Recurrence of Local Kyphosis After Percutaneous Kyphoplasty: The Neglected Injury of the Disc-Endplate Complex.

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  • Additional Information
    • Source:
      Publisher: Dove Medical Press Country of Publication: New Zealand NLM ID: 101273480 Publication Model: eCollection Cited Medium: Internet ISSN: 1178-1998 (Electronic) Linking ISSN: 11769092 NLM ISO Abbreviation: Clin Interv Aging Subsets: MEDLINE
    • Publication Information:
      Original Publication: Auckland : Dove Medical Press
    • Subject Terms:
      Kyphoplasty*/adverse effects ; Spinal Fractures*/diagnostic imaging ; Spinal Fractures*/surgery ; Spinal Fractures*/etiology ; Fractures, Compression*/diagnostic imaging ; Fractures, Compression*/surgery ; Fractures, Compression*/etiology ; Kyphosis*/diagnostic imaging ; Kyphosis*/etiology ; Kyphosis*/surgery ; Osteoporotic Fractures*/diagnostic imaging ; Osteoporotic Fractures*/surgery ; Osteoporotic Fractures*/etiology; Humans ; Retrospective Studies ; Treatment Outcome ; Bone Cements
    • Abstract:
      Background: Recurrent of local kyphosis after percutaneous kyphoplasty (PKP) is rarely reported and discussed. Literatures reported that re-kyphosis is usually a consequence of refractures of augmented or adjacent vertebra. However, whether re-kyphosis should be considered as a complication of refractures and has an impact on clinical efficacy of PKP during follow-up time is unknown. The purpose of this study is to evaluate the related risk factors and clinical significance of the recurrent of local kyphosis in osteoporotic vertebral fracture (OVF) patients without refractures.
      Patients and Methods: A total of 143 patients who underwent single-level PKP were recruited and assigned into the re-kyphosis group and non-re-kyphosis group. Clinical and radiographic data were collected and compared between the two groups. Then, multivariate logistic regression analyses were conducted to identify the related risk factors.
      Results: During follow-up, 16 of the 143 patients presented postoperative re-kyphosis. The average local kyphosis angle increased from 11.81±8.60° postoperatively to 25.13±8.91° at the final follow-up which showed a statistically significant difference ( p <0.05). Both groups had significant improvements in postoperative visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores compared to their preoperative values ( p <0.05). However, in the re-kyphosis group at final follow-up, the VAS and ODI scores showed worsening compared to the postoperative scores. Logistic regression analysis showed that disc-endplate complex injury (OR=17.46, p =0.003); local kyphosis angle correction (OR=1.84, p <0.001); and vertebral height restoration (OR=1.15, p =0.003) were risk factors for re-kyphosis.
      Conclusion: Re-kyphosis is not rare in patients with osteoporotic vertebral fracture and tends to have an inferior prognosis following PKP surgery. Patients with disc-endplate complex injury and more correction of vertebral height and kyphosis angle are at a higher risk for re-kyphosis after PKP surgery than others.
      Competing Interests: The authors report no conflicts of interest in this work.
      (© 2023 Wang et al.)
    • References:
      Clin Interv Aging. 2018 May 04;13:853-861. (PMID: 29765210)
      Spine (Phila Pa 1976). 2019 Jun 15;44(12):827-838. (PMID: 30601358)
      Clin Orthop Surg. 2010 Dec;2(4):203-8. (PMID: 21119935)
      J Orthop Surg Res. 2018 Oct 22;13(1):264. (PMID: 30348192)
      J Spinal Disord Tech. 2010 Feb;23(1):35-9. (PMID: 20065868)
      Medicine (Baltimore). 2017 Jan;96(2):e5675. (PMID: 28079799)
      Acta Radiol. 2006 Oct;47(8):830-40. (PMID: 17050364)
      J Pain Res. 2021 Jul 09;14:2095-2109. (PMID: 34276226)
      World Neurosurg. 2018 Jul;115:e386-e392. (PMID: 29678706)
      Eur Spine J. 2008 Jul;17(7):982-8. (PMID: 18446385)
      Spine (Phila Pa 1976). 2014 Jan 1;39(1):68-73. (PMID: 24108287)
      J Bone Miner Res. 1992 Sep;7(9):1005-10. (PMID: 1414493)
      Spine J. 2019 Jul;19(7):1242-1253. (PMID: 30710732)
      Dis Markers. 2021 Jun 29;2021:4745853. (PMID: 34306254)
      Spine (Phila Pa 1976). 2002 Mar 15;27(6):629-36. (PMID: 11884911)
      Osteoporos Int. 2022 Aug;33(8):1795-1806. (PMID: 35585277)
      J Korean Neurosurg Soc. 2019 Jan;62(1):96-105. (PMID: 29940722)
      Acta Orthop Belg. 2014 Dec;80(4):477-86. (PMID: 26280719)
      BMC Musculoskelet Disord. 2019 Jul 19;20(1):336. (PMID: 31324243)
      Sci Rep. 2021 Jan 8;11(1):122. (PMID: 33420234)
      Acta Orthop Belg. 2013 Oct;79(5):565-71. (PMID: 24350520)
      Medicine (Baltimore). 2018 Jul;97(28):e11442. (PMID: 29995797)
      AJNR Am J Neuroradiol. 2011 Jan;32(1):115-20. (PMID: 20801764)
      Bone. 1992;13 Suppl 2:S27-31. (PMID: 1627411)
      J Neurosurg Spine. 2011 May;14(5):561-9. (PMID: 21375382)
      Eur Spine J. 2008 Apr;17(4):592-9. (PMID: 18204942)
      Osteoporos Int. 2005 Oct;16(10):1247-53. (PMID: 15806323)
    • Contributed Indexing:
      Keywords: clinical efficacy; disc–endplate complex injury; percutaneous kyphoplasty; re-kyphosis; risk factors
    • Accession Number:
      0 (Bone Cements)
    • Publication Date:
      Date Created: 20230525 Date Completed: 20230529 Latest Revision: 20230529
    • Publication Date:
      20230529
    • Accession Number:
      PMC10202700
    • Accession Number:
      10.2147/CIA.S410992
    • Accession Number:
      37229150