Correlation Study Between Bone Cement Distribution and Adjacent Vertebral Fractures After Percutaneous Vertebroplasty

OBJECTIVE: We investigated the correlation between bone cement distribution and adjacent vertebral fractures (AVFs) after percutaneous vertebroplasty (PVP).METHODS: We retrospectively analyzed patients who -nderwent single-segment PVP for osteoporotic compression fractures in our hospital from January 2016 to January 2021 and divided the patients into 2 groups, A and B, on the basis of the criterion of whether there were AVFs of the operated vertebrae within 1 year after surgery. We compared the general data of the 2 groups, assessed the ability of 3 simple X-rayLbased evaluation methods to predict the occurrence of AVF within 1 year after surgery and derived a simple and accurate evaluation method.RESULTS: A total of 570 patients were included in this study: 511 patients in group A and 59 patients in group B. There were no statistical differences in the general data such as age, gender, and fracture site between the 2 groups. The posterior-anterior (PA), lateral (LAT), and PA and LAT methods showed receiver operating characteristic curve (ROC) predicted postoperative AVF of 0.611, 0.691, and 0.714, respectively. The difference between the area under curve (AUC) of the PA method and LAT method was statistically significant (P = 0.0307), the difference between the AUC of PA method and PA and LAT method was statistically significant (P < 0.001), and the difference between the AUC of LAT method and PA and LAT method was not statistically significant (P = 0.3308).There was no statistical difference between the 2 groups of patients with PAmethod point of 1 and statistically different between patients with points of 2 and 3. There was statistical difference in points of 1, 2 and 3 in the LAT method between the 2 groups. There was a positive correlation between cement distribution scores and AVF by linear regression analysis of the 3 evaluation methods.CONCLUSIONS: The 3 evaluation methods reliably predict AVF after PVP, with the LAT method, PA and LAT method being more predictive than the PA method, but the LAT method is simpler, with bone cement being widely distributed after crossing the midline in the PA method and contact with the upper and lower end plates in the LAT method being a risk factor for AVF.

Automated summary

This study investigated the correlation between bone cement distribution and adjacent vertebral fractures after percutaneous vertebroplasty. By retrospectively analyzing patient data and comparing different evaluation methods, a simple and accurate evaluation method was derived.