Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (12): 1829-1834.doi: 10.3969/j.issn.2095-4344.2249

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Risk factors of adjacent vertebral collapse after kyphoplasty with cement injection in older adult women

Wu Bin, Bai Fenghua, Lin Mingxia, Lin Jianping   

  1. Hainan General Hospital, Haikou 570100, Hainan Province, China
  • Received:2019-04-13 Revised:2019-04-19 Accepted:2019-08-19 Online:2020-04-28 Published:2020-03-01
  • Contact: Lin Mingxia, Chief physician, Hainan General Hospital, Haikou 570100, Hainan Province, China
  • About author:Wu Bin, MD, Attending physician, Hainan General Hospital, Haikou 570100, Hainan Province, China
  • Supported by:
    the Scientific Research Fund of Department of Science and Technology of Hainan Province, No. 808212

Abstract:

BACKGROUND: Up to now, there are no reports on the risk factors of adjacent vertebral fractures after kyphoplasty with bone cement injection in older adult women in Haikou city or Hainan province of China.

OBJECTIVE: To investigate the risk factors of adjacent vertebral collapse (fracture) in older adult women with osteoporotic vertebral compression fractures after kyphoplasty with cement injection.

METHODS: 192 older adult women with osteoporotic vertebral compression fractures, aged 61-84 years, who underwent kyphoplasty with bone cement injection during January 2015-October 2018 in Hainan General Hospital, were included in this study. General indexes, orthopedic indexes, and the incidence of adjacent vertebral fractures within 3 months after surgery were recorded. The correlation between patient’s medical records and adjacent vertebral fractures after surgery was analyzed. This study was approved by the Medical Ethics Committee of Hainan General Hospital of China (approval No. 20180917).

RESULTS AND CONCLUSION: (1) Adjacent vertebral fractures occurred in 53 patients (68 vertebrae) within 3 months after surgery. The incidence of adjacent vertebral fractures was 27.60%. (2) Univariate analysis showed that age, body mass index, menopausal age, diabetes mellitus, bone mineral density T value, the number of augmented vertebral bodies, bone cement extravasation, amount of bone cement and use of zoledronic acid after surgery could affect the occurrence of adjacent vertebral fractures after kyphoplasty (P < 0.05). Smoking, drinking, menarche age, pregnancy, times of delivery, hypertension, history of glucocorticoid, degree of vertebrae compression, surgical approach, and distribution of bone cement did not affect the occurrence of adjacent vertebral fractures after kyphoplasty (P > 0.05). (3) Multivariate logistic analysis showed that age (≥ 75 years old), bone mineral density T value (< -4.5), bone cement extravasation, and the number of augmented vertebral bodies were risk factors for adjacent vertebral fractures (P < 0.05). Menopausal age (≥ 47 years old) and use of zoledronic acid after surgery were protective factors for adjacent vertebral fractures (P < 0.05). (4) The results showed that in older adult women with osteoporotic vertebral compression fractures treated by kyphoplasty, in addition to age, bone mineral density T value, bone cement extravasation, the number of augmented vertebral bodies, and anti-osteoporosis treatment, premature menopause should also be paid attention to.

Key words: bone cement, bone cement extravasation, osteoporotic compression fractures, older adult women, percutaneous balloon kyphoplasty, adjacent vertebral fractures, risk factor, tissue engineering 

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