Open AccessRisk Factors for Refracture following Primary Osteoporotic Vertebral Compression Fractures
Author(s) -
Chengyue Ji,
Yuluo Rong,
Jiaxing Wang,
Shikai Yu,
Guoyong Yin,
Jin Fan,
Pengyu Tang,
Dongdong Jiang,
Wei Liu,
Fangyi Gong,
Xuhui Ge,
Weihua Cai
Publication year - 2021
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2021/24/e335
Subject(s) - medicine , osteoporosis , vertebral compression fracture , hounsfield scale , retrospective cohort study , compression (physics) , orthopedic surgery , surgery , radiology , computed tomography , materials science , composite material
Background: In the aging population, osteoporosis and related complications have becomea global public health problem. Osteoporotic vertebral compression fractures are among themost common type of osteoporotic fractures and patients are at risk of secondary vertebralcompression fracture.Objectives: To identify risk factors for secondary vertebral compression fracture followingprimary osteoporotic vertebral compression fractures.Study Design: Retrospective study.Setting: Department of Orthopedic, an affiliated hospital of a medical university.Methods: This retrospective cohort study evaluated the risk factors for secondary vertebralcompression fracture in 317 consecutive patients with systematic osteoporotic vertebralcompression fractures who received percutaneous vertebroplasty and kyphoplasty orconservative treatment. Patients were divided into secondary vertebral compression fracture (n= 43) and non- secondary vertebral compression fracture (n = 274) groups. We retrospectivelyanalyzed clinical characteristics and radiographic parameters, including gender, age, bodymass index, number of primary fractures, primary treatment (percutaneous vertebroplasty andkyphoplasty or conservative treatment), nonspinal fracture history before primary fracture,primary fracture at the thoracolumbar junction, steroid use, bisphosphonate therapy, andHounsfield units value of L1.Results: Comparison between the groups showed significant differences in age (P = 0.001),nonspinal fracture history (P < 0.001), and Hounsfield units value of L1 (P < 0.001). Thereceiver operating characteristic curves demonstrated that the optimal thresholds for age andHounsfield units value of L1 were 75 (sensitivity: 55.8%; specificity: 67.5%) and 50 (sensitivity:88.3%; specificity: 67.4%), respectively. In multivariate logistic regression analysis, nonspinalfracture history (OR = 6.639, 95% CI = 1.809 – 24.371, P = 0.004) and Hounsfield units valueof L1 < 50 (OR = 15.260, 95% CI = 6.957 – 33.473, P < 0.001) were independent risk factorsfor secondary vertebral compression fracture.Limitations: The main limitation is the retrospective nature of this study.Conclusion: Patients with low Hounsfield units value of L1 or non-spinal fracture history arean important population to target for secondary fracture prevention.Key words: Risk factor, vertebral, secondary fracture, osteoporosis