Risk factors of vertebral recompression after kyphoplasty for osteoporotic vertebral compression fracture

WANG Wen-long; CHEN Yin; HAI Yong; GUAN Li; LIU Yu-zeng; CHEN Xiao-long

doi:10.3969/j.issn.2095-252X.2017.07.016

Abstract：Objective To investigate the risk factors of vertebral recompression after percutaneous kyphoplasty in the patients with osteoporotic vertebral compression fractures. Methods The clinical data of 252 patients with osteoporotic vertebral compression fractures who underwent single-level percutaneous kyphoplasty in our hospital from January 2012 to January 2014 were retrospectively reviewed. All the patients were divided into recompression group and non-recompression group according to the radiological data collected during the follow-up. Thirteen potential factors of vertebral recompression were assessed using univariate and multivariate analyses, including age, gender, body mass index, fresh fracture or not, other comorbidities or not, previous vertebral compression fracture or not, cement leakage or not, preoperative bone mineral density T-score, volume of polymethylmethacrylate injected, preoperative and postoperative vertebral compression rate, polymethylmethacrylate-endplates contact or not and intravertebral cleft or not. Results After the surgery, 45 patients experienced recompression of cemented vertebrae, and 207 patients ont. There were 40 patients with other preoperative comorbidities in recompression group, and 141 in non-recompression group. The mean preoperative bone mineral density T-scores were ( -2.89 ± 0.32 ) and ( -2.64 ± 0.29 ) in recompression group and non-recompression group respectively. There were 13 and 141 patients with polymethylmethacrylate-endplates contact in recompression group and non-recompression group respectively. There were 19 patients with intravertebral cleft in recompression group, and 44 in non-recompression group. Other preoperative comorbidities, preoperative bone mineral density T-score and polymethylmethacrylate-endplates contact showed statistically significant differences between the 2 groups by the univariate analysis. And the multivariate logistic regression analysis indicated that combining with other comorbidities ( OR = 0.223 ) and low preoperative T-score ( OR = 0.053 ) were independent risk factors. However, the polymethylmethacrylate-endplates contact ( OR =6.296 ) was a protective factor. Conclusions Combined comorbidities and low preoperative bone mineral density T-score are 2 important risk factors of recompression of cemented vertebrae after percutaneous kyphoplasty, and a careful follow-up is necessary for the patients with these factors.