Effect of bone cement distribution on adjacent vertebral body fracture after unilateral percutaneous vertebroplasty for single segment osteoporotic vertebral compression fracture

doi:10.3969/j.issn.2095-4344.2304

Abstract

Abstract:

BACKGROUND: Previous studies on the risk factors of adjacent vertebral fractures after percutaneous vertebroplasty at home and abroad mainly focus on the leakage of bone cement, the amount of bone cement injected, the viscosity of bone cement, the number and location of vertebral fractures, the loss of vertebral height and sex.

OBJECTIVE: To predict and analyze the influence of bone cement distribution on adjacent vertebral body fracture after unilateral percutaneous vertebroplasty for single segment osteoporotic vertebral compression fracture.

METHODS: Forty patients with single segment osteoporotic vertebral compression fracture, including 16 males and 24 females, aged (71.4 ±5.3) years who received percutaneous vertebroplasty in the Second Affiliated Hospital of Shanxi Medical University from June 2017 to June 2018 were included in this study. These patients were divided into a unilateral group (13 vertebrae in 13 cases) and a bilateral group (27 vertebrae in 27 cases) according to the distribution of bone cement shown on X-ray film. Patients in the unilateral group were sub-divided into groups A (8 vertebrae in 8 cases, contacting the upper and lower endplates at the same time) and B (5 vertebrae in 5 cases, not contacting the upper and lower endplates at the same time) according to whether bone cement contacted the upper and lower endplates at the same time. Patients in the bilateral group were sub-divided into groups C (11 vertebrae in 11 cases, contacting the upper and lower endplates at the same time) and D (16 vertebrae in 16 cases, not contacting with the upper and lower endplates at the same time). Visual analogue scale score, Oswestry disability index, and Cobb angle were compared between unilateral and bilateral groups before and 1 year after surgery. The compression rate between adjacent vertebral bodies and the angle between the upper and lower endplates were compared between groups A, B, C and D. This study was approved by the Medical Ethics Committee of the Second Affiliated Hospital of Shanxi Medical University.

RESULTS AND CONCLUSION: (1) At 1 year after surgery, the Visual Analogue Scale score, Oswestry disability index, and Cobb angle in both unilateral and bilateral groups were significantly decreased compared with before surgery (P < 0.001). There were no significant differences in these indices between unilateral and bilateral groups (P > 0.05). (2) At 1 year after surgery, the compression rate between adjacent vertebral bodies in groups A-D was significantly increased compared with before surgery (P < 0.05), and the angle between the upper and lower endplates in groups A-D was significantly increased compared with before surgery (P < 0.05). (3) Disordered multiclass logistic regression analysis taking group D as reference showed that the compression degree of adjacent vertebrae in group A was the largest after percutaneous vertebroplasty, which was the risk factor of the compression change of adjacent vertebrae after surgery (P=0.003). Group B and group C were not the risk factors of the compression change of adjacent vertebrae after percutaneous vertebroplasty [P=0.065, 0.660]. (4) These results show that after percutaneous vertebroplasty, if bone cement is distributed unilaterally and closer to the upper and lower endplates of the vertebral body at the same time, then the trend of adjacent vertebral body fracture is greater. Therefore, prediction of bone cement distribution of this type is a risk factor of adjacent vertebral body fracture after percutaneous vertebroplasty.

Key words:

bone cement distribution, osteoporotic vertebral compression fracture, vertebroplasty, fracture, adjacent vertebrae, osteoporosis, unilateral puncture, single segment.

CLC Number:

Liu Ruizhen, Wang Wangren, Hao Chen, Liang Dongmu, Guan Haishan. Effect of bone cement distribution on adjacent vertebral body fracture after unilateral percutaneous vertebroplasty for single segment osteoporotic vertebral compression fracture[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(28): 4498-4504.

Figures/Tables 6

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