Analysis of the Causes and Efficacy of Re-fracture After PVP of Thoracolumbar Fracture

Liu Jiangpeng; Yang Shuangshi; Cao Haiquan

doi:10.3969/j.issn.1004-5775.2025.15.007

Abstract：Objective:To explore the causes of postoperative vertebral refracture and the efficacy of revision after thoracolumbar fracture.Methods:A retrospective analysis was adopted.156 patients with thoracolumbra fractures who underwent PVP and were admitted to the Orthopedic Center of Marine Corps Hospital of the People's Liberation Army of China in Chaozhou,Guangdong Province from May 2017 to May 2022 were selected as the research subjects and divided into two groups.A total of 148 patients with good recovery were included in Group 1,and 8 patients who still had refracture of the surgical vertebra after excluding adverse conditions,such as insufficient bone cement filling and premature ambulation were included in Group 2.The first bone mineral density T value,the first bone cement diffusion classification,the amount of bone cement filling and the first time of getting out of bed for activity(postoperative days)of the two groups of patients were compared.Bone cement reperfusion revision surgery was performed on patients in Group 2.The Visual Analogue Scale(VAS)score,Oswestry Disability Index(ODI)score,bone cement diffusion classification,and bone mineral density T value before revision surgery and at the last follow-up after revision surgery were compared.Results:There were significant differences between the two groups in preoperative bone mineral density T value and postoperative cement diffusion type(t=2.172,-2.532;P＜0.05).There was no statistically significant difference in the bone cement filling amount and the time of the first ambulation(postoperative days)between the two group(t=0.143,0.178;P＞0.05).There were statistically significant differences in the VAS score,ODI score,bone mineral density T value,and bone cement diffusion classification of Group 2 before revision and at the last follow-up after revision(t=1 1.263,12.131,-2.354,1.692;P＜0.05).Conclusion:The refracture of the surgical vertebrae after PVP in patients with thoracolumbar fractures is closely related to severe osteoporosis and the dispersion of bone cement.Standardized anti-osteoporosis treatment after surgery is indispensable,and active revision surgery has good therapeutic effect.