Predictive Value of Vertebral Bone Quality Score for Postoperative Adjacent Vertebral Re-Fracture in Osteoporotic Vertebral Compression Fractures

Liu Jincheng; Xiang Zhen; Dong Wenxuan; Ouyang Sihong; Deng Zhuozheng; Li Hao; Xie Junxian; Chen Xiaofeng

Abstract：Objective Correlation analysis of the correlation between adjacent vertebral fracture occurrence and vertebral bone quality(VBQ)in postmenopausal women with osteoporotic vertebral compression fractures(OVCF)undergoing percutaneous vertebral augmentation(PVA).Methods We collected data from postmenopausal women who underwent percutaneous vertebral augmentation for single-segment OVCF at Panyu District Hospital of Traditional Chinese Medicine in Guangzhou between January 2020 and October 2023.The study included 21 patients with postoperative adjacent vertebral fractures(re-fracture group)and 104 patients without adjacent vertebral fractures(non-fracture group).The re-fracture group had a mean age of(78.95±6.22)years,height of(150.95±4.35)cm,and weight of(46.74±7.20)kg.The non-fracture group had a mean age of(71.50±7.67)years,height of(154.62±5.16)cm,and weight of(55.53±9.46)kg.We analyzed general data,including age,body mass index(BMI),femoral neck bone mineral density(BMD),VBQ,functional cross-sectional area(FCSA)of the L3 paraspinal muscles,and fatty infiltration ratio(FIR)of the L3 paraspinal muscles,to identify risk factors and evaluate their predictive value for postoperative adjacent vertebral fractures.Results Patients were followed up postoperatively for 12～18 months,with a mean follow-up duration of(13.14±2.31)months in the re-fracture group and(16.44±2.44)months in the non-fracture group.The time from initial PVA to adjacent vertebral fracture in the re-fracture group averaged(27.81±26.73)weeks.Univariate analysis revealed statistically significant differences(P＜0.05)between the two groups in age,BMI,BMD,history of prior fractures,bone cement leakage,VBQ,L3 paraspinal muscle FCSA,and L3 paraspinal muscle FIR.Multivariate logistic regression analysis identified VBQ,L3 paraspinal muscle FCSA,BMD,and bone cement leakage as independent risk factors for adjacent vertebral fractures after PVA(P＜0.05).Conclusion VBQ,L3 paraspinal muscle FCSA,BMD,and bone cement leakage are risk factors for adjacent vertebral fractures following PVA in postmenopausal women with OVCF.VBQ showed better predictive value for postoperative adjacent vertebral fractures in this population compared to BMD.