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Factors Affecting Recollapse of the Augmented Vertebrae After Percutaneous Vertebral Augmentation: A Prospective
Yawen Zhang1, Junchuan Liu1, Maoyu Zhao1
1Department of Orthopedics Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Beijing China.
Aging Medicine (Milton (N.S.W))
|July 10, 2026
Summary
Intervertebral clefts (IVC) and vertebroplasty (PVP) increase the risk of augmented vertebrae collapsing after treatment for osteoporotic vertebral compression fractures (OVCFs). Careful patient selection and surgical approach are crucial for better outcomes.
Area of Science:
- Orthopedics
- Spine Surgery
- Radiology
Background:
- Osteoporotic vertebral compression fractures (OVCFs) are a common cause of morbidity in elderly patients.
- Percutaneous vertebral augmentation (PVA), including percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP), is a widely used treatment for OVCFs.
- Vertebral height restoration and subsequent recollapse are critical outcomes following PVA.
Purpose of the Study:
- To identify key factors contributing to the recollapse of augmented vertebrae after percutaneous vertebral augmentation (PVA).
- To analyze the association between preoperative imaging findings, surgical techniques, and postoperative vertebral height loss.
- To provide insights for optimizing PVA treatment strategies in patients with OVCFs.
Main Methods:
- A prospective study involving 116 patients with OVCFs and >1/3 anterior vertebral height loss.
- All patients underwent either PKP or PVP.
- Risk factors including age, sex, BMI, surgical approach, fracture patterns, cement leakage, vertebral height restoration (VHR), and intervertebral cleft (IVC) were assessed.
Main Results:
- Twenty-four out of 95 patients who completed the 1-year follow-up experienced postoperative recollapse.
- Preoperative intervertebral cleft (IVC) was significantly more prevalent in the recollapse group (p < 0.050), with an odds ratio (OR) of 157.891.
- The surgical approach was a significant factor (p < 0.050), with PKP demonstrating a lower risk of recollapse (OR = 0.094) compared to PVP.
Conclusions:
- The presence of an intervertebral cleft (IVC) and the use of percutaneous vertebroplasty (PVP) are significant risk factors for augmented vertebral recollapse.
- Patients with OVCFs and significant anterior height loss (>1/3), particularly those with IVC, require careful management.
- PVP should be judiciously considered in patients with IVC to mitigate the risk of postoperative recollapse and potential worsening of their clinical course.
