{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:40:30Z","timestamp":1791549630604,"version":"4.3.4"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T00:00:00Z","timestamp":1651449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The published literatures indicate that patients with osteoporotic vertebral compression fractures (OVCFs) benefit significantly from percutaneous kyphoplasty (PKP), but this surgical technique is associated with frequent postoperative recollapse, a complication that severely limits long-term postoperative functional recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study retrospectively analyzed single-segment OVCF patients who underwent bilateral PKP at our academic center from January 1, 2017 to September 30, 2019. Comparing the plain films of patients within 3 days after surgery and at the final follow-up, we classified patients with more than 10% loss of sagittal anterior height as the recollapse group. Univariate and multivariate logistic regression analyses were performed to determine the risk factors affecting recollapse after PKP. Based on the logistic regression results, we constructed one support vector machine (SVM) classifier to predict recollapse using machine learning (ML) algorithm. The predictive performance of this prediction model was validated by the receiver operating characteristic (ROC) curve, 10-fold cross validation, and confusion matrix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 346 consecutive patients (346 vertebral bodies in total), postoperative recollapse was observed in 40 patients (11.56%). The results of the multivariate logistical regression analysis showed that high body mass index (BMI) (Odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.58\u20132.72, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), low bone mineral density (BMD) T-scores (OR: 4.27, 95% CI: 1.55\u201311.75, <jats:italic>p<\/jats:italic> = 0.005), presence of intravertebral vacuum cleft (IVC) (OR: 3.10, 95% CI: 1.21\u20137.99, <jats:italic>p<\/jats:italic> = 0.019), separated cement masses (OR: 3.10, 95% CI: 1.21\u20137.99, <jats:italic>p<\/jats:italic> = 0.019), cranial endplate or anterior cortical wall violation (OR: 0.17, 95% CI: 0.04\u20130.79, <jats:italic>p<\/jats:italic> = 0.024), cement-contacted upper endplate alone (OR: 4.39, 95% CI: 1.20\u201316.08, <jats:italic>p<\/jats:italic> = 0.025), and thoracolumbar fracture (OR: 6.17, 95% CI: 1.04\u201336.71, <jats:italic>p<\/jats:italic> = 0.045) were identified as independent risk factors for recollapse after a kyphoplasty surgery. Furthermore, the evaluation indices demonstrated a superior predictive performance of the constructed SVM model, including mean area under receiver operating characteristic curve (AUC) of 0.81, maximum AUC of 0.85, accuracy of 0.81, precision of 0.89, and sensitivity of 0.98.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For patients with OVCFs, the risk factors leading to postoperative recollapse were multidimensional. The predictive model we constructed provided insights into treatment strategies targeting secondary recollapse prevention.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.874672","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T05:33:30Z","timestamp":1651469610000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":24,"title":["Development and Internal Validation of Supervised Machine Learning Algorithm for Predicting the Risk of Recollapse Following Minimally Invasive Kyphoplasty in Osteoporotic Vertebral Compression Fractures"],"prefix":"10.3389","volume":"10","author":[{"given":"Sheng-tao","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieyang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenning","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"B1","first-page":"E335","article-title":"Risk factors for refracture following primary osteoporotic vertebral compression fractures","volume":"24","author":"Ji","year":"2021","journal-title":"Pain Phys."},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.1007\/s00264-018-3838-6","article-title":"Risk factor analysis for re-collapse of cemented vertebrae after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP)","volume":"42","author":"Li","year":"2018","journal-title":"Int Orthop."},{"key":"B3","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s00586-021-07064-z","article-title":"Establishment and validation of a nomogram and web calculator for the risk of new vertebral compression fractures and cement leakage after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures","volume":"15","author":"Li","year":"2021","journal-title":"Eur Spine J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e0228341","DOI":"10.1371\/journal.pone.0228341","article-title":"Percutaneous kyphoplasty for osteoporotic vertebral compression fractures improves spino-pelvic alignment and global sagittal balance maximally in the thoracolumbar region","volume":"15","author":"Cao","year":"2020","journal-title":"PLoS ONE."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2662","DOI":"10.1128\/AJTR.01628-20","article-title":"Rapid efficacy of percutaneous kyphoplasty (PKP) in treating thoracolumbar fractures in elderly patients","volume":"13","author":"Hou","year":"2021","journal-title":"Am J Transl Res."},{"key":"B6","doi-asserted-by":"publisher","first-page":"E349","DOI":"10.36076\/ppj.2021\/24\/E349","article-title":"Percutaneous vertebroplasty versus kyphoplasty for thoracolumbar osteoporotic vertebral compression fractures in patients with distant lumbosacral pain","volume":"24","author":"Li","year":"2021","journal-title":"Pain Phys."},{"key":"B7","doi-asserted-by":"publisher","first-page":"E803","DOI":"10.36076\/ppj.2021.24.E803","article-title":"Correlation analysis between basic diseases and subsequent vertebral fractures after Percutaneous Kyphoplasty (PKP) for osteoporotic vertebral compression fractures","volume":"24","author":"Ning","year":"2021","journal-title":"Pain Phys."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1007\/s00198-019-05144-x","article-title":"The association between sarcopenia and osteoporotic vertebral compression refractures","volume":"30","author":"Wang","year":"2019","journal-title":"Osteoporos Int."},{"key":"B9","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1016\/j.bone.2015.04.01","article-title":"Osteoporosis and sarcopenia in older age","volume":"80","author":"Edwards","year":"2015","journal-title":"Bone."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2781","DOI":"10.1007\/s00198-017-4151-8","article-title":"Osteosarcopenia: where bone, muscle, and fat collide","volume":"28","author":"Hirschfeld","year":"2017","journal-title":"Osteoporos Int."},{"key":"B11","doi-asserted-by":"publisher","first-page":"818","DOI":"10.7326\/m15-136","article-title":"Treatment of low bone density or osteoporosis to prevent fractures in men and women: a clinical practice guideline update from the American college of physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann Intern Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"105484","DOI":"10.1016\/j.cmpb.2020.105484","article-title":"Prediction of osteoporotic hip fracture in postmenopausal women through patient-specific FE analyses and machine learning","volume":"193","author":"Villamor","year":"2020","journal-title":"Comput Methods Programs Biomed."},{"key":"B13","first-page":"1","article-title":"Infused heart: A novel knowledge-infused learning framework for diagnosis of cardiovascular events","volume-title":"IEEE Transactions on Computational Social Systems, Vol. 412.","author":"Pandya","year":"2022"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2077","DOI":"10.1109\/tmi.2017.2708988","article-title":"Anisotropic discrete dual-tree wavelet transform for improved classification of trabecular bone","volume":"36","author":"Oulhaj","year":"2017","journal-title":"IEEE Trans Med Imaging."},{"key":"B15","doi-asserted-by":"publisher","first-page":"541","DOI":"10.3390\/jpm11060541","article-title":"Machine learning approaches for predicting bisphosphonate-related osteonecrosis in women with osteoporosis using VEGFA gene polymorphisms","volume":"11","author":"Kim","year":"2021","journal-title":"J Pers Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2568","DOI":"10.1007\/s00586-020-06493-6","article-title":"Risk factors for postoperative residual back pain after percutaneous kyphoplasty for osteoporotic vertebral compression fractures","volume":"29","author":"Li","year":"2020","journal-title":"Eur Spine J."},{"key":"B17","first-page":"5483","article-title":"Nonparametric bayesian prior inducing deep network for automatic detection of cognitive status","volume-title":"IEEE Transactions on Cybernetics, Vol. 51.","author":"Wu","year":"2021"},{"key":"B18","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1109\/TCYB.2020.3033005","article-title":"Self-paced dynamic infinite mixture model for fatigue evaluation of pilots' brains","volume":"24","author":"Wu","year":"2020","journal-title":"IEEE Trans Cybern"},{"key":"B19","first-page":"146","article-title":"Nonparametric hierarchical hidden semi-Markov model for brain fatigue behavior detection of pilots during flight","volume-title":"IEEE Transactions on Intelligent Transportation Systems","author":"Wu","year":"2021"},{"key":"B20","doi-asserted-by":"publisher","first-page":"E671","DOI":"10.1093\/neuros\/nyz070","article-title":"Predicting 90-day and 1-year mortality in spinal metastatic disease: development and internal validation","volume":"85","author":"Karhade","year":"2019","journal-title":"Neurosurgery."},{"key":"B21","doi-asserted-by":"publisher","first-page":"729","DOI":"10.3171\/2019.2.Spine18751","article-title":"Lumbar spondylolisthesis: modern registries and the development of artificial intelligence","volume":"30","author":"Ghogawala","year":"2019","journal-title":"J Neurosurg Spine."},{"key":"B22","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s10278-019-00224-0","article-title":"Computer-aided detection of incidental lumbar spine fractures from routine Dual-Energy X-Ray Absorptiometry (DEXA) studies using a Support Vector Machine (SVM) classifier","volume":"33","author":"Mehta","year":"2020","journal-title":"J Digit Imaging."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1007\/s00586-010-1479-6","article-title":"Recompression of vertebral body after balloon kyphoplasty for osteoporotic vertebral compression fracture","volume":"19","author":"Kim","year":"2010","journal-title":"Eur Spine J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"6005","DOI":"10.1038\/s41598-020-62869-0","article-title":"Teriparatide associated with fewer refractures and higher body heights of cemented vertebrae after vertebroplasty: a matched cohort study","volume":"10","author":"Yang","year":"2020","journal-title":"Sci Rep."},{"key":"B25","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1007\/s00223-016-0229-0","article-title":"Obesity, type 2 diabetes and bone in adults","volume":"100","author":"Walsh","year":"2017","journal-title":"Calcif Tissue Int."},{"key":"B26","doi-asserted-by":"publisher","first-page":"E430","DOI":"10.1097\/BRS.0000000000003324","article-title":"Osteoporosis-related vertebral fragility fractures: a review and analysis of the American Orthopaedic Association's own the bone database","volume":"45","author":"Robinson","year":"2020","journal-title":"Spine."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.3174\/ajnr.A2148","article-title":"Percutaneous vertebroplasty is not a risk factor for new osteoporotic compression fractures: results from VERTOS II","volume":"31","author":"Klazen","year":"2010","journal-title":"AJNR Am J Neuroradiol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1007\/s00586-007-0564-y","article-title":"Refractures in cemented vertebrae after percutaneous vertebroplasty: a retrospective analysis","volume":"17","author":"Lin","year":"2008","journal-title":"Eur Spine J."},{"key":"B29","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1007\/s11657-015-0219-2","article-title":"Association and relative importance of multiple obesity measures with bone mineral density: the National Health and Nutrition Examination Survey 2005-2006","volume":"10","author":"Yang","year":"2015","journal-title":"Arch Osteoporos."},{"key":"B30","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1007\/s00198-007-0487-9","article-title":"Leptin and the sympathetic connection of fat to bone","volume":"19","author":"Hamrick","year":"2008","journal-title":"Osteoporos Int."},{"key":"B31","doi-asserted-by":"publisher","first-page":"M924","DOI":"10.1093\/gerona\/59.9.m924","article-title":"Cytokine-related aging process","volume":"59","author":"Morley","year":"2004","journal-title":"J Gerontol Ser A Biol Sci Med Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1002\/jbmr.2450","article-title":"The association between BMI and QCT-derived proximal hip structure and strength in older men: a cross-sectional study","volume":"30","author":"Shen","year":"2015","journal-title":"J Bone Miner Res."},{"key":"B33","doi-asserted-by":"publisher","first-page":"4664","DOI":"10.1210\/jc.2014-2104","article-title":"Comparison of hip geometry, strength, and estimated fracture risk in women with anorexia nervosa and overweight\/obese women","volume":"99","author":"Bachmann","year":"2014","journal-title":"J Clin Endocrinol Metab."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1007\/s00256-020-03437-5","article-title":"Percutaneous vertebral augmentation using drill rotation for osteoporotic vertebral compression fractures with intravertebral vacuum cleft","volume":"49","author":"Li","year":"2020","journal-title":"Skeletal Radiol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"3624614","DOI":"10.21203\/rs.3.rs-468850\/v1","article-title":"A nomogram for predicting the residual back pain after percutaneous vertebroplasty for osteoporotic vertebral compression fractures","volume":"2021","author":"Li","year":"2021","journal-title":"Pain Res Manage."},{"key":"B36","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1177\/2192568220984129","article-title":"Percutaneous kyphoplasty versus percutaneous vertebroplasty for neurologically intact osteoporotic K\u00fcmmell's disease: a systematic review and meta-analysis","volume":"12","author":"Zhang","year":"2021","journal-title":"Global Spine J"},{"key":"B37","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.ijsu.2017.02.019","article-title":"The therapeutic effect of intravertebral vacuum cleft with osteoporotic vertebral compression fractures: a systematic review and meta-analysis","volume":"40","author":"Yu","year":"2017","journal-title":"Int J Surg."},{"key":"B38","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1007\/s00264-018-4007-7","article-title":"The therapeutic effects of percutaneous kyphoplasty on osteoporotic vertebral compression fractures with or without intravertebral cleft","volume":"43","author":"Li","year":"2019","journal-title":"Int Orthop."},{"key":"B39","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1007\/s00586-014-3457-x","article-title":"Predictors of kyphotic deformity in osteoporotic vertebral compression fractures: a radiological study","volume":"23","author":"Patil","year":"2014","journal-title":"Eur Spine J."},{"key":"B40","doi-asserted-by":"publisher","first-page":"431","DOI":"10.2147\/cia.S113240","article-title":"Bone cement distribution in the vertebral body affects chances of recompression after percutaneous vertebroplasty treatment in elderly patients with osteoporotic vertebral compression fractures","volume":"12","author":"Zhang","year":"2017","journal-title":"Clin Interv Aging."},{"key":"B41","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1016\/j.bone.2008.10.048","article-title":"Vertebral fractures usually affect the cranial endplate because it is thinner and supported by less-dense trabecular bone","volume":"44","author":"Zhao","year":"2009","journal-title":"Bone."},{"key":"B42","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3174\/ajnr.A2223","article-title":"Injury to the vertebral endplate-disk complex associated with osteoporotic vertebral compression fractures","volume":"32","author":"Ortiz","year":"2011","journal-title":"AJNR Am J Neuroradiol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1259\/bjr\/57527063","article-title":"The intravertebral cleft in benign vertebral compression fracture: the diagnostic performance of non-enhanced MRI and fat-suppressed contrast-enhanced MRI","volume":"82","author":"Ryu","year":"2009","journal-title":"Br J Radiol."},{"key":"B44","doi-asserted-by":"publisher","first-page":"495","DOI":"10.3390\/PP17061046","article-title":"Percutaneous kyphoplasty evaluated by cement volume and distribution: an analysis of clinical data","volume":"19","author":"He","year":"2016","journal-title":"Pain Phys."},{"key":"B45","doi-asserted-by":"publisher","first-page":"e1190","DOI":"10.1016\/j.wneu.2019.03.063","article-title":"Distribution pattern making sense: patients achieve rapider pain relief with confluent rather than separated bilateral cement in percutaneous kyphoplasty for osteoporotic vertebral compression fractures","volume":"126","author":"Liu","year":"2019","journal-title":"World Neurosurg."},{"key":"B46","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s00198-018-4754-8","article-title":"Risk factors and score for recollapse of the augmented vertebrae after percutaneous vertebroplasty in osteoporotic vertebral compression fractures","volume":"30","author":"Yu","year":"2019","journal-title":"Osteoporos Int."},{"key":"B47","doi-asserted-by":"publisher","first-page":"16320","DOI":"10.1038\/s41598-020-73513-2","article-title":"novel and convenient method to evaluate bone cement distribution following percutaneous vertebral augmentation","volume":"10","author":"Liu","year":"2020","journal-title":"Sci Rep."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.874672\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T05:33:34Z","timestamp":1651469614000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.874672\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,2]]},"references-count":47,"alternative-id":["10.3389\/fpubh.2022.874672"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.874672","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,2]]},"article-number":"874672"}}