ArticleBMC musculoskeletal disorders2025
Incidence and risk factors of poor prognosis in patients with OVCF following day surgery of percutaneous kyphoplasty: a retrospective study.
Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePrevious studies have shown that percutaneous kyphoplasty (PKP) performed as a day surgery achieves similar efficacy to inpatient treatment. However, with the increasing adoption of day-case PKP, some patients experience poor postoperative prognosis, such as delayed discharge, new-onset vertebral fractures, and persistent low back pain. Despite this, research on the risk factors associated with poor prognosis following day-case PKP remains limited. This study aims to investigate the risk factors for poor prognosis in patients undergoing day-case PKP.
methodsA retrospective analysis was conducted on 424 patients with osteoporotic vertebral compression fractures (OVCF) who underwent day-case PKP in the Spine Surgery Department of Tianjin Hospital between January 2020 and December 2022. Detailed clinical data were collected for each patient, including age, sex, height, weight, history of hypertension, diabetes, prior fractures, smoking history, length of hospital stay, bone cement volume, paraspinal muscle area and fat infiltration, as well as Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores. Univariate analysis and multivariate logistic regression analysis were performed to identify risk factors for poor prognosis following day-case PKP.
resultsUnivariate analysis revealed significant differences between the new vertebral fracture group and the control group in terms of QCT values (X²=8.933, P = 0.003), history of prior fractures (X²=19.882, P < 0.001), and FCSA (t = 2.626, P = 0.009). Significant differences were also found between the persistent low back pain group and the control group regarding smoking history (X²=9.425, P = 0.002) and Fat Infiltration Percentage (FI%) (t = 2.962, P = 0.003). Patients in the delayed discharge group had higher preoperative ODI scores (78.462 ± 6.555 vs. 73.198 ± 12.375, P = 0.033). Multivariate logistic regression analysis identified QCT values (OR = 0.112, P = 0.035), history of prior fractures (OR = 5.266, P < 0.001), and FCSA (OR = 0.935, P = 0.031) as independent risk factors for new-onset vertebral fractures following day-case PKP (P < 0.05). Smoking history (OR = 4.793, P = 0.002) and FI% (OR = 1.059, P = 0.001) were found to be independent risk factors for persistent low back pain (P < 0.05).
conclusionLow bone mineral density, history of old fractures and smaller FCSA were independent risk factors for new vertebral fractures in patients. Smoking history and FI% increased the risk of residual low back pain in patients at 12 months postoperatively. Higher preoperative ODI scores were the main reason for patients’ delayed discharge.
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