Objective To compare the effectiveness between three-dimensional (3D) printed porous titanium alloy cage (3D Cage) and poly-ether-ether-ketone cage (PEEK Cage) in the posterior lumbar interbody fusion (PLIF). Methods A total of 66 patients who were scheduled to undergo PLIF between January 2018 and June 2019 were selected as the research subjects, and were divided into the trial group (implantation of 3D Cage, n=33) and the control group (implantation of PEEK Cage, n=33) according to the random number table method. Among them, 1 case in the trial group did not complete the follow-up exclusion study, and finally 32 cases in the trial group and 33 cases in the control group were included in the statistical analysis. There was no significant difference in gender, age, etiology, disease duration, surgical segment, and preoperative Japanese Orthopaedic Association (JOA) score between the two groups (P>0.05). The operation time, intraoperative blood loss, complications, JOA score, intervertebral height loss, and interbody fusion were recorded and compared between the two groups. Results The operations of two groups were completed successfully. There was 1 case of dural rupture complicated with cerebrospinal fluid leakage during operation in the trial group, and no complication occurred in the other patients of the two groups. All incisions healed by first intention. There was no significant difference in operation time and intraoperative blood loss between groups (P>0.05). All patients were followed up 12-24 months (mean, 16.7 months). The JOA scores at 1 year after operation in both groups significantly improved when compared with those before operation (P<0.05); there was no significant difference between groups (P>0.05) in the difference between pre- and post-operation and the improvement rate of JOA score at 1 year after operation. X-ray film reexamination showed that there was no screw loosening, screw rod fracture, Cage collapse, or immune rejection in the two groups during follow-up. At 3 months and 1 year after operation, the rate of intervertebral height loss was significantly lower in the trial group than in the control group (P<0.05). At 3 and 6 months after operation, the interbody fusion rating of trial group was significantly better in the trial group than in the control group (P<0.05); and at 1 year after operation, there was no significant difference between groups (P>0.05). ConclusionThere is no significant difference between 3D Cage and PEEK Cage in PLIF, in terms of operation time, intraoperative blood loss, complications, postoperative neurological recovery, and final intervertebral fusion. But the former can effectively reduce vertebral body subsidence and accelerate intervertebral fusion.
Objective To analyze the demographic and clinical characteristics of inpatients with osteoporotic vertebral compression fractures (OVCF) and provide a basis for clinical prevention and treatment. Methods A retrospective analysis was performed on the clinical data of 744 inpatients diagnosed with OVCF between January 2017 and December 2021, who met the inclusion criteria. Among them, 146 were male and 598 were female, with ages ranging from 50 to 95 years (mean, 69.37 years). The analysis covered various demographic and clinical characteristics, including causes of injury, history of vertebral fractures, smoking and drinking habits in males, comorbidities (hypertension, diabetes, coronary atherosclerotic heart disease, cerebral infarction), body mass index (BMI), blood lipid levels, menopausal age in females, vertebral bone mineral density T-scores, sites and counts of vertebral compression fractures, and fracture segment distribution. Additionally, correlation and multiple linear regression analyses were performed to identify potential factors influencing osteoporosis. Results The demographic analysis indicated that female patients with OVCF were significantly younger than male patients (P<0.05). A significant difference in the age distribution at the onset of OVCF between genders was observed (P<0.05). The highest proportion of male patients was in the 70–80 age range (37.0%), while the highest proportion of female patients was in the 60-70 age range (37.6%). From 2017 to 2021, the age of onset for OVCF gradually increased, with similar trends observed in both genders. Occupational distribution varied significantly between genders (P<0.05); the most common occupations among males were farming (48.6%), retirement (24.7%), and manual labor (13.7%), whereas females were primarily engaged in farming (51.5%), retirement (19.4%), and service worker (10.0%). Female patients had higher BMI, higher vertebral bone mineral density T-scores, and a higher incidence of previous vertebral fractures compared to male patients (P<0.05). No significant gender differences were found in ethnicity, seasonal distribution, regional distribution, urban-rural distribution, causes of injury, fracture count, or comorbidity rates (P>0.05). A total of 1 309 vertebrae were affected in 744 OVCF patients, with 628 thoracic vertebrae (48.0%) and 681 lumbar vertebrae (52.0%). The most frequently fractured segments were L1 (22.5%), T12 (21.2%), followed by L2 (12.2%) and T11 (10.2%). No significant gender differences were observed in fracture segment distribution (P>0.05). Correlation analysis showed no significant relationship between smoking and drinking history in males, menopausal age in females, and vertebral bone mineral density T-scores (P>0.05). However, a positive correlation was found between the history of vertebral fractures and the number of vertebral fractures (P<0.05), and a negative correlation between vertebral bone mineral density T-scores and the number of vertebral fractures (P<0.05). Multiple linear regression analysis identified advanced age, female gender, and lower BMI as independent risk factors for vertebral osteoporosis (P<0.05). ConclusionThe age at onset of OVCF has increased gradually over the years. The incidence, age distribution, occupational distribution, causes of injury, BMI, history of vertebral fractures, hypertension, and blood lipid levels exhibit gender-related differences, while seasonal distribution, fracture segments, and other comorbidities do not. OVCF predominantly occurs in the thoracolumbar region. Female gender, advanced age, and lower BMI are independent risk factors for osteoporosis, with patients having more severe osteoporosis showing a higher number of vertebral fractures.