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. 2022 May 14;23(1):458.
doi: 10.1186/s12891-022-05409-3.

Risk factors for recollapse of new vertebral compression fractures after percutaneous kyphoplasty in geriatric patients: establishment of a nomogram

FuCheng Bian #  1   2 , GuangYu Bian #  3 , Li Zhao  4 , Shuo Huang #  5 , JinHui Fang  6 , YongSheng An  7
Affiliations

Risk factors for recollapse of new vertebral compression fractures after percutaneous kyphoplasty in geriatric patients: establishment of a nomogram

FuCheng Bian et al. BMC Musculoskelet Disord. .

Abstract

Background: The main objective of this study was to investigate the risk factors for recollapse of new vertebral compression fractures (NVCFs) after percutaneous kyphoplasty (PKP) treatment for osteoporotic vertebral compression fracture (OVCF) and to construct a new nomogram model.

Methods: We retrospectively analysed single-level OVCFs from January 2017 to June 2020, randomizing patients to a training set and a testing set. In the training set, independent risk factors for NVCFs in OVCF patients treated with PKP were obtained by univariate and multivariate regression analyses. These risk factors were then used as the basis for constructing a nomogram model. Finally, internal validation of the built model was performed in the testing set using the consistency index (C-index), receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA).

Results: In total, 371 patients were included in this study. NVCFs occurred in 21.7% of the training set patients, and multivariate regression analysis showed that a low Hounsfield unit (HU) value, cement leakage, and thoracolumbar (TL) junction fracture were independent risk factors for NVCF after PKP. The C-index was 0.81 (95% CI: 0.74-0.81), and the validation showed that the predicted values of the established model were in good agreement with the actual values.

Conclusions: In this study, three independent risk factors were obtained by regression analysis. A nomogram model was constructed to guide clinical work and to make clinical decisions relatively accurately to prevent the occurrence of vertebral recollapse fractures.

Keywords: Nomogram; Osteoporotic vertebral compression fracture; Percutaneous kyphoplasty; Risk factor.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
CT values were measured by PACS. A is a sagittal image of the lumbar spine with three tangents made on the measured vertebrae, corresponding to the three levels of (B), (C) and (D) in the axial position. The largest elliptical region of interest (ROI) containing only bone trabeculae was drawn in the axial position to obtain the average Hu value
Fig. 2
Fig. 2
Nomogram for predicting NVCFs in patients with OVCFs after PKP operation. Each risk factor was assigned one point, which was summed to give a total number of points that corresponded to the probability of the hazard on the bottom row of the figure according to the total points
Fig. 3
Fig. 3
Comparison of the area under the receiver operating characteristic curve between nomogram-independent predictors in the training set (A) and the testing set (B)
Fig. 4
Fig. 4
Comparison of calibration curves between the training set (A) and the testing set (B)
Fig. 5
Fig. 5
Comparison of decision curve analyses between the training set (A) and the testing set (B)
Fig. 6
Fig. 6
A and (B) are the lateral and anteroposterior X-rays after the first fracture operation; (C) and (D) are the lateral and positive X-rays after the second fracture
See this image and copyright information in PMC

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