{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:11:41Z","timestamp":1788786701412,"version":"build-2803163510"},"reference-count":26,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82260181"],"award-info":[{"award-number":["82260181"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2022JZ-43"],"award-info":[{"award-number":["2022JZ-43"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2021PSLK32"],"award-info":[{"award-number":["2021PSLK32"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key project of Natural Science Basic Research Plan of Shaanxi Province","award":["82260181"],"award-info":[{"award-number":["82260181"]}]},{"name":"Key project of Natural Science Basic Research Plan of Shaanxi Province","award":["2022JZ-43"],"award-info":[{"award-number":["2022JZ-43"]}]},{"name":"Key project of Natural Science Basic Research Plan of Shaanxi Province","award":["2021PSLK32"],"award-info":[{"award-number":["2021PSLK32"]}]},{"name":"Science and Technology Association of Shaanxi","award":["82260181"],"award-info":[{"award-number":["82260181"]}]},{"name":"Science and Technology Association of Shaanxi","award":["2022JZ-43"],"award-info":[{"award-number":["2022JZ-43"]}]},{"name":"Science and Technology Association of Shaanxi","award":["2021PSLK32"],"award-info":[{"award-number":["2021PSLK32"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: To investigate the independent influencing factors of bone cement displacement following percutaneous vertebral augmentation (PVA) in patients with stage I and stage II K\u00fcmmell\u2019s disease. Methods: We retrospectively reviewed the records of 824 patients with stage \u2160 and stage \u2161 K\u00fcmmell\u2019s disease treated with percutaneous vertebroplasty (PVP) or percutaneous vertebroplasty (PKP) from January 2016 to June 2022. Patients were divided into the postoperative bone cement displacement group (n = 150) and the bone cement non-displacement group (n = 674) according to the radiographic inspection results. The following data were collected: age, gender, body mass index (BMI), underlying disease, bone mineral density (BMD), involved vertebral segment, K\u00fcmmell\u2019s disease staging, anterior height, local Cobb angle, the integrity of anterior vertebral cortex, the integrity of endplate in surgical vertebrae, surgical method, surgical approach, the volume of cement, distribution of cement, the viscosity of cement, cement leakage, and postoperative anti-osteoporosis treatment. Binary logistic regression analysis was performed to determine the independent influencing factors of bone cement displacement. The discrimination ability was evaluated using the area under the curve (AUC) of the receiver operating characteristic (ROC). Results: The results of logistic regression analysis revealed that thoracolumbar junction (odds ratio (OR) = 3.23, 95% confidence interval (CI) 2.12\u20134.50, p = 0.011), K\u00fcmmell\u2019s disease staging (OR = 2.23, 95% CI 1.81\u20133.41, p &lt; 0.001), anterior cortex defect (OR = 5.34, 95% CI 3.53\u20137.21, p &lt; 0.001), vertebral endplates defect (OR = 0.54, 95% CI 0.35\u20130.71, p &lt; 0.001), cement distribution (OR = 2.86, 95% CI 2.03\u20133.52, p = 0.002), cement leakage (OR = 4.59, 95% CI 3.85\u20135.72, p &lt; 0.001), restoration of local Cobb angle (OR = 3.17, 95% CI 2.40\u20135.73, p = 0.024), and postoperative anti-osteoporosis treatment (OR = 0.48, 95% CI 0.18\u20130.72, p = 0.025) were independently associated with the bone cement displacement. The results of the ROC curve analysis showed that the AUC was 0.816 (95% CI 0.747\u20130.885), the sensitivity was 0.717, and the specificity was 0.793. Conclusion: Thoracolumbar fracture, stage \u2161 K\u00fcmmell\u2019s disease, anterior cortex defect, uneven cement distribution, cement leakage, and high restoration of the local Cobb angle were risk factors for cement displacement after PVA in K\u00fcmmell\u2019s disease, while vertebral endplates defect and postoperative anti-osteoporosis treatment are protective factors.<\/jats:p>","DOI":"10.3390\/jcm11247479","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T08:41:41Z","timestamp":1671439301000},"page":"7479","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Predictive Factors for Bone Cement Displacement following Percutaneous Vertebral Augmentation in K\u00fcmmell\u2019s Disease"],"prefix":"10.3390","volume":"11","author":[{"given":"Xiangcheng","family":"Gao","sequence":"first","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"},{"name":"Medical College, Yan\u2019an University, Yan\u2019an 716000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinpeng","family":"Du","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongyuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-0252","authenticated-orcid":false,"given":"Yining","family":"Gong","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zechao","family":"Qu","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingjun","family":"Hao","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baorong","family":"He","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Yan","sequence":"additional","affiliation":[{"name":"Xi\u2019an Honghui Hospital, Xi\u2019an Jiaotong University, Xi\u2019an 710049, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/0049-0172(81)90004-4","article-title":"Delayed traumatic vertebral body compression fracture; part II: Pathologic features","volume":"10","author":"Benedek","year":"1981","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3340\/jkns.2017.0505.010","article-title":"Posttraumatic Delayed Vertebral Collapse: Kummell\u2019s Disease","volume":"61","author":"Lim","year":"2018","journal-title":"J. Korean Neurosurg. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Adamska, O., Modzelewski, K., Stolarczyk, A., and Kseniuk, J. (2021). Is Kummell\u2019s Disease a Misdiagnosed and\/or an Underreported Complication of Osteoporotic Vertebral Compression Fractures? A Pattern of the Condition and Available Treatment Modalities. J. Clin. Med., 10.","DOI":"10.3390\/jcm10122584"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"893404","DOI":"10.3389\/fsurg.2022.893404","article-title":"Comparative Efficacy of Three Minimally Invasive Procedures for K\u00fcmmell\u2019s Disease: A Systematic Review and Network Meta-Analysis","volume":"9","author":"Wang","year":"2022","journal-title":"Front. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"B4","DOI":"10.1097\/BRS.0000000000000538","article-title":"A review of osteoporotic vertebral fracture nonunion management","volume":"39","author":"Yang","year":"2014","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1097\/AAP.0000000000000445","article-title":"Insufficient Penetration of Bone Cement into the Trabecular Bone: A Potential Risk for Delayed Bone Cement Displacement After Kyphoplasty?","volume":"41","author":"Jeong","year":"2016","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E457","DOI":"10.1097\/01.BRS.0000096668.54378.25","article-title":"Polymethylmethacrylate cement dislodgment following percutaneous vertebroplasty: A case report","volume":"28","author":"Tsai","year":"2003","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3340\/jkns.2008.43.4.212","article-title":"Delayed bone cement displacement following balloon kyphoplasty","volume":"43","author":"Wang","year":"2008","journal-title":"J. Korean Neurosurg. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1111\/papr.12561","article-title":"Failed Percutaneous Vertebroplasty Due to Insufficient Correction of Intravertebral Instability in Kummell\u2019s Disease: A Case Report","volume":"17","author":"Kim","year":"2017","journal-title":"Pain Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"387","DOI":"10.3171\/2011.12.SPINE11671","article-title":"Postvertebroplasty instability","volume":"16","author":"Nagad","year":"2012","journal-title":"J. Neurosurg. Spine"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1142\/S0218957704001181","article-title":"Staging of K\u00fcmmell\u2019s disease","volume":"8","author":"Li","year":"2004","journal-title":"J. Musculoskelet. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"947212","DOI":"10.3389\/fsurg.2022.947212","article-title":"Risk factors for bone cement displacement after percutaneous vertebral augmentation for osteoporotic vertebral compression fractures","volume":"9","author":"Gao","year":"2022","journal-title":"Front. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2131","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":"ref_14","doi-asserted-by":"crossref","first-page":"964578","DOI":"10.3389\/fendo.2022.964578","article-title":"Risk factors of new vertebral compression fracture after percutaneous vertebroplasty or percutaneous kyphoplasty","volume":"13","author":"Cheng","year":"2022","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1559325816682867","DOI":"10.1177\/1559325816682867","article-title":"Is There a Dose-Response Relationship of Cement Volume with Cement Leakage and Pain Relief after Vertebroplasty?","volume":"14","author":"Fu","year":"2016","journal-title":"Dose Response"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e430","DOI":"10.1016\/j.wneu.2022.01.050","article-title":"Does the Relationship Between Bone Cement and the Intravertebral Cleft of Kummell Disease Affect the Efficacy of PKP?","volume":"160","author":"Lv","year":"2022","journal-title":"World Neurosurg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/j.jss.2014.12.053","article-title":"Biomechanical effects of cement distribution in the fractured area on osteoporotic vertebral compression fractures: A three-dimensional finite element analysis","volume":"195","author":"Liang","year":"2015","journal-title":"J. Surg. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"812023","DOI":"10.3389\/fpubh.2021.812023","article-title":"Machine Learning Applications for the Prediction of Bone Cement Leakage in Percutaneous Vertebroplasty","volume":"9","author":"Li","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1007\/s00586-010-1286-0","article-title":"Conversion to hypertrophic vertebral pseudarthrosis following percutaneous vertebroplasty","volume":"19","author":"Kawaguchi","year":"2010","journal-title":"Eur. Spine J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1186\/s13018-021-02722-w","article-title":"Risk factors for secondary fractures to percutaneous vertebroplasty for osteoporotic vertebral compression fractures: A systematic review","volume":"16","author":"Mao","year":"2021","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/s13018-022-03038-z","article-title":"Risk factors of vertebral re-fracture after PVP or PKP for osteoporotic vertebral compression fractures, especially in Eastern Asia: A systematic review and meta-analysis","volume":"17","author":"Dai","year":"2022","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"844","DOI":"10.5535\/arm.2011.35.6.844","article-title":"Predictive risk factors for refracture after percutaneous vertebroplasty","volume":"35","author":"Kang","year":"2011","journal-title":"Ann. Rehabil. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"Itc17","DOI":"10.7326\/AITC201708010","article-title":"Osteoporosis","volume":"167","author":"Ensrud","year":"2017","journal-title":"Ann. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1001\/jama.2017.21995","article-title":"Treatment of Osteoporosis","volume":"319","author":"Cotts","year":"2018","journal-title":"Jama"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1007\/s00774-018-0974-4","article-title":"Re-fracture and correlated risk factors in patients with osteoporotic vertebral fractures","volume":"37","author":"Ma","year":"2019","journal-title":"J. Bone Miner. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.maturitas.2013.01.002","article-title":"Low BMD is an independent predictor of fracture and early menopause of mortality in post-menopausal women\u2014A 34-year prospective study","volume":"74","author":"Svejme","year":"2013","journal-title":"Maturitas"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7479\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:42:56Z","timestamp":1760146976000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,16]]},"references-count":26,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jcm11247479"],"URL":"https:\/\/doi.org\/10.3390\/jcm11247479","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,16]]}}}