[A clinic analysis of thoracolumbar vertebral fracture cascade]

Objective: To observe the clinical characteristics of thoracolumbar vertebral fracture cascade, analyze the relationship between the baseline fractures and the subsequent fractures and compare the distribution differences of subsequent fractures following vertebral augmentation or non-operation. Methods: From July 2012 to August 2016, 1 363 patients admitted to the First Affiliated Hospital of Soochow University with vertebral augmentation for the treatment of vertebral fractures were retrospectively analyzed.There were 190 cases of vertebral fracture cascade, 160 females and 30 males, with an average age of (74±9) years.The location and sequence of all vertebral fractures were recorded.The relationships between the baseline and the subsequent fractures were analyzed.According to different treatment on the baseline vertebral fractures, 190 cases were divided into vertebral augmentation group and non-operation group.The distribution differences of the subsequent fractures following vertebral augmentation and non-operation were compared with chi-square test. Results: Vertebral fracture cascade mainly located in the thoracolumbar spine T(11)-L(2) with an incidence of 52.0%.According to the direction of fracture development, the fracture cascade could be divided into up, down, centrifugation and concentration, and the incidence was 39.8%, 39.2%, 8.4% and 12.6%, respectively.The closer the vertebral body to the baseline fractures, the subsequent fractures incidence was higher.For distance with zero, one, two, three and four vertebrae, the incidence of subsequent vertebral fractures was 36.5%, 26.2%, 15.2%, 11.5% and 3.7%, respectively.A linear relationship was found between the subsequent fractures and the baseline fractures with a correlation coefficient of 0.90.The distribution difference of subsequent fractures between vertebral augmentation and non-operation group was not significant (χ(2)=17.16, P>0.05). Conclusions: The main directions of vertebral fracture cascade is up or down spiral development.The closer the vertebral body to the baseline fractures, the subsequent fractures incidence is higher.Vertebral augmentation doesn't affect the distribution of subsequent fractures.