Correlation Analysis Between Basic Diseases and Subsequent Vertebral Fractures After Percutaneous Kyphoplasty (PKP) for Osteoporotic Vertebral Compression Fractures

Abstract

BACKGROUND: Percutaneous kyphoplasty (PKP) is a widely accepted surgical treatment modality for painful osteoporotic vertebral compression fractures. The risk factors cause of subsequent vertebral fractures after PKP are debated. OBJECTIVES: To evaluate risk factors for the occurrence of new vertebral compression fractures after PKP. STUDY DESIGN: A retrospective study. SETTING: A single-center inpatient population. METHODS: A total of 921 patients (1,152 vertebrae) with PKP were investigated. Among those patients, 111 patients (155 levels) incurred refractures after PKP. RESULTS: The average bone mineral density was -3.27 in the “refracture”group and -3.00 in the “no fracture” group (P = 0.031). Morbidities of women were significantly higher in the “refracture” group (90.99%) compared with the “no fracture” group (81.73%) (P = 0.015). Among the basic diseases, several diseases (history of previously fracture, previously osteoporosis, gallstone disease, stomach disease, and ovariectomy) are associated with refractures after PKP (P < 0.05). And antiosteoporotic treatment (calcium + vitamin D or zoledronate) after PKP can also significantly reduce the occurrence of refracture (P < 0.000). In addition, logistic regression analysis also showed that most of the above contents had significant correlation with the refracture after PKP (P < 0.05), except for gallstone disease (P = 0.362). LIMITATIONS: Retrospective study, single center. CONCLUSION: Osteoporosis is the main cause of refracture after PKP. Elderly women were found to be more susceptible than elderly men to refracture. Patients with a history of previously fracture, previously osteoporosis, stomach ulcer, and ovariectomy are more likely to be refracture. Antiosteoporosis treatment (calcium + vitamin D or zoledronate) after PKP can reduce the risk of refracture. KEY WORDS: Osteoporosis, percutaneous kyphoplasty, vertebral compression fractures, bone mineral density

Development and Internal Validation of Supervised Machine Learning Algorithm for Predicting the Risk of Recollapse Following Minimally Invasive Kyphoplasty in Osteoporotic Vertebral Compression Fractures

“…Percutaneous kyphoplasty (PKP) is a minimally invasive surgical option widely performed to treat symptomatic OVCFs as it provides rapid pain relief, restoration of local kyphotic deformity, and early mobilization ( 4 – 6 ). It is worth noting that the augmented vertebral body recollapse is a common and serious complication after PKP technique, and deserves extensive caution as it is regularly the primary culprit for low back pain and functional impairment ( 1 , 2 , 7 ). The published literatures suggest less cement volume, sarcopenia, low bone mineral density (BMD), advanced age, and being female as risk factors for recollapse, but comprehensive and innovative risk factor selection criteria and predictive models are absent ( 2 , 8 – 10 ).…”

Clinical effect of kyphoplasty in the treatment of osteoporotic thoracolumbar compression fractures in patients with diabetes

“…In our study, increased age was a risk factor for patient satisfaction after PKP. Zhang et al (12) and Ning et al (13) also showed that age was an independent risk factor for the prognosis of OTCF patients. Therefore, elderly diabetic patients should be informed that PKP may have limited efficacy.…”

Comparison of the effectiveness of different machine learning algorithms in predicting new fractures after PKP for osteoporotic vertebral compression fractures

“…The degree of osteoporosis is a major risk factor for the development of postoperative NVCF, and bone mineral density, an index to assess the mineral content of bone, is commonly used to diagnose osteoporosis [ 26 ]. Ning et al [ 27 ] found that by including 921 cases with low T values, bone trabeculae that were denser became sparse, leading to reduced bone support and toughness, an increased risk of fracture postoperatively and a greater risk of NVCF. It has been suggested that the progression of osteoporosis is associated with the development of postoperative NVCFs [ 28 ] and that anti-osteoporosis treatment may slow the progression of osteoporosis and prevent the development of NVCFs [ 27 – 29 ].…”

“…Ning et al [ 27 ] found that by including 921 cases with low T values, bone trabeculae that were denser became sparse, leading to reduced bone support and toughness, an increased risk of fracture postoperatively and a greater risk of NVCF. It has been suggested that the progression of osteoporosis is associated with the development of postoperative NVCFs [ 28 ] and that anti-osteoporosis treatment may slow the progression of osteoporosis and prevent the development of NVCFs [ 27 – 29 ]. A 3-year follow-up study by Bawa et al [ 30 ] showed that effective anti-osteoporosis treatment significantly reduced the incidence of postoperative VCFs.…”