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Background <p>Stress concentration is a primary pathogenesis of adjacent vertebral fracture (AVF) following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Disc degeneration (DD) is highly prevalent in the elderly, including OVCF patients. As a key biomechanical function of the intervertebral disc (IVD) is to ensure uniform load distribution, the progression of DD may impair this capacity, leading to localized stress concentrations. This study aims to investigate the impact of DD on AVF risk and elucidate its underlying biomechanical mechanisms.</p> Methods <p>Clinical data from 65 patients were retrospectively reviewed. The cohort was stratified by the presence or absence of cranial AVF. The cranial IVDs adjacent to the fractured vertebrae were classified based on their degeneration phenotype, specifically the presence of disc fibrosis or collapse. We compared the incidence of these phenotypes between the AVF and non-AVF groups. Furthermore, regression analysis was employed to identify potential risk factors for AVF. In parallel, PVP simulations were conducted using biomechanical models that simulated disc fibrosis and collapse. Stress distributions within the cranial vertebral body and the motion range of the corresponding segment were computed and compared across the different models.</p> Results <p>Clinically, neither the incidence of disc fibrosis (<i>P</i> = 0.549) nor collapse (<i>P</i> = 0.586) differed significantly between cohorts with and without AVF, nor did they serve as independent risk factors (OR: 1.428 and 1.385, respectively). Biomechanical simulations aligned with clinical findings, demonstrating that neither disc fibrosis nor collapse altered stress distributions in the cranial vertebral body. Conversely, DD models exhibited a reduced motion—quantified by the overall model displacement—across all loading conditions when compared to the non-degenerated model.</p> Conclusion <p>Our clinical and biomechanical analysis did not demonstrate an increased incidence of AVF in DD patients with wedge-type OVCF following PVP. This phenomenon may be attributed to a reduction in segmental motion, which subsequently lowers the stress values within the degenerative segment.</p>

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Disc degeneration did not lead to an increased incidence of adjacent vertebral fractures in wedge-type OVCF patients

  • 期刊论文

  • 发表日期：

    2026年2月9日

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  • Yingguang Zhou,
  • Cheng Luo,
  • Yawei Li,
  • Lijunpeng Jia,
  • Zongyu Zhang,
  • Xin Tian,
  • Jingchi Li

摘要

Background

Stress concentration is a primary pathogenesis of adjacent vertebral fracture (AVF) following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Disc degeneration (DD) is highly prevalent in the elderly, including OVCF patients. As a key biomechanical function of the intervertebral disc (IVD) is to ensure uniform load distribution, the progression of DD may impair this capacity, leading to localized stress concentrations. This study aims to investigate the impact of DD on AVF risk and elucidate its underlying biomechanical mechanisms.

Methods

Clinical data from 65 patients were retrospectively reviewed. The cohort was stratified by the presence or absence of cranial AVF. The cranial IVDs adjacent to the fractured vertebrae were classified based on their degeneration phenotype, specifically the presence of disc fibrosis or collapse. We compared the incidence of these phenotypes between the AVF and non-AVF groups. Furthermore, regression analysis was employed to identify potential risk factors for AVF. In parallel, PVP simulations were conducted using biomechanical models that simulated disc fibrosis and collapse. Stress distributions within the cranial vertebral body and the motion range of the corresponding segment were computed and compared across the different models.

Results

Clinically, neither the incidence of disc fibrosis (P = 0.549) nor collapse (P = 0.586) differed significantly between cohorts with and without AVF, nor did they serve as independent risk factors (OR: 1.428 and 1.385, respectively). Biomechanical simulations aligned with clinical findings, demonstrating that neither disc fibrosis nor collapse altered stress distributions in the cranial vertebral body. Conversely, DD models exhibited a reduced motion—quantified by the overall model displacement—across all loading conditions when compared to the non-degenerated model.

Conclusion

Our clinical and biomechanical analysis did not demonstrate an increased incidence of AVF in DD patients with wedge-type OVCF following PVP. This phenomenon may be attributed to a reduction in segmental motion, which subsequently lowers the stress values within the degenerative segment.