Risk factors and long-term efficacy on the treatment of Osteoporotic Vertebral Compression Fracture with Vertebral augmentation: A prospective cohort study

Objectives To investigate the risk factors and long-term efficacy on the treatment of Osteoporotic Vertebral Compression Fracture (OVCF) with Vertebral augmentation (VA), recruited from a 5-year prospective cohort. Methods A total of 104 cases diagnosed with OVCF undergoing VA were Continuously included from January 2017 to October 2019. Follow-ups were conducted on all included patients for at least 5 years. Paired T-test, Mann-Whitney test and chi-square test was used for evaluating the long-term efficacy, and Logistic regression was used to identify the independent risk factors for recurrent OVCF after VA. Results The follow-up dropout rate was 5.76% (6/104), and the recurrence of VCF rate was 17.3% (18/104). No significant differences were observed between the patients who experienced a reccurrent VCF with those who did not in terms of pre-op spine bone density T-score (p<0.001),1y-post-op ODI scores (p=0.002), 5y-post-op ODI scores (p=0.002), 1y-post-op VAS(p<0.001), 5y-post-op VAS(p<0.001),regular use of calcium and vitamin D(p=0.039), and treatment with anti-osteoporosis medications(p=0.002).The pre-op lumbar spine bone density T-score level(OR=0.22, 95%CI: 0.07-0.63, p=0.005) and regular use of anti-osteoporosis therapy(OR=8.33, 95%CI: 1.40-49.53, p=0.020) were found to have a significant correlation with the risk of recurrence of VCF after VA. Conclusion Patients with OVCF can experience significant improvements in pain and functional capabilities immediately after the VA procedure. In the long term, effective pain control and maintenance of social activity capabilities were significantly achieved. There were no significantly differences in the long-term efficacy between PVP and PKP. A lower bone density level indicates a higher risk of recurrent VCF after VA.