Vertebral Recompression after Vertebroplasty or Kyphoplasty

Deuk Soo Jun; Do Hyun Moon; Young Kyu Ko; Jang Seok Choi; Byoung Keun An; Je Won Paik; Min Ho Park

doi:10.12671/jkfs.2015.28.2.110

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Jun, Moon, Ko, Choi, An, Paik, and Park: Vertebral Recompression after Vertebroplasty or Kyphoplasty

Original Article

Journal of the Korean Fracture Society 2015; 28(2): 110-117.

Published online: 21 April 2015

DOI: https://doi.org/10.12671/jkfs.2015.28.2.110

Vertebral Recompression after Vertebroplasty or Kyphoplasty

Deuk Soo Jun, M.D., Do Hyun Moon, M.D., Young Kyu Ko, M.D.^*, Jang Seok Choi, M.D., Byoung Keun An, M.D., Je Won Paik, M.D., Min Ho Park, M.D.

Department of Orthopedic Surgery, Gachon University Gil Medical Center, Incheon, Korea.

^*Joongang Medical Clinic, Incheon, Korea.

Address reprint requests to: Byoung Keun An, M.D. Department of Orthopedic Surgery, Gachon University Gil Medical Center, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 405-760, Korea. Tel: 82-32-460-8201, Fax: 82-32-468-5437, abgajs0710@naver.com

Current affiliation:

Byoung Keun An's current affiliation: MiRaeRo EuRatCha Orthopaedic Clinic, 178 Wangsan-ro, Dongdaemun-gu, Seoul 130-851, Korea. Tel: 82-2-965-7582, Fax: 82-2-965-7583.

Received 1 December 2014 Revised 15 December 2014 Accepted 2 January 2015

(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/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to examine incidence of recompression and risk factors in the patients with osteoporotic vertebral compression fracture (OVCF) after vertebroplasty or kyphoplasty.

Materials and Methods

This study was conducted on 179 vertebral bodies of 126 patients who underwent vertebroplasty or kyphoplasty on OVCF from January 2004 to August 2013.

Results

When anterior vertebral height of fractured vertebrae declined by more than 3 mm from the height immediately after vertebroplasty or kyphoplasty, it was judged that recompression had occurred. Recompression was observed in a total of 58 vertebrae (32.4%). Recompression occurrences were found to be decreasing significantly when fractured vertebrae were the thoracic spine. In addition, osteonecrosis occurred in the preoperative vertebrae and restoration degree of anterior vertebral height immediately after vertebroplasty or kyphoplasty affected recompression occurrences significantly. The other factors (age, sex, bone mineral density, steroid medication history, follow-up duration, cement volume, vertebroplasty or kyphoplasty, and approach method) were compared, but no statistical significance was found.

Conclusion

The risk of vertebral recompression is more common, especially when osteonecrosis occurred in preoperative vertebrae or when vertebroplasty or kyphoplasty achieved remarkable restoration of anterior vertebra height. When performing vertebroplasty or kyphoplasty, such conditions should be considered carefully.

Keywords: Osteoporotic fractures, Fracture, Vertebroplasty, Kyphoplasty

Figures and Tables

Fig. 1

Sagittal thoracic vertebra (T2)-weigted magnetic resonance imaging showing (A) the intervertebral cleft with surrounding bone edema signal intensity, (B) high signal lesion (fluid collection).

Fig. 2

A 65-year-old female with lumbar vertebra (L1) osteoporotic vertebral compression fracture (dual energy x-ray absorptiometry T-score: -4.4). (A) Initial lateral radiograph. (B) Sagittal thoracic vertebra (T2)-weighted magnetic resonance imaging (MRI) shows intervertebral cleft (osteonecrosis). (C) Immediately postoperative lateral radiograph. (D) At 6 weeks after vertebroplasty, lateral dynamic radiograph (flexion and extension) shows recompression with resorption of the inferior portion of the vertebral body. (E) Postoperative sagittal T2-weighted MRI shows fluid collection around cement. (F) Postoperative (2nd vertebroplasty) radiograph.

Fig. 3

A 60-year-old male with thoracic vertebra (T8, 9) osteoporotic vertebral compression fracture (dual energy x-ray absorptiometry T-score: -3.2). (A) Postoperative (vertebroplasty T8) lateral radiograph. (B) Postoperative (vertebroplasty T9) lateral radiograph. (C) At 2 years after 2nd vertebroplasty, local kyphotic angle was 55° with severe back pain. (D) Postoperative sagittal T2-weighted magnetic resonance imaging shows fluid collection around cement. (E) Postoperative radiograph.

Table 1

Comparison of Factors between Recompression Group and Well-Maintained Group

Values are presented as mean±standard deviation or number only. ^*Statistical significance was defined as p<0.05. T: Thoracic vertebra, L: Lumbar vertebra.

Notes

^{Financial support} Financial support: None.

^{Conflict of interest} Conflict of interest: None.

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