Chief physician Taizhou Hospital of Zhejiang Province Taizhou, Zhejiang, China (People's Republic)
Introduction: Vertebral biopsy in percutaneous vertebroplasty (PVP) is a useful and safe procedure to identify the underlying pathology of compression fractures. Recurrent osteoporotic vertebral fractures and postoperative surgical site infection in patients after PVP treatment seriously affect their quality of life and become a heavy health care burden. The neutrophil-to-lymphocyte ratio (NLR) is commonly used as an inflammatory index to assess systemic inflammation. We observed that NLR in bone section obtained from vertebral biopsy was diverse, but its clinical role was unclear.
Aim: The aim of this study is to clarify the relationship between the NLR in bone section and post-PVP infection and recurrent vertebral fractures within 6 months after PVP.
Method: This study is a single-center retrospective clinical study. Patients with vertebral fractures and undergoing PVP surgery from January 1to December 31, 2021 were allocated to the high-NLR group (NLR≥2) and the control group (NLR < 2). Student’s t test and chi-square test were used to identify risk factors affecting the NLR. Binary logistic regression was performed to further prove the impact of these risk factors.
Results: 139 patients with PVP surgery were recruited, 112 valid cases were identified (36 patients in the high-NLR group and 76 patients in the control group). At the initial analysis, there was a significant difference between the high-NLR group and the control group in terms of post-PVP infection (P=0.04) and recurrent vertebral fractures within 6 months after PVP (P=0.02). We observed an obvious extension of operative duration in the high-NLR group compared with the control group (80.97 ± 32.38 vs 66.8 ± 18.4; P=0.02). The inflammation group had a significant higher proportion of old vertebral fractures (61.1% vs 36.8%; P=0.02).
Conclusion: NLR in bone section obtained from vertebral biopsy is predictive of the development of post-PVP infection and recurrent vertebral fractures within 6 months after PVP. The High-NLR group had a longer operative time and a higher rate of postoperative infection and re-fracture. Patients with old vertebral fracture also had a high NLR in bone section.
