Background Percutaneous kyphoplasty (PKP) is a common treatment modality for painful osteoporotic vertebral compression fractures (OVCFs). Pre- and postoperative identification of risk factors for cement leakage and follow-up complications would therefore be helpful but has not been systematically investigated. Purpose To evaluate pre- and postoperative risk factors for the occurrence of short-term cement leakages and long-term complications after PKP for OVCFs. Material and Methods A total of 283 vertebrae with PKP in 239 patients were investigated. Possible risk factors causing cement leakage and complications during follow-up periods were retrospectively assessed using multivariate analysis. Cement leakage in general, three fundamental leakage types, and complications during follow-up period were directly identified through postoperative computed tomography (CT). Results Generally, the presence of cortical disruption ( P = 0.001), large volume of cement ( P = 0.012), and low bone mineral density (BMD) ( P = 0.002) were three strong predictors for cement leakage. While the presence of intravertebral cleft and Schmorl nodes ( P = 0.045 and 0.025, respectively) were respectively identified as additional risk factors for paravertebral and intradiscal subtype of cortical (C-type) leakages. In terms of follow-up complications, occurrence of cortical leakage was a strong risk factor both for new VCFs ( P = 0.043) and for recompression ( P = 0.004). Conclusion The presence of cortical disruption, large volume of cement, and low BMD of treated level are general but strong predictors for cement leakage. The presence of intravertebral cleft and Schmorl nodes are additional risk factors for cortical leakage. During follow-up, the occurrence of C-type leakage is a strong risk factor, for both new VCFs and recompression.
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<p>As an advanced technique, compressed sensing has been used for rapid magnetic resonance imaging in recent years, Two-step Iterative Shrinkage Thresholding Algorithm (TwIST) is a popular algorithm based on Iterative Thresholding Shrinkage Algorithm (ISTA) for fast MR image reconstruction. However TwIST algorithms cannot dynamically adjust shrinkage factor according to the degree of convergence. So it is difficult to balance speed and efficiency. In this paper, we proposed an algorithm which can dynamically adjust the shrinkage factor to rebalance the fidelity item and regular item during TwIST iterative process. The shrinkage factor adjusting is judged by the previous reconstructed results throughout the iteration cycle. It can greatly accelerate the iterative convergence while ensuring convergence accuracy. We used MR images with 2 body parts and different sampling rates to simulate, the results proved that the proposed algorithm have a faster convergence rate and better reconstruction performance. We also used 60 MR images of different body parts for further simulation, and the results proved the universal superiority of the proposed algorithm.</p>
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