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Erschienen in: International Orthopaedics 9/2018

20.02.2018 | Original Paper

Risk factor analysis for re-collapse of cemented vertebrae after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP)

verfasst von: Yong-xian Li, Dan-qing Guo, Shun-cong Zhang, De Liang, Kai Yuan, Guo-ye Mo, Da-xing Li, Hui-zhi Guo, Yongchao Tang, Pei-jie Luo

Erschienen in: International Orthopaedics | Ausgabe 9/2018

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Abstract

Purpose

Re-collapse of cemented vertebrae occasionally occurs after percutaneous augmentation. However, the potential risks still remain unclear. Several articles have reported some possible risk factors which were not consistent or comprehensive. This study aimed to make a retrospective review on patients with osteoporotic vertebral compression fracture (OVCF) after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) and to further analyse the risk factors for treated vertebral refracture.

Methods

All patients receiving the PKP/PVP with bilateral approach were retrospectively reviewed from January 2014 to January 2016, among whom 230 patients with single level augmentation (30 in refracture group and 200 in the non-refracture group) were enrolled according to inclusion criteria. The following covariates were reviewed: gender, age, height, weight, body mass index (BMI), bone mineral density (BMD), serum bone turnover markers, surgical parameters including approach, cement volume, anterior height, and Cobb angle restoration. Binary logistic regression analysis was used to determine the relative risk of re-collapse of cemented vertebrae.

Results

Regarding the patient data, weight, BMI, and BMD were of statistical significance in refracture group (P < 0.01), among which only low BMD was a risk factor to cemented vertebral re-collapse (P = 0.022, OR = 4.197). In respect of surgical variables, the better restoration of anterior height and Cobb angle was found in refracture group (P < 0.05), both of which might increase the refracture risk but not be risk factors (P = 0.065, OR = 0.891, and P = 0.937, OR = 0.996, respectively). Besides, less injected cement (3.30 ± 0.84 ml vs 4.46 ± 1.10 ml, P = 0.000, OR = 19.433) and PKP (P = 0.007, OR = 13.332) significantly boosted the potential risk of refracture (P < 0.001).

Conclusion

Patients with low BMD, or undergoing PKP, or receiving a low volume of injected cement might have a high risk of re-collapse in surgical vertebrae.
Literatur
1.
Zurück zum Zitat Kanis JA (2007) Assessment of osteoporosis at the primary health care level. WHO Collaborating Centre for Metabolic Bone Diseases. WHO Collaborating Centre for Metabolic Bone Diseases Kanis JA (2007) Assessment of osteoporosis at the primary health care level. WHO Collaborating Centre for Metabolic Bone Diseases. WHO Collaborating Centre for Metabolic Bone Diseases
7.
Zurück zum Zitat Gaughen JR Jr, Jensen ME, Schweickert PA, Marx WF, Kallmes DF (2002) The therapeutic benefit of repeat percutaneous vertebroplasty at previously treated vertebral levels. AJNR Am J Neuroradiol 23(10):1657–1661PubMed Gaughen JR Jr, Jensen ME, Schweickert PA, Marx WF, Kallmes DF (2002) The therapeutic benefit of repeat percutaneous vertebroplasty at previously treated vertebral levels. AJNR Am J Neuroradiol 23(10):1657–1661PubMed
9.
Zurück zum Zitat Mudano AS, Bian J, Cope JU, Curtis JR, Gross TP, Allison JJ, Kim Y, Briggs D, Melton ME, Xi J, Saag KG (2009) Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population-based cohort study. Osteoporos Int 20(5):819–826. https://doi.org/10.1007/s00198-008-0745-5 CrossRefPubMed Mudano AS, Bian J, Cope JU, Curtis JR, Gross TP, Allison JJ, Kim Y, Briggs D, Melton ME, Xi J, Saag KG (2009) Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population-based cohort study. Osteoporos Int 20(5):819–826. https://​doi.​org/​10.​1007/​s00198-008-0745-5 CrossRefPubMed
12.
Zurück zum Zitat Belkoff SM, Mathis JM, Jasper LE, Deramond H (2001) The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine 26(14):1537–1541CrossRefPubMed Belkoff SM, Mathis JM, Jasper LE, Deramond H (2001) The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine 26(14):1537–1541CrossRefPubMed
13.
Zurück zum Zitat Klazen CA, Venmans A, de Vries J, van Rooij WJ, Jansen FH, Blonk MC, Lohle PN, Juttmann JR, Buskens E, van Everdingen KJ, Muller A, Fransen H, Elgersma OE, Mali WP, Verhaar HJ (2010) Percutaneous vertebroplasty is not a risk factor for new osteoporotic compression fractures: results from VERTOS II. AJNR Am J Neuroradiol 31(8):1447–1450. https://doi.org/10.3174/ajnr.A2148 CrossRefPubMed Klazen CA, Venmans A, de Vries J, van Rooij WJ, Jansen FH, Blonk MC, Lohle PN, Juttmann JR, Buskens E, van Everdingen KJ, Muller A, Fransen H, Elgersma OE, Mali WP, Verhaar HJ (2010) Percutaneous vertebroplasty is not a risk factor for new osteoporotic compression fractures: results from VERTOS II. AJNR Am J Neuroradiol 31(8):1447–1450. https://​doi.​org/​10.​3174/​ajnr.​A2148 CrossRefPubMed
14.
Zurück zum Zitat Liebschner MA, Rosenberg WS, Keaveny TM (2001) Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine 26(14):1547–1554CrossRefPubMed Liebschner MA, Rosenberg WS, Keaveny TM (2001) Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine 26(14):1547–1554CrossRefPubMed
16.
Zurück zum Zitat Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285(3):320–323CrossRefPubMed Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, Licata A, Benhamou L, Geusens P, Flowers K, Stracke H, Seeman E (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285(3):320–323CrossRefPubMed
18.
Zurück zum Zitat Villarraga ML, Bellezza AJ, Harrigan TP, Cripton PA, Kurtz SM, Edidin AA (2005) The biomechanical effects of kyphoplasty on treated and adjacent nontreated vertebral bodies. J Spinal Disord Tech 18(1):84–91CrossRefPubMed Villarraga ML, Bellezza AJ, Harrigan TP, Cripton PA, Kurtz SM, Edidin AA (2005) The biomechanical effects of kyphoplasty on treated and adjacent nontreated vertebral bodies. J Spinal Disord Tech 18(1):84–91CrossRefPubMed
20.
Zurück zum Zitat Fribourg D, Tang C, Sra P, Delamarter R, Bae H (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29(20):2270–2276 discussion 2277 CrossRefPubMed Fribourg D, Tang C, Sra P, Delamarter R, Bae H (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29(20):2270–2276 discussion 2277 CrossRefPubMed
21.
Zurück zum Zitat Kim YY, Rhyu KW (2010) Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture. European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 19(11):1907–1912. https://doi.org/10.1007/s00586-010-1479-6 CrossRef Kim YY, Rhyu KW (2010) Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture. European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 19(11):1907–1912. https://​doi.​org/​10.​1007/​s00586-010-1479-6 CrossRef
27.
Zurück zum Zitat Kang S-K, Lee CW, Park NK, Kang T-W, Lim J-W, Cha KY, Kim JH (2011) Predictive risk factors for refracture after percutaneous vertebroplasty. Annals of Rehabilitation Medicine 35(6):844–851CrossRefPubMedPubMedCentral Kang S-K, Lee CW, Park NK, Kang T-W, Lim J-W, Cha KY, Kim JH (2011) Predictive risk factors for refracture after percutaneous vertebroplasty. Annals of Rehabilitation Medicine 35(6):844–851CrossRefPubMedPubMedCentral
Metadaten
Titel
Risk factor analysis for re-collapse of cemented vertebrae after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP)
verfasst von
Yong-xian Li
Dan-qing Guo
Shun-cong Zhang
De Liang
Kai Yuan
Guo-ye Mo
Da-xing Li
Hui-zhi Guo
Yongchao Tang
Pei-jie Luo
Publikationsdatum
20.02.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 9/2018
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-3838-6

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