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. 2023 Mar 23:14:1072087.
doi: 10.3389/fendo.2023.1072087. eCollection 2023.

Correlation analysis of larger side bone cement volume/vertebral body volume ratio with adjacent vertebral compression fractures during vertebroplasty

Chengqiang Zhou  1   2 , Shaolong Huang  1   2 , Yifeng Liao  1   2 , Han Chen  2 , Yazhong Zhang  1 , Hua Li  1 , Ziqiang Zhu  1 , Yunqing Wang  1
Affiliations

Correlation analysis of larger side bone cement volume/vertebral body volume ratio with adjacent vertebral compression fractures during vertebroplasty

Chengqiang Zhou et al. Front Endocrinol (Lausanne). .

Abstract

Objective: To investigate the correlation analysis of larger side bone cement volume/vertebral body volume ratio (LSBCV/VBV%) with adjacent vertebral compression fracture (AVCF) in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).

Methods: A retrospective analysis of 245 OVCF patients who underwent PVP treatment from February 2017 to February 2021, including 85 males and 160 females. The age ranged from 60 to 92 years, with a mean of (70.72 ± 7.03) years. According to whether AVCF occurred after surgery, they were divided into 38 cases in the AVCF group (fracture group) and 207 cases in the no AVCF group (non-fracture group). The correlation between gender, age, bone mineral density (BMD), body mass index (BMI), thoracolumbar segment fracture, bone cement disc leakage, LSBCV, bone cement volume (BCV), VBV, LSBCV/VBV ratio (LSBCV/VBV%), and BCV/VBV% and AVCF were analyzed in both groups. Risk factors for AVCF after PVP were analyzed by multifactorial logistic regression, and then the receiver operating characteristic curves (ROC curves) were plotted to identify the critical value of LSBCV/VBV%.

Results: 38 patients (15.5%) developed AVCF postoperatively. Univariate analysis showed that BMD, bone cement disc leakage, LSBCV, and LSBCV/VBV% were risk factors for AVCF after PVP (P<0.05), while gender, age, BMI, thoracolumbar segment fracture, BCV, VBV, and BCV/VBV% were not significantly different in both groups (P>0.05). Multifactorial logistic regression analysis revealed that BMD, bone cement disc leakage, and LSBCV/VBV% were independent risk factors for AVCF after PVP (P<0.05). According to the ROC curve, the LSBCV/VBV% had an area under the curve of 71.6%, a sensitivity and specificity of 89.5% and 51.7%, respectively, and a critical value of 13.82%.

Conclusion: BMD, bone cement disc leakage and LSBCV/VBV% are independent risk factors for AVCF after PVP. With LSBCV/VBV at 13.82%, the incidence of AVCF significantly increased.

Keywords: adjacent vertebral compression fracture; bone cement volume; osteoporotic vertebral compression fracture; percutaneous kyphoplasty; percutaneous vertebroplasty; vertebral body volume.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of primary vertebral fractures.
Figure 2
Figure 2
VBV.
Figure 3
Figure 3
BCV.
Figure 4
Figure 4
LSBCV.
Figure 5
Figure 5
ROC curve for the diagnosis of AVCF.
Figure 6
Figure 6
A 76-year-old female was admitted to the hospital with no obvious cause of low back pain for 1 week, was diagnosed with OVCF (T12), and underwent PVP under local anesthesia on the third day after admission. (A) Preoperative fat-suppressed image showed T12 vertebral fracture, (B, C) T12 vertebral bone cement filling could be seen in the anterior and lateral X-rays after the operation, (D) Postoperative CT showed that the bone cement was unevenly distributed on the bilateral sides of the vertebrae, (E, F) MRI showed L1 vertebral fracture 5 months after the operation, (G, H) T12 and L1 vertebral bodies were filled with bone cement in the anterior and lateral X-rays after the operation.
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