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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.
Objective:
To investigate the relevant factors of augmented vertebrae recollapse after percutaneous vertebral augmentation (PVA) for the treatment of osteoporotic vertebral compression fractures (OVCFs).
Method:
A prospective study was performed on 116 patients who were diagnosed with osteoporotic compression fractures in which the anterior height loss of the vertebral body was greater than 1/3. All patients underwent percutaneous vertebral augmentation (PKP or PVP). Possible risk factors for augmented vertebral height decrease, such as age, sex, body mass index, surgical approach, fracture location, cement leakage, patterns of vertebral fractures, Vertebral height restoration (VHR), and intervertebral cleft (IVC), were analyzed.
Results:
The radiography follow-up period was 1 year. Ninety-five patients completed the trial. Twenty-four patients suffered postoperative recollapse. Preoperative magnetic resonance imaging showed that the incidence of IVC in the recollapse group was significantly higher than that in the no-recollapse group (p < 0.050). The OR value (157.891) indicates that the presence of IVC before surgery significantly exacerbates the incidence of postoperative recollapse. The surgical approaches of the recollapse group and the no-recollapse group were statistically significant (p < 0.050), and the risk of recollapse in the PKP group was lower compared to the PVP group (OR = 0.094).
Conclusion:
Intervertebral cleft (IVC) and those with PVP intervention are at higher risk of recollapse. Patients with osteoporotic compression fractures with anterior vertebral height loss greater than 1/3, especially those with IVC, should be concerned and taken seriously, and PVP should be carefully selected to prevent their clinical course from worsening.
