Risk factors for nonunion of osteoporotic vertebral compression fracture: a case‒control study

• Published in: BMC musculoskeletal disorders 2024-04, Vol.25 (1), p.295-295, Article 295
• Main Authors: Liao, Shichuan, Xu, Yan, Liu, Jing, Jiang, Ling, Dai, Guogang, Wang, Yi
• Format: Article
• Language: English
• Subjects: Age; Back pain; Blood tests; Bone marrow; Care and treatment; Case-Control Studies; Case‒control study; Cholesterol; Comorbidity; Complications and side effects; Compression; Creatinine; Decision making; Diabetes; Diabetes Mellitus; Edema; Female; Fractures; Fractures, Compression - diagnostic imaging; Fractures, Compression - epidemiology; Fractures, Compression - surgery; Graft rejection; High density lipoprotein; Hospitals; Humans; Hypertension; Immobilization; Life expectancy; Magnetic resonance imaging; Male; Medical records; Middle age; Nonunion; Older people; Orthopedics; Osteoporosis; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; Osteoporotic vertebral compression fracture; Patients; Prevention; Regression analysis; Rehabilitation; Retrospective Studies; Risk Factors; Smoking; Spinal Fractures - diagnostic imaging; Spinal Fractures - epidemiology; Spinal Fractures - etiology; Statistical analysis; Surgery; Surgical outcomes; Tomography; Trauma; Treatment Outcome; Vertebrae
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-024-07386-1

Early assessment of the risk of nonunion in osteoporotic vertebral compression fracture (OVCF) is beneficial to early clinical decision making. However, a comprehensive understanding of the risk factors for OVCF nonunion is lacking. We conducted a case-control study to investigate risk factors for OVCF nonunion. Patients who underwent surgery for nonunited OVCFs between January 2011 and December 2021 were eligible for inclusion as cases. Patients with successful OVCF healing confirmed by MRI over the same period were identified as controls. Patient demographics, comorbidities, and fasting blood test data were extracted for analysis. A total of 201 patients with nonunited OVCFs and 1044 controls were included to evaluate the risk factors for nonunited OVCFs. There were statistically significant differences in sex, age, number of patients with hypertension, number of patients on bed rest after OVCF and T-score of BMD between the two groups. Logistic regression showed that female patients had a higher risk of OVCF nonunion than male patients and that smoking, drinking, diabetes, and hypertension were risk factors for nonunion of OVCFs, while bed rest and spinal support were protective factors against nonunion of OVCFs. We also found that age, BMD, FBG, and β-CTX were positively correlated with nonunited OVCFs, and that HGB and 1,25-(OH)2VitD3 level were negatively correlated with nonunited OVCFs. Smoking, drinking, diabetes and hypertension were risk factors for nonunion of OVCFs, while bed rest and spinal support were protective factors against nonunion of OVCFs. Age, BMD, FBG and β-CTX were positively correlated with nonunited OVCFs, while HGB and 1,25-(OH)2VitD3 level were negatively correlated with nonunited OVCFs. Based on the results of our study, we suggest that bed rest or spinal support for at least 3 consecutive weeks is necessary to reduce the risk of OVCFs nonunion.