World Neurosurg. 2023 Aug 8:S1878-8750(23)01112-9. doi: 10.1016/j.wneu.2023.08.008. Online ahead of print.
ABSTRACT
OBJECTIVE: Analysis to investigate the correlation between bone cement distribution and adjacent vertebral fractures(AVF) after percutaneous vertebroplasty(PVP).
METHODS: We retrospectively analyzed patients who underwent single-segment PVP for osteoporotic compression fractures in our hospital from January 2016 to January 2021, and divided the patients into two groups, A and B, based on the criterion of whether there were AVF of the operated vertebrae within 1 year after surgery, and compared the general data of the two groups; we assessed the ability of three simple X-ray-based evaluation methods to predict the occurrence of AVF within 1 year after surgery, and derived a simple and accurate evaluation method.
RESULTS: A total of 570 patients were included in this study, including 511 patients in group A and 59 patients in group B. There were no statistical differences in the general data such as age, gender and fracture site between the two groups. The posterior-anterior (PA), lateral (LAT) and PA & LAT methods showed receiver operating characteristic curve (ROC) predicted postoperative AVF of 0.611,0.691 and 0.714, respectively. The difference between the area under curve(AUC) of PA method and LAT method was statistically significant(P=0.0307), the difference between the AUC of PA method and PA & LAT method was statistically significant (P<0.001), the difference between the AUC of LAT method and PA & LAT method was not statistically significant (P= 0.3308).There was no statistical difference between the two groups of patients with PA method point of 1 and statistically different between patients with points of 2 and 3 , statistically different in patients with LAT method points of 1, 2 and 3 in the two groups, and a positive correlation between cement distribution scores and AVF by linear regression analysis of the three evaluation methods.
CONCLUSIONS: The three evaluation methods reliably predict AVF after PVP, with LAT, PA & LAT method being more predictive than the PA method, but the LAT method being simpler, with bone cement being widely distributed after crossing the midline in the PA method and contact with the upper and lower endplates in the LAT method being a risk factor for AVF.
PMID:37562680 | DOI:10.1016/j.wneu.2023.08.008
