP) for Osteoporotic Vertebral Compression Fractures (OVCFs).

Methods: Clinical data of 189 OVCFs patients undergoing PKP were retrospectively analyzed. Gender, age, bone density and other parameters were analyzed. Risk factors causing NSVF after PKP were investigated.

Results: Among 189 enrolled patients, 22 presented with secondary adjacent vertebral fracture after PKP. Univariate analysis revealed no statistical significance in age, gender, severity of compression fracture, bone cement volume and restoration rate of vertebral height between patients with and without secondary adjacent vertebral fracture (all P>0.05). Type of fracture, type of bone cement, leakage of bone cement, anesthesia approach, whether use of systemic anti-osteoporosis treatment or not, bone density, quantity of surgically augmented vertebra and postoperative incidence of vertebral fracture significantly differed between two groups (all P<0.05). Multivariate logistic regression analysis demonstrated that type of fracture, whether use of systemic anti-osteoporosis treatment or not, leakage of bone cement into intervertebral disc, anesthesia approach and bone density acted as risk factors causing secondary adjacent vertebral fracture following PKP (all P<0.05).

Conclusions: Fissure fracture, absence of systemic anti-osteoporosis therapy, leakage of bone cement into intervertebral disc, topical anesthesia and loss in bone density are high-risk factors of secondary adjacent vertebral fracture after PKP.

Author(s): Jian Wu, Yuehong Guan, Shengli Fan