Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures

PurposeTo explore the risk factors of bone cement displacement after percutaneous vertebral augmentation (PVA) in patients with osteoporotic vertebral compression fracture (OVCF).MethodsWe retrospectively reviewed the records of 1,538 patients with OVCF treated with percutaneous vertebroplasty (PVP)...

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Main Authors: Xiangcheng Gao, Jinpeng Du, Lin Gao, Dingjun Hao, Hua Hui, Baorong He, Liang Yan
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-07-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2022.947212/full
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author Xiangcheng Gao
Xiangcheng Gao
Jinpeng Du
Lin Gao
Dingjun Hao
Hua Hui
Baorong He
Liang Yan
author_facet Xiangcheng Gao
Xiangcheng Gao
Jinpeng Du
Lin Gao
Dingjun Hao
Hua Hui
Baorong He
Liang Yan
author_sort Xiangcheng Gao
collection DOAJ
description PurposeTo explore the risk factors of bone cement displacement after percutaneous vertebral augmentation (PVA) in patients with osteoporotic vertebral compression fracture (OVCF).MethodsWe retrospectively reviewed the records of 1,538 patients with OVCF treated with percutaneous vertebroplasty (PVP) or percutaneous vertebroplasty (PKP) from January 2016 to June 2021. Patients were divided into bone cement displacement group (n = 78) and bone cement non-displacement group (n = 1,460) according to the radiographic images. Possible risk factors for bone cement displacement were noted, including age, gender, body mass index (BMI), bone mineral density (BMD), underlying disease, number of fractured vertebrae, involved vertebral segment, surgical method, surgical approach, vertebral height, Cobb angle, cement leakage, the viscosity of bone cement, bone cement diffuse ratio, degree of bone cement interweaving, sagittal bone cement placement, targeted location of bone cement, the distance between the bone cement and the upper and lower endplates, the time of wearing brace and postoperative osteoporosis treatment. Risk factors were identified with univariate and multivariate logistic regressions and the discrimination ability of the predictive indicators was evaluated using area under the curve (AUC) of the receiver operating characteristic (ROC).ResultsIn multivariate regression, independent risk factors for bone cement displacement included: high restoration of Cobb angle (OR = 2.019, 95%[CI] 1.545–4.852, P < 0.001), cement leakage (anterior edge) (OR = 1.727, 95%[CI] 1.05–2.20, P < 0.001), small degree of bone cement interweaving (OR = 1.917, 95%[CI] 1.129–2.747, P < 0.001), non-targeted location of bone cement (OR = 2.323, 95%[CI] 1.645–4.134, P < 0.001), short duration of brace wearing (OR = 3.207, 95%[CI] 2.036–4.348, P < 0.001) and postoperative osteoporosis treatment (OR = 0.422, 95% CI = 0.323–0.547, P < 0.001). The AUCs for the high restoration of Cobb angle, cement leakage (anterior edge), small degree of bone cement interweaving, non-targeted location of bone cement, short duration of brace wearing and non-postoperative osteoporosis treatment were 0.784 (95% CI, 0.747–0.821), 0.811 (95% CI 0.764–0.859), 0.917 (95%CI 0.864–0.970), 0.610 (95%CI 0.552–0.669), 0.854 (95%CI 0.816–0.892) and 0.756 (95% CI, 0.712–0.800), respectively.ConclusionHigh restoration of Cobb angle, cement leakage (anterior edge), small degree of bone cement interweaving, non-targeted location of bone cement, short duration of brace wearing and non-postoperative osteoporosis treatment were the independent risk factors of bone cement displacement after PVA.
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spelling doaj.art-da28f10e69664acc81055bb406a51bf42022-12-22T02:14:26ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-07-01910.3389/fsurg.2022.947212947212Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fracturesXiangcheng Gao0Xiangcheng Gao1Jinpeng Du2Lin Gao3Dingjun Hao4Hua Hui5Baorong He6Liang Yan7Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, ChinaMedical College, Yan'an University, Yan'an, ChinaDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, ChinaDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, ChinaDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, ChinaDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, ChinaDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, ChinaDepartment of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, ChinaPurposeTo explore the risk factors of bone cement displacement after percutaneous vertebral augmentation (PVA) in patients with osteoporotic vertebral compression fracture (OVCF).MethodsWe retrospectively reviewed the records of 1,538 patients with OVCF treated with percutaneous vertebroplasty (PVP) or percutaneous vertebroplasty (PKP) from January 2016 to June 2021. Patients were divided into bone cement displacement group (n = 78) and bone cement non-displacement group (n = 1,460) according to the radiographic images. Possible risk factors for bone cement displacement were noted, including age, gender, body mass index (BMI), bone mineral density (BMD), underlying disease, number of fractured vertebrae, involved vertebral segment, surgical method, surgical approach, vertebral height, Cobb angle, cement leakage, the viscosity of bone cement, bone cement diffuse ratio, degree of bone cement interweaving, sagittal bone cement placement, targeted location of bone cement, the distance between the bone cement and the upper and lower endplates, the time of wearing brace and postoperative osteoporosis treatment. Risk factors were identified with univariate and multivariate logistic regressions and the discrimination ability of the predictive indicators was evaluated using area under the curve (AUC) of the receiver operating characteristic (ROC).ResultsIn multivariate regression, independent risk factors for bone cement displacement included: high restoration of Cobb angle (OR = 2.019, 95%[CI] 1.545–4.852, P < 0.001), cement leakage (anterior edge) (OR = 1.727, 95%[CI] 1.05–2.20, P < 0.001), small degree of bone cement interweaving (OR = 1.917, 95%[CI] 1.129–2.747, P < 0.001), non-targeted location of bone cement (OR = 2.323, 95%[CI] 1.645–4.134, P < 0.001), short duration of brace wearing (OR = 3.207, 95%[CI] 2.036–4.348, P < 0.001) and postoperative osteoporosis treatment (OR = 0.422, 95% CI = 0.323–0.547, P < 0.001). The AUCs for the high restoration of Cobb angle, cement leakage (anterior edge), small degree of bone cement interweaving, non-targeted location of bone cement, short duration of brace wearing and non-postoperative osteoporosis treatment were 0.784 (95% CI, 0.747–0.821), 0.811 (95% CI 0.764–0.859), 0.917 (95%CI 0.864–0.970), 0.610 (95%CI 0.552–0.669), 0.854 (95%CI 0.816–0.892) and 0.756 (95% CI, 0.712–0.800), respectively.ConclusionHigh restoration of Cobb angle, cement leakage (anterior edge), small degree of bone cement interweaving, non-targeted location of bone cement, short duration of brace wearing and non-postoperative osteoporosis treatment were the independent risk factors of bone cement displacement after PVA.https://www.frontiersin.org/articles/10.3389/fsurg.2022.947212/fullosteoporotic vertebral compression fracture (OVCF)percutaneous vertebral augmentationcomplicationrisk factorsbone cement displacement
spellingShingle Xiangcheng Gao
Xiangcheng Gao
Jinpeng Du
Lin Gao
Dingjun Hao
Hua Hui
Baorong He
Liang Yan
Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures
Frontiers in Surgery
osteoporotic vertebral compression fracture (OVCF)
percutaneous vertebral augmentation
complication
risk factors
bone cement displacement
title Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures
title_full Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures
title_fullStr Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures
title_full_unstemmed Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures
title_short Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures
title_sort risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures
topic osteoporotic vertebral compression fracture (OVCF)
percutaneous vertebral augmentation
complication
risk factors
bone cement displacement
url https://www.frontiersin.org/articles/10.3389/fsurg.2022.947212/full
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