Risk factor analysis of the incidence of adjacent vertebral compression fracture following PKP surgery in postmenopausal women

Abstract Objective This study aimed to evaluate the risk factors for adjacent vertebral compression fracture following PKP surgery in postmenopausal women. Methods A total of 297 patients who received PKP surgery between January 2016 and December 2020 were divided into two groups according to whether the adjacent vertebral body was fractured. The covariates recorded were age, bone mineral density (BMD), the number of surgical vertebral body, the VAS scores of back, the surgical site (thoracic spine/lumbar spine), the surgical method (unilateral/bilateral), the single section of bone cement volume, the height and the kyphosis angle of the change before and after surgery, the leakage of bone cement. A one-way ANOVA was performed with the above mentioned parameters and binary logistic regression analysis was used to determine the relative risk factors. Results A total of 297 patients were followed-up at a mean of 2.1 ± 0.4 years (range,2–3years). Sixty-seven patients demonstrated fractures in the adjacent vertebral body following surgery. Analysis by one-way ANOVA demonstrated that the age(p = 0.001), the bone mineral density (BMD)(p = 0.000), the number of surgical vertebral body(p = 0.014), the VAS scores of back(p = 0.000), the surgical site (thoracic spine/lumbar spine)(p = 0.001), the single section of bone cement volume(p = 0.034), the height of change after surgery(p = 0.000) and the kyphosis angle of change after surgery(p = 0.000) were potential risk factors (all parameters, p<0.05). Furthermore, binary logistic regression analysis showed that the age(OR = 4.022, 95%CI 1.348–12.002, p = 0.013), the BMD(OR = 2.008, 95%CI 1.465–2.754, p = 0.000), the VAS scores of back(OR = 1.472, 95%CI 1.135–1.909, p = 0.004), the change of height after operation(OR = 0.181, 95%CI 0.089–0.367, p = 0.000) and the change of kyphosis angle after operation(OR = 0.806, 95%CI 0.689–0.943, p = 0.007) were also risk factors for adjacent vertebral compression fractures following PKP surgery in postmenopausal women. Conclusions The age, the BMD, the VAS scores of back, the change of height after operation and the change of kyphosis angle after operation may be risk factors for fractures in the adjacent vertebral body of postmenopausal women following PKP surgery.