建立骨质疏松性椎体压缩骨折术后再骨折预测模型

Abstract
Figure/Table
References (0)
Related Citation (14)

Download: PDF (1621 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract

Objective〓To investigate the risk of refracture after osteoporotic vertebral compression fracture (OVCF) surgery，construct a risk prediction model，and identify effective prevention and treatment measures.Methods〓A total of 119 patients with OVCF admitted to Beijing Jishuitan Hospital from August 2021 to June 2022 were selected as the research subjects.According to the occurrence of postoperative refracture，they were divided into a recurrent group and a non-recurrent group.The recurrent group comprised 22 patients (11 males and 11 females) with a mean age of (72.02±5.58)years，while the non-recurrent group consisted of 97 patients (50 males and 47 females) with a mean age of (70.79±6.81)years.Statistical analysis was conducted on the general characteristics of both groups.The Lasso-Logistic regression model was used to screen the independent variables of recurrent fractures after OVCF surgery.The Akaike’s information criterion (AIC) and Bayesian information criterion (BIC) were used to compare the predictive performance of full variable logistic regression，stepwise logistic regression，and Lasso-Logistic regression.The nomogram model was constructed，and the receiver operating characteristic (ROC) and calibration curve were used to analyze the performance of the nomogram model for recurrent fractures after OVCF surgery.Results〓After a follow-up period ranging from 8 to 20 months，with a mean duration of (12.00±2.40)months.Univariate analysis revealed significant differences between the refracture and non-refracture groups in terms of body mass index (BMI)，bone mineral density T-score，tartrate-resistant acid phosphatase 5b(TPACP-5b)，receptor activator of nuclear factor kappa B ligand (RANKL)，osteoprotegerin (OPG)，postoperative anti-osteoporosis treatment，interleukin(IL)-17，history of long-term glucocorticoid use，spinal deformity index (SDI) value，surgical segment Cobb angle，kyphosis angle，and number of operated vertebral bodies (P＜0.05).The Lasso-Logistic regression model analysis identified an optimal lambda.lse value of 0.049，at which point the variables included in the model were bone density，SDI value，IL-17，and postoperative anti-osteoporosis treatment.Validation using BIC and AIC confirmed the good fitting and predictive capabilities of the constructed model.The nomogram model demonstrated an area under the receiver operating characteristic curve(AUC) of 0.865，with a sensitivity of 95.45% and a specificity of 68.04%.Additionally，the calibration curve indicated a close alignment between the model’s predictions and actual outcomes.Conclusion〓The occurrence of postoperative re-fracture after OVCF is affected by various aspects during the perioperative period，including BMD T-value，SDI value，Cobb angle of the operated segment，IL-17，posterior convexity angle，postoperative anti-osteoporosis treatment，and the number of operated vertebral bodies，based on which the risk of re-fracture of the patients can be predicted effectively，providing a reference basis for the prevention and treatment of re-fracture in the clinic.

Key words： spinal deformity index value osteoporotic vertebral compression fracture postoperative refracture risk prediction model

Corresponding Authors: He Da

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Shi Zhan
	Fan Mingxing
	Wang Qilong
	He Da

Cite this article:

Shi Zhan,Fan Mingxing,Wang Qilong, et al. Establishing a Prediction Model for Post-Operative Refracture of Osteoporotic Vertebral Compression Fractures[J]. sygkzz, 2024, 30(3): 205-.

URL:

http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2024/V30/I3/205

［1］Huang HY，Hu HG，Lin X，et al.Application of curved diffusion needle in unilateral percutaneous vertebroplasty［J］.Zhongguo Xiufu Chongjian Waike Zazhi，2021，35(12)：1587-1594.
［2］栾昊鹏，邓强，帕尔哈提·热西提，等.经皮椎体后凸成形术后邻近椎体继发骨折的危险因素分析［J］.中国骨与关节杂志，2022，11(4)：269-275.
［3］Ma YH，Tian ZS，Liu HC，et al.Predictive risk factors for recollapse of cemented vertebrae after percutaneous vertebroplasty：A meta-analysis［J］.World J Clin Cases，2021，9(12)：2778-2790.
［4］中国康复医学会骨质疏松预防与康复专业委员会.骨质疏松性椎体压缩骨折诊治专家共识(2021版)［J］.中华医学杂志，2021，101(41)：3371-3379.
［5］Genant HK，Wu CY，van Kuijk C et al.Vertebral fracture assessment using a semiquantitative technique［J］.J Bone Miner Res，1993，8(9)：1137-1148.
［6］Dai C，Liang G，Zhang Y，et al.Risk factors of vertebral re-fracture after PVP or PKP for osteoporotic vertebral compression fractures，especially in Eastern Asia：A systematic review and meta-analysis［J］.J Orthop Surg Res，2022，17(1)：161.
［7］Gendreau JL，Nguyen A，Brown NJ，et al.External validation of the global alignment and proportion (GAP) score as prognostic tool for corrective surgery in adult spinal deformity：A systematic review and meta-analysis［J］.World Neurosurg，2023(30)，S1878.
［8］林通，韩衍龙，米尔阿里木·木尔提扎，等.肌肉减少症和骨质疏松症对绝经后髋部骨折病人发生椎体压缩性骨折的影响［J］.骨科，2021，12(6)：505-508.
［9］Chislu BA，Cringus LI，Vreju FA，et al.New insights into IL-17/IL-23 signaling in ankylosing spondylitis (Review)［J］.Exp Ther Med，2020，20(4)：3493-3497.
［10］Bhadricha H，Patel V，Singh AK，et al.Increased frequency of Th17 cells and IL-17 levels are associated with low bone mineral density in postmenopausal women［J］.Sci Rep，2021，11(1)：16155.
［11］Qiu J，Lu C，Zhang L，et al.Osteoporosis in patients with rheumatoid arthritis is associated with serum immune regulatory cellular factors［J］.Clin Rheumatol，2022，41(9)：2685-2693.
［12］Wos I，Tabarkiewicz J.Effect of interleukin(IL)-6，IL-17，IL-21，IL-22，and IL-23 and STAT3 on signal transduction pathways and their inhibition in autoimmune arthritis［J］.Immunol Res，2021，69(1)：26-42.
［13］熊亮霞，彭云，谭婧，等.CT值及差值在椎体急慢性骨折中的诊断价值［J］.放射学实践，2023，38(2)：204-209.
［14］Zhang Z，Jing Q，Qiao R，et al.Risk factors analysis of adjacent fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fracture［J］.Zhongguo Xiufu Chongjian Waike Zazhi，2021，35(1)：20-25.
［15］崔智慧，孟纯阳，李庆伟，等.老年椎骨压缩性骨折椎体增强术后新发骨折的因素［J］.中国矫形外科杂志，2021，29(18)：1715-1717.
［16］An Z，Chen C，Wang J，et al.Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation［J］.J Orthop Surg Res，2021，16(1)：374.
［17］Li W，Wang H，Dong S，et al.Establishment and validation of a nomogram and web calculator for the risk of new vertebral compression fractures and cement leakage after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures［J］.Eur Spine J，2022，31(5)：1108-1121.
［18］Lu Q，Gao S，Zhou M.The effect of bone cement on the curative effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture［J］.Ann Palliat Med，2021，10(10)：11013-11023.
［19］Hou JG，Zhang N，Chen GD.Factors affecting cement leakage in percutaneous vertebroplasty：A retrospective cohort study of 309 patients［J］.Eur Rev Med Pharmacol Sci，2023，27(9)：3877-3886.
［20］Park HB，Son S，Jung JM，et al.Safety and efficacy of bone cement (Spinofill?) for vertebroplasty in patients with osteoporotic compression fracture：A preliminary prospective study［J］.J Korean Neurosurg Soc，2022，65(5)：730-740.
［21］Tan L，Wen B，Guo Z，et al.The effect of bone cement distribution on the outcome of percutaneous vertebroplasty：A case cohort study［J］.BMC Musculoskelet Disord，2020，21(1)：541.
［22］Kobayashi M，Toribatake Y，Okamoto S，et al.Insufficient augmentation of bone cement causes recompression of augmented vertebra after balloon kyphoplasty［J］.Spine Surg Relat Res，2021，5(6)：375-380.
［23］Wu XG，Zhang DY，Zhu BQ，et al.Efficacy of zoledronic acid with percutaneous kyphoplasty/vertebroplasty in the treatment of osteoporotic vertebral compression fractures：A systematic review and meta-analysis［J］.Eur Rev Med Pharmacol Sci，2020，24(23)：12358-12367.
［24］郑敏哲，徐君翔，冯宗贤.经皮球囊扩张椎体成形术辅助维生素D治疗老年骨质疏松性胸腰椎压缩骨折的远期疗效分析［J］.中华内分泌外科杂志，2022，16(5)：589-594.
［25］Wang W，Liu Y，Wan H，et al.Effectiveness and prognostic factors of different minimally invasive surgeries for vertebral compression fractures［J］.BMC Musculoskelet Disord，2023，24(1)：11.