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Abstract
Objective
Percutaneous vertebroplasty is an effective treatment that relieves pain caused by vertebral compression fracture. However, vertebroplasty may increase the risk for subsequent vertebral compression fracture. The purpose of this study is to evaluate the incidence of and risk factors for subsequent fracture after vertebroplasty.
Methods
A retrospective analysis was performed for 112 patients who were diagnosed with a first osteoporotic compression fracture at a single level and underwent vertebroplasty at that level. Possible risk factors for subsequent fracture, such as age, sex, bone mineral density (BMD), location of treated vertebrae, pattern of cement distribution, cement volume, presence of intradiscal cement leakage, and direction of cement leakage, were analyzed.
Results
During the follow-up period, 18 new subsequent vertebral fractures developed (16.1%). Subsequent fractures were more common in osteoporotic patients (T-score ≤-2.5)(p=0.034, r=0.208). Intravertebral cement volume ≥3.5 cc were also associated with a significantly higher risk of fracture (p=0.012, r=0.238).
References
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FIGURE 1.
Postoperative anteroposterior (A) and lateral (B) plain X-ray show evenly distributed cement in vertebral body.
FIGURE 2.
Postoperative anteroposterior (A) and lateral (B) plain X-ray show partially augmented cement in vertebral body.
TABLE 1.
The demographics of the patients
| Number of cases (n) | |
|---|---|
| Sex | |
| Male | 060 |
| Female | 052 |
| Mean ages (years) | 76.0 (range 61–92) |
| Level of initial compression fracture | |
| Thoracolumbar (T12-L2) | 084 |
| Above T12 | 012 |
| Below L2 | 016 |
| Total | 112 |
TABLE 2.
The relation of factors and subsequent fractures after percutaneous vertebroplasty
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