Factors influencing further vertebral height loss following percutaneous vertebroplasty in osteoporotic vertebral compression fractures: A 1-year follow-up study

Table 1 Comparison of patient characteristics between two distinct groups of patients with osteoporotic vertebral compression fracture who underwent percutaneous vertebroplasty with cement augmentation

Characteristics	No Further Height Loss, n = 179	Further Height Loss, n = 21	P value
Age in years	68.72 ± 7.93	68.43 ± 6.67	0.871
Sex			0.110
Male	48 (26.8%)	2 (9.5%)
Female	131 (73.2%)	19 (90.5%)
BMI in kg/m2	21.14 ± 1.61	21.04 ± 1.63	0.783
BMD by T-score	-3.2 (-3.5 to -2.8)	-3.8 (-3.95 to -3.7)	< 0.001
Back pain before procedure in d	20.59 ± 7.06	19.9 ± 6.83	0.776
Vertebral compression degree	26% (16%-37%)	39% (32.5%-42.5%)	< 0.001
Operation time in minutes	54.72 ± 5.95	54.29 ± 5.62	0.750
Preoperative VAS	7.47 ± 1.79	7.19 ± 1.5	0.092
Postoperative VAS	4.45 ± 2.01	4.05 ± 1.88	0.062
Preoperative ODI	40.84 ± 6.12	39.86 ± 5.77	0.154
Postoperative ODI	20.59 ± 7.06	19.9 ± 6.83	0.135
Presence of intravertebral cleft on MRI			< 0.001
Yes	2 (1.1)	15 (71.4)
No	177 (98.9)	6 (28.6)
Morphology			1.000
Wedge	88 (49.2)	10 (47.6)
Biconcave	91 (50.8)	11 (52.4)
Vertebral level			0.126
Lumbar (L) or Thoracic (T)	63 (35.2)	3 (14.3)
Thoracolumbar (TL)	116 (64.8)	18 (85.7)
Bone cement			< 0.001
MC-PMMA	114 (63.7)	3 (14.3)
PMMA	65 (36.3)	18 (85.7)
Bone cement volume in mL	5.03 ± 2.34	5.82 ± 2.49	0.151
Bone cement distribution			< 0.001
Trabecular	119 (66.5)	2 (9.5)
Cleft	60 (33.5)	19 (90.5)
Filling from Inferior to Superior Endplate			0.211
Yes	35 (71.4)	2 (9.5)
No	144 (28.6)	19 (90.5)
Bone cement leakage			0.194
Yes	135 (75.4)	13 (61.9)
No	44 (24.6)	8 (38.1)
Length of hospital stay in days	8 (6-9)	8 (7-9)	0.544

Data are n (%). BMD: Bone mineral density; IVF: Intravertebral cleft; MC-PMMA: Mineralized collagen modified-poly(methyl methacrylate); ODI: Oswestry disability index; OVCF: Osteoporotic vertebral compression fracture; PVP: Percutaneous vertebroplasty; VAS: Visual analog scale.

Table 2 Results of the binary univariate regression analysis revealed significant associations with further height loss among osteoporotic vertebral compression fracture patients undergoing percutaneous vertebroplasty with cement augmentation

Parameter	B	SE	Wals	P value	OR (95%CI)
Age in years	-0.005	0.030	0.027	0.871	0.995 (0.939-1.055)
Sex as male vs female	-1.247	0.762	2.677	0.102	0.287 (0.064-1.28)
BMI in kg/m2	-0.040	0.144	0.077	0.782	0.961 (0.724-1.275)
BMD by T score	-5.925	1.239	22.886	< 0.001	0.003 (0.000-0.030)
Presence of intravertebral cleft as yes vs no	5.399	0.860	39.449	< 0.001	221.25 (41.035-1192.92)
Operation time in minutes	-0.013	0.039	0.102	0.749	0.987 (0.914-1.067)
Preoperative VAS	-0.100	0.138	0.526	0.468	0.905 (0.690-1.186)
Postoperative VAS	-0.068	0.124	0.295	0.587	0.935 (0.732-1.193)
Preoperative ODI	0.029	0.038	0.564	0.453	1.029 (0.955-1.110)
Postoperative ODI	0.033	0.033	0.973	0.324	1.033 (0.968-1.103)
Back pain before procedure in days	0.005	0.018	0.082	0.775	1.005 (0.970-1.042)
Vertebral compression degree	0.046	0.016	8.060	0.005	1.048 (1.014-1.082)
Morphology as biconcave vs wedge	0.062	0.462	0.018	0.894	1.064 (0.430-2.630)
Vertebral level as thoracolumbar vs lumbar and thoracic	1.181	0.643	3.376	0.066	3.259 (0.924-11.490)
Bone cement volume in mL	0.147	0.103	2.036	0.154	1.158 (0.947-1.418)
Bone cement distribution as cleft vs trabecular	2.936	0.760	14.922	< 0.001	18.842 (4.248-83.578)
Filling from inferior to superior endplate as no vs yes	0.837	0.767	1.191	0.275	2.309 (0.514-10.381)
Bone cement as MC-PMMA vs PMMA	2.354	0.643	13.411	< 0.001	0.095 (0.027-0.335)
Bone cement leakage as yes vs no	-0.636	0.482	1.741	0.187	0.530 (0.206-1.361)
Length of hospital stay in days	0.087	0.134	0.418	0.518	1.090 (0.839-1.418)

BMD: Bone mineral density; CI: Confidence interval; IVF: Intravertebral cleft; MC-PMMA: Mineralized collagen modified-poly(methyl methacrylate); ODI: Oswestry disability index; OR: Odds ratio; OVCF: Osteoporotic vertebral compression fracture; PVP: Percutaneous vertebroplasty; VAS: Visual analog scale.

Table 3 Results of the binary multivariate regression analysis revealed significant associations with further height loss among osteoporotic vertebral compression fracture patients undergoing percutaneous vertebroplasty with cement augmentation

Parameter	B	SE	Wals	P value	OR (95%CI)
BMD by T score	-3.326	1.695	3.850	0.046	0.036 (0.001-0.996)
Presence of intravertebral cleft as yes vs no	5.095	1.451	12.326	< 0.001	163.189 (9.493-2805.209)
Vertebral compression degree	0.006	0.041	0.021	0.885	1.006 (0.928-1.090)
Vertebral level as thoracolumbar vs lumbar and thoracic	0.151	1.018	0.022	0.882	1.163 (0.158-8.552)
Bone cement distribution as cleft vs trabecular	2.472	1.416	3.049	0.081	11.852 (0.739-190.132)
Bone cement as MC-PMMA vs PMMA	-1.834	1.501	1.493	0.222	0.16 (0.008-3.026)

BMD: Bone mineral density; CI: Confidence interval; IVF: Intravertebral cleft; MC-PMMA: Mineralized collagen modified-poly (methyl methacrylate); OR: Odds ratio; OVCF: Osteoporotic vertebral compression fracture; PVP: Percutaneous vertebroplasty.