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Development and validation of a prediction model for vertebral recompression and adjacent vertebral fracture after kyphoplasty in geriatric patients.
Lu, Yi; Cai, Xiaobing; Shen, Juexin; Luo, Rengui.
Afiliación
  • Lu Y; Department of Orthopedics, Chongming Branch, Shanghai Tenth People's Hospital, Shanghai, China. lyyi61today@163.com.
  • Cai X; Department of Orthopedics, Chongming Branch, Shanghai Tenth People's Hospital, Shanghai, China.
  • Shen J; Department of Orthopedics, Chongming Branch, Shanghai Tenth People's Hospital, Shanghai, China.
  • Luo R; Department of Orthopedics, Chongming Branch, Shanghai Tenth People's Hospital, Shanghai, China.
Eur Spine J ; 2024 Sep 09.
Article en En | MEDLINE | ID: mdl-39245779
ABSTRACT

PURPOSE:

Short-term efficacy of percutaneous kyphoplasty (PKP) for treating osteoporotic vertebral compression fracture (OVCF) in elderly patients is good, but long-term complications such as vertebral recompression (VRC) and adjacent vertebral fracture (AVF) may arise. Identifying risk factors in patients with poor prognoses, we developed a nomogram model to mitigate these potential complications.

METHODS:

Patients with OVCFs who underwent PKP had their medical data retrospectively evaluated. Analysis of the sample included their pre- and postoperative conditions. Stepwise logistic regression analyses were conducted to identify independent risk factors for postoperative complications. For forecasting the likelihood of postoperative comorbidities, we offered a nomogram. The prognostic performance was assessed using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analyses (DCA). Internal model validation using the Bootstrap method.

RESULTS:

A total of 235 patients were included in this study. Among them, 147 patients were utilized to develop nomograms and for internal validation, while the remaining 88 patients from a different time period were designated as the external validation cohort. The results of stepwise logistic regression analysis showed that thoracolumbar (TL) fracture, posterior wall of vertebral fracture, vertebral compression > 30%, and lack of continuous anti-osteoporosis therapy after surgery as independent risks associated with poor prognosis. The nomogram exhibited outstanding predictive accuracy and clinical utility.

CONCLUSIONS:

This study identified four independent predictors of poor prognosis following PKP and devised a straightforward yet efficient predictive model. This model offers valuable insights for guiding clinical decision-making in the management of elderly patients with OVCFs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Spine J Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Alemania