Risk Factors for Refracture following Primary
Osteoporotic Vertebral Compression Fractures

Ji, Chengyue; Rong, Yuluo; Wang, Jiaxing; Yu, Shikai; Yin, Guoyong; Fan, Jin; Tang, Pengyu; Jiang, Dongdong; Liu, Wei; Gong, Fangyi; Ge, Xuhui; Cai, Weihua

doi:10.36076/ppj.2021/24/e335

Cited by 26 publications

(10 citation statements)

References 21 publications

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“…NVCF after OVCF is common in clinical practice. According to previous reports, the incidence of NVCF after OVCF ranges from 9.3 to 38.4% (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Although the conclusions vary, most studies and systematic reviews have found no significant differences in the probability of NVCF between PVP and CT (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 98%

Long-term outcome of percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: a retrospective cohort study with three-year follow-up

Chen,

Xu,

Shi

et al. 2024

Front. Med.

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BackgroundOsteoporotic vertebral compression fractures (OVCF) appear to be more common as the population ages. Previous studies have found that percutaneous vertebroplasty (PVP) can achieve better short-term clinical outcomes than conservative treatment (CT) for OVCF. However, the long-term outcomes of PVP compared with CT for OVCF has been rare explored. This study was designed to explore the clinical outcomes of PVP or CT within 3 years after OVCF.MethodsThis study reviewed the clinical outcomes of patients who underwent PVP or CT for OVCF in a single center from January 2015 to December 2019. The back pain visual analogue scale (VAS), Oswestry disability index (ODI) and satisfaction rate were compared between the two groups at baseline, 1 week, 1 month, 3 months, 6 months, 12 months, 24 months and 36 months after treatment.OutcomesThe baseline data including gender, age, bone mineral density, body mass index, back pain VAS, and ODI were not significantly different between the two groups. The back pain VAS and ODI of CT patients were significantly higher than those of PVP group at 1 week, 1 month, 3 months, 6 months and 12 months after treatment. The satisfaction rate in the PVP group were significantly higher than those in the CT group at 1 week, 1 month, 3 months and 6 months after treatment. Subsequently, the back pain VAS and ODI showed no significant difference between the two groups at 24 and 36 months. In addition, there was no significant difference in treatment satisfaction between the two groups at 36 months. There was no significant difference in the rate of new vertebral compression fractures between the two groups within 36 months after treatment.ConclusionThe clinical outcomes within 12 months after PVP and patient satisfaction rate within 6 months after PVP were significantly higher than CT. However, during 12 months to 36 months, this advantage generated by PVP was gradually diluted over time. Compared with CT, the long-term effect of PVP on OVCF should not be overestimated.

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Section: Discussionmentioning

confidence: 98%

Long-term outcome of percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: a retrospective cohort study with three-year follow-up

Chen,

Xu,

Shi

et al. 2024

Front. Med.

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“…Recently, Zhang et al found that older age, female sex, and smoking were risk factors for NVCF in patients with OVCF, whereas postoperative exercise and osteoporosis treatment were protective factors [ 19 ]. In addition, although not widely adopted, some studies have found a positive correlation between the HU values of CT and NVCF in patients with primary OVCF [ 14 , 20 , 21 ]. This study included 611 patients with OVCF.…”

Section: Discussionmentioning

confidence: 99%

Prediction of new vertebral compression fracture within 3 years after percutaneous vertebroplasty for osteoporotic vertebral compression fracture: Establishment and validation of a nomogram prediction model

Nie,

Chen,

Shi

et al. 2024

PLoS ONE

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New vertebral compression fractures (NVCF) are common in patients with osteoporotic vertebral compression fractures (OVCF) who have undergone percutaneous vertebroplasty (PVP). We sought to develop a nomogram prediction model for better identification and prevention of NVCF within 3 years after PVP in patients with OVCF. The demographic, clinical, and imaging data of patients who underwent PVP for OVCF between January 2010 and December 2019 were reviewed. Multivariate logistic regression analysis was used to screen for risk factors for NVCF within 3 years after PVP. A nomogram prediction model was then developed and validated to visually predict NVCF. The samples in the model were randomly divided into training and validation sets at a ratio of 7:3. Twenty-seven percent of patients experienced NVCF in other segments within 3 years after PVP. Older age, lower bone mineral density (BMD), smoking, lack of anti-osteoporosis therapy, and postoperative trauma were risk factors for NVCF. The area under the receiver operating characteristic curve suggested good discrimination of this model: training set (0.781, 95% confidence interval: 0.731–0.831) and validation set (0.786, 95% confidence interval: 0.708–0.863). The calibration curve suggested good prediction accuracy between the actual and predicted probabilities in the training and validation sets. The DCA results suggested that, when the probability thresholds were 0.0452–08394 and 0.0336–0.7262 in the training and validation set, respectively, patients can benefit from using this model to predict NVCF within 3 years after PVP. In conclusion, this nomogram prediction model that included five risk factors (older age, lower BMD, smoking, postoperative minor trauma, and lack of anti-osteoporosis treatment can effectively predict NVCF within 3 years after PVP. Postoperative smoking cessation, standard anti-osteoporosis treatment, and reduction in incidental minor trauma are necessary and effective means of reducing the incidence of NVCF.

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“…The mechanisms underlying AVF are multifaceted, with some researchers proposing it as a natural progression of osteoporosis ( 21 ). Nevertheless, most studies suggest a strong association with osteoporosis and alterations in the local mechanical environment following the introduction of bone cement into the vertebra ( 22 - 25 ). Liu et al ( 22 ) and Movrin and Komadina ( 23 ) conducted analyses of AVF risk factors and discovered that lower vertebral BMD, intervertebral leakage, steroid use, excessive vertebral body restoration, and fractures located in the thoracolumbar region were all contributors to AVF.…”

Section: Discussionmentioning

confidence: 99%

The correlation between self-Hounsfield units and adjacent vertebral fracture after percutaneous vertebral augmentation: a retrospective cohort study

Qi,

Zhang,

Han

et al. 2024

Quant Imaging Med Surg

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Background Adjacent vertebral fracture (AVF) represents a prevalent and challenging complication after percutaneous vertebral augmentation (PVA) treatment for osteoporosis vertebral compressive fracture (OVCF). Lower bone mineral density (BMD) and intervertebral leakage are reportedly independent risk factors for AVF. Vertebral Hounsfield units (HU) measured from computed tomography (CT) scans can evaluate bone quality. This study sought to explore the risk factors associated with AVF and analyze the relationship between AVF and the Hounsfield units of adjacent vertebrae (self-HU) following PVA. Methods In this retrospective cohort study, we included consecutive OVCF patients who presented to Xuzhou Central Hospital in Jiangsu Province, China from 1 January 2016, to 31 December 2019 for PVA treatment. Clinical and imaging data were collected, and baseline data were recorded. Patients were divided into the AVF group and the no-AVF group based on the presence of AVF during follow-up. Patients in the AVF group were further subdivided into the leakage group and the no-leakage group according to the presence of intervertebral leakage. Age, body mass index (BMI), fracture location, prior fracture, self-HU, and intervertebral leakage were included in univariate logistic regression analysis. Variables with a P value of less than 0.1 were then included in multivariate logistic regression analysis to determine the risk factors for AVF. Kaplan-Meier curves were plotted to assess the effect of intervertebral leakage on AVF using a log-rank test. Results A total of 460 patients were included in this study and followed up for an average of 50.9 months (range, 37–83 months). Among them, 82 cases (17.83%) developed AVF and were included in the AVF group. Multivariate logistic regression analysis showed that lower self-HU [odds ratio (OR) =0.972, 95% confidence interval (CI): 0.959–0.985, P<0.001] and intervertebral leakage (OR =2.618, 95% CI: 1.415–4.844, P=0.002) were risk factors for AVF following PVA. In the AVF group, 29 patients (35.37%) with intervertebral leakage were included in the leakage group. Patients in the leakage group had a shorter time to AVF (22.07±13.83 vs. 31.42±18.73, P=0.021) and higher self-HU (78.05±16.41 vs. 64.23±20.49, P=0.002) than those in the no-leakage group. Kaplan-Meier curves showed that the fracture-free time was shorter in the leakage group compared to the no-leakage group (log-rank test, P=0.014). Conclusions Lower self-HU and intervertebral leakage are risk factors for AVF, and higher self-HU may lead to AVF when intervertebral leakage is present.

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Risk Factors for Refracture following Primary Osteoporotic Vertebral Compression Fractures

Cited by 26 publications

References 21 publications

Long-term outcome of percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: a retrospective cohort study with three-year follow-up

Long-term outcome of percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: a retrospective cohort study with three-year follow-up

Prediction of new vertebral compression fracture within 3 years after percutaneous vertebroplasty for osteoporotic vertebral compression fracture: Establishment and validation of a nomogram prediction model

The correlation between self-Hounsfield units and adjacent vertebral fracture after percutaneous vertebral augmentation: a retrospective cohort study

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