The Predictive Value of DWI in the Recurrence Fracture of the Same Vertebra after PVP Abstract: Objective To explore the predictive value of diffusion-weighted imaging (DWI) in the recurrence fracture of the same vertebra after percutaneous vertebroplasty (PVP). Methods A total of 80 patients with osteoporotic vertebral compression fracture (OVCF) admitted to Liaoyou Baoshihua Hospital in Panjin from January 2020 to June 2022 were included in the study, all of whom were treated with PVP. They were divided into refracture group and non-fracture group according to whether there were postoperative refractures of the same vertebra. The clinical, surgical and imaging data of the two groups were compared, and statistically analyzed by Logistic, Pearson and ROC curve. Results OVCF patients were followed up for 15 to 32 (18.0±4.0) months, and 24 (30.0%) of the same vertebra were refractured. Bone mineral density (BMD) in the refracture group was significantly lower than that in the non-fracture group (P < 0.05), and the values of IVC, fracture line to end plate, fluid accumulation around bone cement, vertebral height recovery rate and ADC in the refracture group were significantly higher than those in the non-fracture group (P < 0.05). Logistic analysis showed: IVC (OR=8.864, P=0.005), fluid accumulation around bone cement (OR=2.261, P=0.029), vertebral height recovery rate (OR=2.746, P=0.012) and ADC value (OR=3.241, P=0.024) were independent risk factors for recurrent fracture of the same vertebra after surgery. ROC curve analysis showed that the area under the curve of ADC value predicting recurrent fracture was 0.953. ADC values in OVCF patients were negatively correlated with bone mineral density (T) (P < 0.05), and positively correlated with vertebral height recovery (P < 0.05). Conclusions DWI has a certain predictive value for the recurrence of the same vertebral body fracture after PVP, and it is necessary to evaluate the DWI-ADC value, IVC and other risk factors by MRI to prevent the recurrence of postoperative fracture.