Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Department of Orthopaedics, Suzhou Ninth People's Hospital, Suzhou, Jiangsu, People's Republic of China.
Clin Interv Aging. 2023 May 18;18:827-834. doi: 10.2147/CIA.S410992. eCollection 2023.
Recurrent of local kyphosis after percutaneous kyphoplasty (PKP) is rarely reported and discussed. Literatures reported that re-kyphosis is usually a consequence of refractures of augmented or adjacent vertebra. However, whether re-kyphosis should be considered as a complication of refractures and has an impact on clinical efficacy of PKP during follow-up time is unknown. The purpose of this study is to evaluate the related risk factors and clinical significance of the recurrent of local kyphosis in osteoporotic vertebral fracture (OVF) patients without refractures.
A total of 143 patients who underwent single-level PKP were recruited and assigned into the re-kyphosis group and non-re-kyphosis group. Clinical and radiographic data were collected and compared between the two groups. Then, multivariate logistic regression analyses were conducted to identify the related risk factors.
During follow-up, 16 of the 143 patients presented postoperative re-kyphosis. The average local kyphosis angle increased from 11.81±8.60° postoperatively to 25.13±8.91° at the final follow-up which showed a statistically significant difference (<0.05). Both groups had significant improvements in postoperative visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores compared to their preoperative values (<0.05). However, in the re-kyphosis group at final follow-up, the VAS and ODI scores showed worsening compared to the postoperative scores. Logistic regression analysis showed that disc-endplate complex injury (OR=17.46, =0.003); local kyphosis angle correction (OR=1.84, <0.001); and vertebral height restoration (OR=1.15, =0.003) were risk factors for re-kyphosis.
Re-kyphosis is not rare in patients with osteoporotic vertebral fracture and tends to have an inferior prognosis following PKP surgery. Patients with disc-endplate complex injury and more correction of vertebral height and kyphosis angle are at a higher risk for re-kyphosis after PKP surgery than others.
经皮椎体后凸成形术（PKP）后局部后凸复发很少有报道和讨论。文献报道，再后凸通常是增强或相邻椎体骨折的结果。然而，再后凸是否应被视为骨折的并发症，并对 PKP 随访期间的临床疗效有影响尚不清楚。本研究旨在评估骨质疏松性椎体骨折（OVF）患者无骨折再发局部后凸的相关危险因素和临床意义。
共纳入 143 例接受单节段 PKP 的患者，将其分为再后凸组和无再后凸组。收集并比较两组的临床和影像学资料。然后，进行多变量逻辑回归分析以确定相关危险因素。
随访期间，143 例患者中有 16 例术后出现后凸再发。术后局部后凸角从 11.81°±8.60°增加到最终随访时的 25.13°±8.91°，差异有统计学意义（<0.05）。与术前相比，两组术后视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）评分均显著改善（<0.05）。然而，在再后凸组，最终随访时 VAS 和 ODI 评分较术后评分恶化。Logistic 回归分析显示，椎间盘-终板复合体损伤（OR=17.46，=0.003）；局部后凸角矫正（OR=1.84，<0.001）；椎体高度恢复（OR=1.15，=0.003）是再后凸的危险因素。
骨质疏松性椎体骨折患者再后凸并不少见，PKP 术后往往预后较差。与其他患者相比，椎间盘-终板复合体损伤和更多矫正椎体高度和后凸角度的患者 PKP 术后再后凸的风险更高。
