Risk Factors for Infection after Percutaneous Vertebroplasty Augmentation for Osteoporotic Vertebral Compression Fracture

Abstract

Background: Percutaneous vertebral augmentation (PVA) is a widely implemented treatment of osteoporotic vertebral compression fracture (OVCF). Although rare, surgical site infection (SSI) is a serious complication of PVA. Even though it is of great medical significance to minimize SSIs after PVA, there have been few reports on systematic risk factor analysis and prevention strategies.The goal of this study was to analyze the incidence and risk factors of postoperative SSI in PVA at a single center and formulate prevention strategies. Methods: The study involved 2624 patients who underwent PVA for osteoporotic vertebral compression fracture (OVCF) at our hospital between 2015 and 2021. The case-control study method was utilized. The case group consisted of patients who developed postoperative infections, while the control group was composed of uninfected patients selected at a ratio of 1:3.We collected data on risk factors for SSIs from patients' electronic medical records, imaging findings, and laboratory test results. We then analyzed the independent risk factors for postoperative SSIs using Cox univariate and multivariate regression analyses. Results: In our study, 17/2624 patients (0.65%) developed postoperative vertebral infections.Use of steroid drugs, NEUT%, C-type bone cement leakage after the operation were identified as risk factors in univariate analysis but not in multivariate analysis. Finally, multivariate analysis revealed the following risk factors for infectious spondylitis: age ≥ 80 years, type 2 diabetes, pulmonary infection, Alb ≤ 35 g/L, preoperative MRI indicating signs of fluid accumulation in the fractured vertebral body, and D-type bone cement leakage after the operation. Conclusions: Multivariate analyses identified the abovementioned independent risk factors for postoperative SSIs after PVA. These data may help guide clinicians take preoperative preventive measures to reduce the incidence of postoperative SSIs after PVA. Trial registration: This study was approved by Guangdong Province Hospital of Traditional Chinese Medicine. This article is a retrospective study. Therefore, the institution waived the requirement to obtain distinct written informed consent from the patients (approval number: ZE2023-176-01).