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The effects of biomechanical factors on adjacent vertebral compression fractures after percutaneous kyphoplasty: a propensity score matching analysis

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A Correction to this article was published on 17 June 2022

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Abstract

Summary

Adjacent vertebral compression fracture (AVCF) is the primary factor affecting satisfaction after PKP surgery. In addition to osteoporosis, certain structural characteristics of the vertebral body itself also increase their risk. The purpose of this study was to explore the impact of biomechanical changes on AVCF after balancing other factors.

Introduction

As a routine treatment of OVCF, the postoperative refracture of PKP is a serious problem. The aim of our study was to explore the impact of lumbar biomechanical changes on the risk of AVCF. A propensity score matching was performed to balance the interference of osteoporosis, which is the primary risk factor of AVCF.

Methods

A retrospective, single-center case–control study was performed. From September 2013 to March 2020, 1752 patients were enrolled, and AVCF was assessed in 80 of these patients. A propensity score matching (PSM) analysis was performed, and 5 potential confounding factors were matched (age, BMI, number of fractured vertebral bodies, fracture region, and HDL). The preoperative and postoperative radiological factors were measured in the matched cohort of 48 pairs. A conditional logistic regression analysis to adjust the comparative risks.

Results

The preoperative wedge angle and its postoperative recovery of the AVCF group were significantly higher than that of the non-AVCF group. The local kyphosis of the fractured vertebral body between the two groups was similar, but the recovery in the AVCF group was slightly higher than that in the non-AVCF group. The preoperative and postoperative relative anterior height (RAH) of the fractured vertebral body was familiar in two groups, so was the recovery of RAH. The preoperative spino-sacral angle (SSA) was significantly higher in the AVCF group than in the non-AVCF group. The preoperative wedge angle was identified as the only significant risk factor for AVCF in the multivariate analysis.

Conclusion

In conclusion, a larger preoperative fracture vertebral wedge angle is a risk factor for AVCF. For such high-risk patients, surgeons should be cautious about surgical decisions. The postoperative active measures and tailored surveillance should be attached to great importance as well.

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Data availability

The data used in this study are available from the corresponding author upon request.

Code availability

Not applicable.

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Acknowledgements

We gratefully acknowledge the assistance of Dr. Kong Meng for his help in the revision of the paper, and his previous research has been of great help to us.

Funding

This work was funded by grants from the National Natural Science Foundation of China (81871804) and the National Key Research and Development Project (CN) (2019YFC0121400).

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Authors and Affiliations

  1. Department of Spine Surgery, The Affiliated Hospital of Qingdao University, No.59 Haier Road, Qingdao, 266000, Shandong, China

    Chong Zhao, Yan Wang, Jianwei Guo, Shuo Han, Hao Zhang, Mingrui Chen, Chuanli Zhou & Xuexiao Ma

  2. Department of Orthopedics Surgery, Weihai Branch of 970 Hospital of the PLA Joint Logistic Support Force, Weihai, Shandong, China

    Xiaojie Liu

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  1. Chong Zhao
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Correspondence to Chuanli Zhou or Xuexiao Ma.

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Zhao, C., Liu, X., Wang, Y. et al. The effects of biomechanical factors on adjacent vertebral compression fractures after percutaneous kyphoplasty: a propensity score matching analysis. Osteoporos Int 33, 1795–1806 (2022). https://doi.org/10.1007/s00198-022-06428-5

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