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Radiographic adjacent segment degeneration and risk factors for osteoporotic vertebral compression fractures treated with percutaneous kyphoplasty

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A Letter to the Editor to this article was published on 21 December 2022

Abstract

Purpose

In this study, we aimed to clarify whether osteoporotic vertebral compression fracture (OVCF) following percutaneous kyphoplasty (PKP) was associated with a high risk for radiographic adjacent segment degeneration (ASD) and to identify the risk factors for radiographic ASD in these individuals.

Methods

We retrospectively reviewed consecutive patients with OVCFs who underwent PKP at our institution between November 2015 and January 2021. The incidence of radiographic ASD was calculated and specific subgroups of ASD were identified. Univariate and multivariate analyses of demographic, clinical baseline, and radiologic data were performed to identify risk factors associated with radiographic ASD.

Results

With a mean follow-up time of 27.3 months, a total of 95 eligible patients were enrolled. The incidence of radiographic ASD distinguished from natural degeneration was 52.6%. Patients with OVCFs who underwent PKP had a high risk of developing radiographic ASD, particularly disc degeneration. Intradiscal cement leakage (odds ratio [OR], 5.706; 95% confidence interval [CI], 2.039–15.970; P = 0.001) and preoperative disc height (OR, 0.681; 95% CI, 0.518–0.895; P = 0.006) were identified as independent risk factors.

Conclusion

Patients with OVCFs who underwent PKP were more likely to develop radiographic ASD, and their progression was distinguished from natural degeneration. Disc degeneration was the most common type of degeneration. Intradiscal cement leakage and preoperative disc height were identified as independent risk factors for developing radiographic ASD in these patients. Further validation through prospective multicenter studies is required.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Author notes

  1. Tianyi Wang and Fangda Si contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, 5 JingYuan Road, Shijingshan District, Beijing, 100043, China

    Tianyi Wang, Fangda Si, Lei Zang, Ning Fan, Shuo Yuan, Peng Du, Qichao Wu, Aobo Wang & Xuanyu Lu

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Contributions

Tianyi Wang, MM and Fangda Si, MD contributed equally to this work. TW and FS designed and wrote this manuscript; LZ conducted manuscript review and editing; TW, FS, SY, PD, QW, AW, and XL participated in data collection. All authors were involved in writing the manuscript. All authors read and approved the final manuscript.

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Correspondence to Lei Zang.

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The research conducted has been performed in accordance with the Declaration of Helsinki. Approval for the study was obtained from the ethics committees of the Beijing Chaoyang Hospital (2022-KE-15). Informed consent to this study was waived because of this was a retrospective study, which was also approved by the institutional ethical review board.

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Wang, T., Si, F., Zang, L. et al. Radiographic adjacent segment degeneration and risk factors for osteoporotic vertebral compression fractures treated with percutaneous kyphoplasty. International Orthopaedics (SICOT) 46, 2619–2628 (2022). https://doi.org/10.1007/s00264-022-05510-1

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