Relationship between pre-existing kyphosis and new vertebral compression fractures following percutaneous vertebroplasty in patients with osteoporotic thoracolumbar fracture.

Abstract Background: Thoracolumbar kyphosis disrupts the overall balance of the spine, thus the stress on each segment of the spine is different from that of the normal sequence. This may affect the outcome after Percutaneous vertebroplasty (PVP). But few studies have examined the relationship between thoracolumbar kyphosis and new fractures after PVP. Methods: A cross-sectional was conducted to evaluate the effect of the thoracolumbar kyphosis angle on postoperative recurrent fractures in patients with osteoporotic thoracolumbar fractures. From 2013 to 2018, 486 patients were treated with PVP in our hospital, and 242 patients were included in the study. These patients were divided into groups A and B based on the Cobb angle (greater or less than 10 °) in the thoracolumbar region. Patients were followed up for 36 months. The average CT value of the thoracolumbar spine, BMD, and the time of recurrence of fractures were recorded. Results: A clear relationship was observed between thoracolumbar Cobb kyphosis and recurrent vertebral fractures (OR = 1.061, P = 0.003). In group A, the proportion of women was larger and the BMD values was lower than that in group B. But no difference was found in the average CT value. K-M survival analysis found no significant difference in the rate of fracture recurrence between the two groups, but the time interval of second fracture occured at adjacent levels was significantly shorter than that occurred at distant levels in group A, which was not found in group B. Conclusions: When patients have thoracolumbar kyphosis before surgery, PVP should not be a recommended treatment.