title: [Clinical characteristics and risk factors of newly developed vertebral fractures after vertebral augmentation].
abstract: OBJECTIVE
  To identify the characteristics and risk factors of the refractures after percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP).
  
  
  METHODS
  A retrospective analysis of 148 patients who had undergone PKP or PVP between March 2006 and October 2013 in Peking University People's Hospital was conducted. In the study, 29 patients with 42 refractured vertebra and 119 patients without refracture were included. All the patients were observed for a time of (34.4±26.8) months. Clinical, imaging and procedure related factors (gender, age, height, weight, body mass index, the level of the injured vertebra, the time interval between the procedure and the refracture, the level of the refractured vertebra, the bone cement volume injected, performed PKP or PVP,performed unilateral or bilateral, the percentage of anterior vertebral height restoration, the correction of the Cobb angle, cement diffusion, bone mineral density, presence or absence of diabetes mellitus, history of fractures of the whole body, anti-osteoporosis treatment, cement leakage) for each group were analyzed by Cox proportional hazards regression analysis.
  
  
  RESULTS
  Of all the patients,16 (55.17%, 16/29) had refractures in the adjacent vertebra, and 13 (44.83%, 13/29) had refractures in the nonadjacent vertebra. Refractures within 3 months accounted for 31.03% (9/29) of all the refractures, and within 1 year accounted for 55.17% (16/29). Both older age (P=0.027, HR=1.051, 95% CI=1.006-1.098) and a history of fractures of the whole body (P=0.012, HR=0.386, 95% CI=0.184-0.812) were statistically significant as the independent risk factors for predicting refractures. Others were not associated with refractures (P>0.05).
  
  
  CONCLUSIONS
  Older age and a history of fractures of the whole body are the independent risk factors of the refractures after PKP and PVP. The mechanism of the refractures after PKP and PVP is mainly the natural development of osteoporosis.
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: T J
authors.initials: TJ
authors.lastname: Huang
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: Y H
authors.initials: YH
authors.lastname: Kou
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: X F
authors.initials: XF
authors.lastname: Yin
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: J
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: P X
authors.initials: PX
authors.lastname: Zhang
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: D Y
authors.initials: DY
authors.lastname: Zhang
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: Z G
authors.initials: ZG
authors.lastname: Fu
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: F
authors.initials: F
authors.lastname: Xue
authors.affiliation: Department of Trauma and Orthopedics, Peking University People's Hospital; Peking University Traffic medicine Center, Beijing 100044, China.
authors.forename: B G
authors.initials: BG
authors.lastname: Jiang
mesh_terms: D001843:Bone Cements; D015519:Bone Density; D050815:Fractures, Compression / Q000473:pathology*; D006801:Humans; D010024:Osteoporosis; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000473:pathology*; D054854:Vertebroplasty
chemical_list: D001843:Bone Cements