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Abstract：
OBJECTIVE: To analyze the association between scoliosis and vertebral refracture after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCFs).
METHODS: A retrospective study was conducted on 269 patients meeting the criteria from January 2014 to October 2022. All patients underwent PKP with complete data and were followed-up for > 12 months. First, it was verified that scoliosis was a risk factor in 269 patients. Second, patients with scoliosis were grouped based on the Cobb angle to evaluate the impact of the post-operative angle. The cox proportional hazards regression analysis and survival analysis were used to calculate the hazard ratio and recurrence time.
RESULTS: A total of 56 patients had scoliosis, 18 of whom experienced refractures after PKP. The risk factors for vertebral refractures included a T-score < - 3.0 and presence of scoliosis (both p < 0.001). The results indicated that the vertebral fractured arc (T10 - L4) was highly influential in scoliosis and vertebral fractures. When scoliotic and initially fractured vertebrae were situated within T10 - L4, the risk factors for vertebral refracture included a postoperative Cobb angle of ≥ 20° (p = 0.002) and an increased angle (p = 0.001). The mean recurrence times were 17.2 (10.7 - 23.7) months and 17.6 (7.9 - 27.3) months, respectively.
CONCLUSIONS: Osteoporosis combined with scoliosis significantly increases the risk of vertebral refractures after PKP in patients with OVCFs. A postoperative Cobb angle of ≥ 20° and an increased angle are significant risk factors for vertebral refractures when scoliotic and initially fractured vertebrae are situated within T10 - L4.
METHODS: A retrospective study was conducted on 269 patients meeting the criteria from January 2014 to October 2022. All patients underwent PKP with complete data and were followed-up for > 12 months. First, it was verified that scoliosis was a risk factor in 269 patients. Second, patients with scoliosis were grouped based on the Cobb angle to evaluate the impact of the post-operative angle. The cox proportional hazards regression analysis and survival analysis were used to calculate the hazard ratio and recurrence time.
RESULTS: A total of 56 patients had scoliosis, 18 of whom experienced refractures after PKP. The risk factors for vertebral refractures included a T-score < - 3.0 and presence of scoliosis (both p < 0.001). The results indicated that the vertebral fractured arc (T10 - L4) was highly influential in scoliosis and vertebral fractures. When scoliotic and initially fractured vertebrae were situated within T10 - L4, the risk factors for vertebral refracture included a postoperative Cobb angle of ≥ 20° (p = 0.002) and an increased angle (p = 0.001). The mean recurrence times were 17.2 (10.7 - 23.7) months and 17.6 (7.9 - 27.3) months, respectively.
CONCLUSIONS: Osteoporosis combined with scoliosis significantly increases the risk of vertebral refractures after PKP in patients with OVCFs. A postoperative Cobb angle of ≥ 20° and an increased angle are significant risk factors for vertebral refractures when scoliotic and initially fractured vertebrae are situated within T10 - L4.
摘要：
目的：分析脊柱侧凸与骨质疏松性椎体压缩骨折(OVCFs)患者经皮椎体后凸成形术(PKP)后椎体再骨折的关系。
方法：对2014年1月至2022年10月符合该标准的269例患者进行了回顾性研究。所有患者均行PKP，资料完整，随访时间>12个月。首先,在269例患者中证实脊柱侧弯是一个危险因素.第二,根据Cobb角对脊柱侧凸患者进行分组,以评估术后角度的影响.采用Cox比例风险回归分析和生存分析计算风险比和复发时间。
结果：共有56例脊柱侧凸，其中18人在PKP后经历了折射。椎体折返的危险因素包括T评分<-3.0和脊柱侧凸的存在（均p<0.001）。结果表明，椎体骨折弧（T10-L4）在脊柱侧凸和椎体骨折中有很高的影响。当脊柱侧凸和最初骨折的椎骨位于T10-L4内时，椎骨再骨折的危险因素包括术后Cobb角≥20°（p=0.002）和角度增加（p=0.001）。平均复发时间为17.2（10.7-23.7）个月和17.6（7.9-27.3）个月，分别。
结论：骨质疏松合并脊柱侧凸可显著增加OVCFs患者PKP术后椎体折返的风险。当脊柱侧凸和最初骨折的椎骨位于T10-L4内时，术后Cobb角≥20°和角度增加是椎骨折返的重要危险因素。
方法：对2014年1月至2022年10月符合该标准的269例患者进行了回顾性研究。所有患者均行PKP，资料完整，随访时间>12个月。首先,在269例患者中证实脊柱侧弯是一个危险因素.第二,根据Cobb角对脊柱侧凸患者进行分组,以评估术后角度的影响.采用Cox比例风险回归分析和生存分析计算风险比和复发时间。
结果：共有56例脊柱侧凸，其中18人在PKP后经历了折射。椎体折返的危险因素包括T评分<-3.0和脊柱侧凸的存在（均p<0.001）。结果表明，椎体骨折弧（T10-L4）在脊柱侧凸和椎体骨折中有很高的影响。当脊柱侧凸和最初骨折的椎骨位于T10-L4内时，椎骨再骨折的危险因素包括术后Cobb角≥20°（p=0.002）和角度增加（p=0.001）。平均复发时间为17.2（10.7-23.7）个月和17.6（7.9-27.3）个月，分别。
结论：骨质疏松合并脊柱侧凸可显著增加OVCFs患者PKP术后椎体折返的风险。当脊柱侧凸和最初骨折的椎骨位于T10-L4内时，术后Cobb角≥20°和角度增加是椎骨折返的重要危险因素。
