Wang Feng, Sun Rui, Zhang Shao-Dong, Wu Xiao-Tao
Department of Spine Surgery, Zhongda Hospital, School of Medicine, Southeast University, 87# Dingjiaqiao Road, Nanjing, 210009, China.
Surgery Research Center, School of Medicine, Southeast University, 87# Dingjiaqiao Road, Nanjing, 210009, China.
J Orthop Surg Res. 2024 Dec 19;19(1):844. doi: 10.1186/s13018-024-05337-z.
Osteoporotic vertebral compression fractures (OVCF) cascades (OVCFcs) repeatedly cause vertebral compression to involve multiple vertebra. This study aimed to introduce an accelerated form of OVCFcs: acute multiple OVCF (amOVCF).
OVCF patients with multiple vertebral augmentations in a spine center between June 2016 and October 2020 were retrospectively studied. Demographics, spine trauma, anatomical distribution, and distribution pattern of OVCF in OVCFcs and amOVCF were summarized and compared.
429 patients with multiple vertebral augmentations in 1164 vertebra were included. There were 210 OVCFcs accumulating 622 OVCF and 219 amOVCF simultaneously involving 542 vertebra. The OVCFcs progressed at 0.48 fractures and 0.56 vertebra per year. Both OVCFcs and amOVCF demonstrated asymmetrical bimodal distribution in spine and most frequently involved L1. The incidence of adjacent OVCF was 40.14% in amOVCF with 2 OVCF and 84.72% in amOVCF with ≥ 3 OVCF, and the distribution pattern of OVCF was not significantly different between amOVCF and OVCFcs. The female/male ratio was 5.56 in OVCFcs and not different from that of 4.34 in amOVCF. The age of females (73.41 ± 8.08 and 76.29 ± 8.25 years old) but not males (77.20 ± 10.13 and 79.75 ± 10.21 years old) was significantly increased from initial to last OVCF in OVCFcs. amOVCF had similar age (72.26 ± 10.09 years old) as OVCFcs at initial OVCF (73.99 ± 8.51 years old) and were significantly younger than OVCFcs at last OVCF (76.82 ± 8.64 years old). 54.29% in OVCFcs and 48.4% in amOVCF reported no evident trauma, and the ratio of apparent spine trauma was higher in amOVCF (43.38%) than in OVCFcs (28.54%).
amOVCF are accelerated form of OVCFcs showing similar anatomical distribution and distribution pattern of OVCF in spine. Both amOVCF and OVCFcs cause multiple fragility fractures without significant spine trauma.
骨质疏松性椎体压缩骨折（OVCF）级联反应（OVCFcs）反复导致椎体压缩并累及多个椎体。本研究旨在介绍一种加速形式的OVCFcs：急性多发性OVCF（amOVCF）。
回顾性研究2016年6月至2020年10月期间在一家脊柱中心接受多次椎体强化治疗的OVCF患者。总结并比较了OVCFcs和amOVCF中OVCF的人口统计学、脊柱创伤、解剖分布及分布模式。
纳入429例接受多次椎体强化治疗的患者，共1164个椎体。有210例OVCFcs累计622处OVCF，同时有219例amOVCF累及542个椎体。OVCFcs每年进展0.48处骨折和0.56个椎体。OVCFcs和amOVCF在脊柱中均表现为不对称双峰分布，最常累及L1。在有2处OVCF的amOVCF中，相邻OVCF的发生率为40.14%，在有≥3处OVCF的amOVCF中为84.72%，amOVCF和OVCFcs中OVCF的分布模式无显著差异。OVCFcs的女性/男性比例为5.56，与amOVCF的4.34无差异。在OVCFcs中，女性从初次到末次OVCF的年龄显著增加（分别为73.41±8.08岁和76.29±8.25岁），而男性无显著变化（分别为77.20±10.13岁和79.75±10.21岁）。amOVCF在初次OVCF时的年龄与OVCFcs相似（72.26±10.09岁与73.99±8.51岁），且在末次OVCF时显著低于OVCFcs（76.82±8.64岁）。OVCFcs中有54.29%、amOVCF中有48.4%报告无明显创伤，amOVCF中明显脊柱创伤的比例（43.38%）高于OVCFcs（28.54%）。
amOVCF是OVCFcs的加速形式，在脊柱中显示出相似的解剖分布和OVCF分布模式。amOVCF和OVCFcs均导致多发性脆性骨折，且无明显脊柱创伤。
