Clinical characteristics and risk factors of newly developed vertebral fractures after vertebral augmentation / 北京大学学报(医学版)

ABSTRACT

Objective:To identify the characteristics and risk factors of the refractures after percuta-neous kyphoplasty ( PKP) and percutaneous vertebroplasty ( PVP) .Methods:A retrospective analysis of 148 patients who had undergone PKP or PVP between March 2006 and October 2013 inPeking University People’ s Hospital was conducted.In the study, 29 patients with 42 refractured vertebra and 119 patients without refracture were included.All the patients were observed for a time of (34.4 ±26.8) months. Clinical, imaging and procedure related factors ( gender, age, height, weight, body mass index, the level of the injured vertebra, the time interval between the procedure and the refracture, the level of the refractured vertebra, the bone cement volume injected, performed PKP or PVP,performed unilateral or bilateral, the percentage of anterior vertebral height restoration, the correction of the Cobb angle, cement diffusion, bone mineral density, presence or absence of diabetes mellitus, history of fractures of the whole body, anti-osteoporosis treatment, cement leakage) for each group were analyzed by Cox propor-tional hazards regression analysis.Results:Of all the patients,16 (55.17%, 16/29) had refractures in the adjacent vertebra, and 13 (44.83%, 13/29) had refractures in the nonadjacent vertebra.Refrac-tures within 3 months accounted for 31.03%(9/29) of all the refractures, and within 1 year accounted for 55.17%(16/29).Both older age (P=0.027, HR=1.051, 95%CI=1.006-1.098) and a his-tory of fractures of the whole body (P=0.012, HR=0.386, 95%CI=0.184-0.812) were statistical-ly significant as the independent risk factors for predicting refractures.Others were not associated with re-fractures ( P>0.05) .Conclusion:Older age and a history of fractures of the whole body are the inde-pendent risk factors of the refractures after PKP and PVP.The mechanism of the refractures after PKP and PVP is mainly the natural development of osteoporosis.