Association Between Abdominal Aortic Calcification and adjacent vertebral fracture after percutaneous kyphoplasty: a case control study.

Abstract

Purpose To demonstrate the potential impact of abdominal aortic calcification (AAC) as a risk factor for the occurrence of adjacent vertebral compression fracture (AVCF) after percutaneous kyphoplasty surgery. Methods A review of imaging and demographic data of patients treated with percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF) was conducted. The patients were divided into two groups: groups with and without AVCF. The severity of AAC was assessed from the lateral spine images using the AAC24 score. Data on patients with and without AVCF were compared and independent risk factors were identified using regression analysis. Results 32 patients (12.6%) developed AVCF postoperatively. AVCF after PKP was associated with BMD, cardio/cerebrovascular diseases, history of vertebral fractures, Vitamin D, AAC, postoperative kyphotic angle, postoperative vertebral body’s collapse rate, collapse height restoration rate, and bone cement distribution according to a univariate analysis (P < 0.05). The results of multifactorial logistic regression analysis indicate that BMD, AAC, bone cement distribution (impact), and cardio/cerebrovascular diseases are independent predictors of AVCF after PKP (P < 0.05). As shown by the ROC curve, the AAC had an area under the curve of 79.3%, a sensitivity and specificity of 84.4% and 62.9%, respectively, and a cut-off value of 5.0 points of the AAC24 score. Conclusions BMD, AAC, bone cement distribution (impact), and cardio/cerebrovascular diseases are independent risk factors for AVCF after PKP. In cases where the AAC24 score exceeded 5.0 points, the incidence of AVCF increased significantly.