Wu Fan, Chen Xingda, Jiang Rueishiuan, Li Liqun, Qin Lei, Qi Weizhen, Hao Chizi, Tang Jingjing
Geriatric Hospital Affiliated of Wuhan University of Science and Technology, Wuhan, 430075, China.
Department of Orthopedics, Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, 430015, China.
Sci Rep. 2025 Feb 17;15(1):5772. doi: 10.1038/s41598-025-85381-9.
To evaluate the risk factors for adjacent vertebral compression fracture(AVCF) following the surgery of percutaneous kyphoplasty (PKP) in postmenopausal women. Two hundred and ninety-seven postmenopausal female patients had been reviewed, underwent PKP surgery between January 2016 and December 2020, were divided into two groups according to whether or not AVCF. Receiver operating characteristic (ROC) curves were generated to analyze the sensitivity and specificity of the relative risk factors in the identification of AVCF. In this study of 297 postmenopausal women who underwent PKP, 67 developed AVCF during follow-up. There were no significant differences in BMI, surgical method, or cement leakage between the groups. The AVCF group was older, had lower BMD, less bone cement volume per section, higher VHA, and larger VKAC. The non-fracture group had lower postoperative VAS and fewer surgical vertebrae. The model showed good discrimination with age, BMD, postoperative VAS, VHR, and VKAC. ROC analysis indicated that a postoperative with high VHR, high VKAC or VAS score > 2.5 was highly predictive of AVCF in postmenopausal women after PKP. In the context of PKP for OVCF in postmenopausal women, it is crucial to avoid excessive VHR and VKAC. Postoperatively, clinicians should prioritize pain management strategies to ensure optimal patient outcomes.
评估绝经后女性经皮椎体后凸成形术（PKP）术后相邻椎体压缩骨折（AVCF）的危险因素。回顾了297例绝经后女性患者，这些患者在2016年1月至2020年12月期间接受了PKP手术，并根据是否发生AVCF分为两组。绘制受试者工作特征（ROC）曲线，以分析相关危险因素在识别AVCF中的敏感性和特异性。在这项对297例接受PKP的绝经后女性的研究中，67例在随访期间发生了AVCF。两组之间的体重指数、手术方法或骨水泥渗漏情况无显著差异。AVCF组年龄较大，骨密度较低，每节段骨水泥体积较少，椎体高度增加（VHA）较高，椎体矢状面后凸角（VKAC）较大。未骨折组术后视觉模拟评分（VAS）较低，手术椎体较少。该模型在年龄、骨密度、术后VAS、椎体高度增加率（VHR）和VKAC方面显示出良好的区分能力。ROC分析表明，术后VHR高、VKAC高或VAS评分>2.5对绝经后女性PKP术后AVCF具有高度预测性。在绝经后女性骨质疏松性椎体压缩骨折（OVCF）的PKP治疗中，避免VHR和VKAC过高至关重要。术后，临床医生应优先考虑疼痛管理策略，以确保患者获得最佳预后。
