Risk Factors for Subsequent Vertebral Compression Fracture Following Osteoporotic Compression Fracture

Sung Soo Kim; Dong Hyun Lee; Jung Hoon Kim; Dong Ju Lim; Byung Wan Choi; Jin Hwan Kim; Jin Hyok Kim; Jun Seung Lee

doi:10.4055/jkoa.2016.51.6.479

Journal List > J Korean Orthop Assoc > v.51(6) > 1013484

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim, Lee, Kim, Lim, Choi, Kim, Kim, and Lee: Risk Factors for Subsequent Vertebral Compression Fracture Following Osteoporotic Compression Fracture

Original Article

Journal of the Korean Orthopaedic Association 2016; 51(6): 479-485.

Published online: 30 December 2016

DOI: https://doi.org/10.4055/jkoa.2016.51.6.479

Risk Factors for Subsequent Vertebral Compression Fracture Following Osteoporotic Compression Fracture

Sung Soo Kim, M.D., Ph.D., Dong Hyun Lee, M.D., Jung Hoon Kim, M.D., Ph.D.^*, Dong Ju Lim, M.D., Ph.D.^†, Byung Wan Choi, M.D., Ph.D., Jin Hwan Kim, M.D., Ph.D.^*, Jin Hyok Kim, M.D., Ph.D.^†, Jun Seung Lee, M.D.

Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea.

^*Department of Orthopaedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

^†Department of Orthopaedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea.

Correspondence to: Dong Hyun Lee, M.D. Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, 875 Haeun-daero, Haeundae-gu, Busan 48108, Korea. TEL: +82-51-797-0240, FAX: +82-51-797-0249, theorthopedia@hanmail.net

Received 17 February 2016 Revised 6 June 2016 Accepted 28 June 2016

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the risk factors for subsequent vertebral fracture following acute osteoporotic vertebral compression fracture.

Materials and Methods

This was a multicenter retrospective study. We recruited 135 patients treated for acute osteoporotic compression fracture with available spine image taken at the 1-year follow-up mark in 3 different hospitals. The patients were divided into 2 groups in accordance with the occurrence of subsequent vertebral fracture. Variables including age, sex, bone mineral density, medical comorbidity, acute fracture level, presence of prior vertebral fracture, osteoporosis medication, and treatment method were analyzed and compared between the 2 groups.

Results

The new subsequent vertebral fractures were detected in 25 patients (18.5%). There were no significant differences between the 2 groups with respect to age, sex, medical comorbidity, presence of prior vertebral fracture, and acute fracture level, as shown by univariate analysis. However, in the group with subsequent vertebral fracture, more patients were treated by vertebroplasty or kyphoplasty and had a femur neck T-score of ≤-2.5, as well as poor compliance of osteoporosis medication with significant difference (p<0.05). According to the multivariate analysis, subsequent vertebral fractures were significantly influenced by vertebroplasty or kyphoplasty (p=0.003, odds ratio=4.71) and femur neck T-score of ≤-2.5 (p=0.013, odds ratio=3.47).

Conclusion

Subsequent vertebral fractures were found in 19% at the 1-year mark after the treatment of acute osteoporotic compression fracture. The two risk factors for subsequent vertebral fractures were vertebroplasty or kyphoplasty and femur neck T-score of ≤-2.5.

Keywords: osteoporotic fractures, spinal fractures, risk factors, vertebroplasty, bone densiry

Figures and Tables

Table 1

Demographics and BMD

Values are presented as mean±standard deviation (range), number only or mean±standard deviation only. BMD, bone mineral density.

Table 2

Univariate Analysis for Subsequent Vertebral Compression Fracture

N, no; Y, yes; CI, confidence interval; BMD, bone mineral density; MRP, medication possession rate.

Table 3

Multivariate Analysis for Subsequent Vertebral Compression Fracture

^*Vertebroplasty or kyphoplasty vs. conservative. ^†T≤−2.5 vs. T>−2.5. ^‡Poor vs. good. CI, confidence interval; BMD, bone mineral density.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose.

References

1. Borgström F, Zethraeus N, Johnell O, et al. Costs and quality of life associated with osteoporosis-related fractures in Sweden. Osteoporos Int. 2006; 17:637–650.

2. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006; 17:1726–1733.

3. Kim JH, Kim SS, Lee DH, et al. Analysis of treatment methods for subsequent vertebral fractures following osteoporotic compression fractures. J Korean Soc Spine Surg. 2015; 22:75–81.

4. Zhao QM, Gu XF, Liu ZT, Cheng L. The value of radionuclide bone imaging in defining fresh fractures among osteoporotic vertebral compression fractures. J Craniofac Surg. 2016; 27:745–748.

5. Guermazi A, Mohr A, Grigorian M, Taouli B, Genant HK. Identification of vertebral fractures in osteoporosis. Semin Musculoskelet Radiol. 2002; 6:241–252.

6. Siris ES, Selby PL, Saag KG, Borgström F, Herings RM, Silverman SL. Impact of osteoporosis treatment adherence on fracture rates in North America and Europe. Am J Med. 2009; 122:S3–S13.

7. Rousing R, Hansen KL, Andersen MO, Jespersen SM, Thomsen K, Lauritsen JM. Twelve-months follow-up in forty-nine patients with acute/semiacute osteoporotic vertebral fractures treated conservatively or with percutaneous vertebroplasty: a clinical randomized study. Spine (Phila Pa 1976). 2010; 35:478–482.

8. Kang SK, Lee CW, Park NK, et al. Predictive risk factors for refracture after percutaneous vertebroplasty. Ann Rehabil Med. 2011; 35:844–851.

9. Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001; 285:320–323.

10. Yen CH, Teng MM, Yuan WH, Sun YC, Chang CY. Preventive vertebroplasty for adjacent vertebral bodies: a good solution to reduce adjacent vertebral fracture after percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2012; 33:826–832.

11. Li YA, Lin CL, Chang MC, Liu CL, Chen TH, Lai SC. Subsequent vertebral fracture after vertebroplasty: incidence and analysis of risk factors. Spine (Phila Pa 1976). 2012; 37:179–183.

12. Baroud G, Heini P, Nemes J, Bohner M, Ferguson S, Steffen T. Biomechanical explanation of adjacent fractures following vertebroplasty. Radiology. 2003; 229:606–607. author reply 607-8.

13. Baroud G, Nemes J, Heini P, Steffen T. Load shift of the intervertebral disc after a vertebroplasty: a finite-element study. Eur Spine J. 2003; 12:421–426.

14. Lin WC, Lee YC, Lee CH, et al. Refractures in cemented vertebrae after percutaneous vertebroplasty: a retrospective analysis. Eur Spine J. 2008; 17:592–599.

15. Wasnich RD. Vertebral fracture epidemiology. Bone. 1996; 18:179S–183S.

TOOLS

Similar articles