The temporal and spatial relationship between percutaneous vertebral augmentation and new symptomatic fractures

IF 1.4 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Diagnostic and interventional radiology Pub Date : 2024-07-08 Epub Date: 2023-08-09 DOI:10.4274/dir.2023.221424
Jing Tang, Jin Liu, Zuchao Gu, Yu Zhang, Haosen Yang, Zhenlin Li
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引用次数: 0

Abstract

Purpose: This study aimed to explore the relationship between the time from percutaneous vertebral augmentation (PVA) until subsequent fracture and the risk of new symptomatic fractures (NSFs) in untreated vertebrae at different distances from "augmented vertebrae".

Methods: Patients who underwent PVA for the treatment of osteoporotic vertebral compression fractures at the West China Hospital of Sichuan University from May 2014 to April 2019 were retrospectively recruited. Vertebrae not treated during PVA were stratified based on their distance from the nearest augmented vertebra and the time elapsed since PVA. Survival curves were plotted to compare the risk of NSFs in untreated vertebrae at different distances from augmented vertebrae. The Cox proportional hazards model was used to identify risk factors of NSFs in untreated vertebrae.

Results: total, 162 patients with 228 NSFs (2.760 vertebrae) were analyzed. More than half of the NSFs (56.6%) occurred within the first year after PVA. Rates and hazard ratios (HRs) of NSFs were higher in vertebrae located one segment away from the augmented vertebrae (21.0%, HR: 3.99, P < 0.001), two segments away (10.6%, HR: 1.97, P = 0.003), or three segments away (10.5%, HR: 2.26, P < 0.001) than in vertebrae located five or more segments away (3.81%, HR: 1.00). Similar results were observed regardless of whether the untreated vertebrae were located in the thoracolumbar junction. In addition to distance, other risk factors of NSFs were the thoracolumbar location of untreated vertebrae, the number of augmented vertebrae, and percutaneous vertebroplasty.

Conclusion: The risk of NSFs is greater for untreated vertebrae located closer to augmented vertebrae than for untreated vertebrae further away. This distance dependence occurs mainly within the three segments closest to the augmented vertebra. The risk of NSFs decreases with time after augmentation, and it is also related to the number of augmented vertebrae, the type of augmentation, and whether the untreated vertebrae are thoracolumbar or not.

经皮椎体置换术与新的症状性骨折之间的时空关系
目的:本研究旨在探讨经皮椎体增强术(PVA)至后续骨折的时间与距 "增强椎体 "不同距离的未治疗椎体发生新症状性骨折(NSF)风险之间的关系:回顾性招募2014年5月至2019年4月在四川大学华西医院接受PVA治疗骨质疏松性椎体压缩骨折的患者。根据椎体与最近的增生椎体的距离以及自PVA后的时间,对PVA期间未治疗的椎体进行分层。绘制了生存曲线,以比较与增强椎体不同距离的未治疗椎体发生 NSF 的风险。结果:共对162例患者的228个NSF(2.760个椎体)进行了分析。一半以上的 NSF(56.6%)发生在 PVA 术后第一年内。与距离增生椎体一个节段(21.0%,HR:3.99,P <0.001)、两个节段(10.6%,HR:1.97,P = 0.003)或三个节段(10.5%,HR:2.26,P <0.001)的椎体相比,距离五个或更多节段(3.81%,HR:1.00)的椎体的NSF发生率和危险比(HR)更高。无论未经治疗的椎体是否位于胸腰交界处,都观察到了类似的结果。除距离外,NSF的其他风险因素还包括未治疗椎体的胸腰椎位置、增粗椎体的数量以及经皮椎体成形术:结论:与距离较远的未治疗椎体相比,距离增生椎体较近的未治疗椎体发生NSF的风险更大。这种距离依赖性主要发生在最靠近增强椎体的三个节段。发生 NSF 的风险随着椎体增量术后时间的推移而降低,而且还与增量椎体的数量、增量类型以及未治疗椎体是否为胸腰椎有关。
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来源期刊
Diagnostic and interventional radiology
Diagnostic and interventional radiology Medicine-Radiology, Nuclear Medicine and Imaging
自引率
4.80%
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0
期刊介绍: Diagnostic and Interventional Radiology (Diagn Interv Radiol) is the open access, online-only official publication of Turkish Society of Radiology. It is published bimonthly and the journal’s publication language is English. The journal is a medium for original articles, reviews, pictorial essays, technical notes related to all fields of diagnostic and interventional radiology.
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