Factors affecting recompression of augmented vertebrae after successful percutaneous balloon kyphoplasty: a retrospective analysis.
BACKGROUND
The instantaneously recovered stability and strength following vertebral augmentation prevent continuous micro-motion and further collapse of fractured vertebrae. Despite this, during follow-up of our patients, we observed recompression of augmented vertebrae with significant vertebral height loss and aggravation of local kyphotic deformity.


PURPOSE
To identify the risk factors related to recompression and to evaluate the clinical significance of recompression.


MATERIAL AND METHODS
One hundred and twenty-one patients who underwent single-level kyphoplasty for osteoporotic vertebral fractures were retrospectively analyzed and classified into the following two groups: group 1 with recompression and group 2 without recompression. Characteristics of patients and fractured vertebrae were compared between the two groups. Univariate and multivariate regression analyses were performed to identify risk factors for recompression. We evaluated the visual analogue scale (VAS) and the Oswestry disability index (ODI) scores in both groups to elucidate the clinical impact.


RESULTS
During an average of 20.75 ± 4.43 months of follow-up, 17 augmented vertebrae developed recompression. In the recompression group, vertebral height loss was accompanied by significantly aggravated local kyphotic deformity. The local kyphotic angle differed significantly between the two groups at final follow-up (P = 0.011). However, the VAS and ODI scores were maintained at final follow-up in both groups although the values were slightly higher in group 1. Solid lump distribution pattern (OR = 8.718; P = 0.003) and the degree of vertebral height restoration (OR = 1.260; P < 0.001) were identified as the most important risk factors for recompression.


CONCLUSION
Fractured vertebrae containing solid lump cement and those with more vertebral height restoration are at higher risk of recompression. More attention should be given to these patients considering the aggravated local kyphotic deformity.
['Niu|Junjie|J|', 'Zhou|Haifei|H|', 'Meng|Qian|Q|', 'Shi|Jinhui|J|', 'Meng|Bin|B|', 'Yang|Huilin|H|']
D015502:Absorptiometry, Photon D000368:Aged D015519:Bone Density D003952:Diagnostic Imaging D004185:Disability Evaluation D005260:Female D050815:Fractures, Compression D006801:Humans D058498:Kyphoplasty D008297:Male D058866:Osteoporotic Fractures D010147:Pain Measurement D012008:Recurrence D012189:Retrospective Studies D012307:Risk Factors D016103:Spinal Fractures D016896:Treatment Outcome
recompression augmented vertebrae Percutaneous balloon kyphoplasty risk factors clinical efficacy