The Effect of Trauma in Osteoporotic Vertebral Compression Fractures Treated by Percutaneous Vertebroplasty: A Comparison of Radiological Features in Presence or Absence of Trauma

Dong Hyuk Nam; Kwan Ho Park; Tae Wan Kim; Moon Pyo Chi; Jae O Kim

doi:10.13004/jknts.2011.7.1.29

Journal List > J Korean Neurotraumatol Soc > v.7(1) > 1084093

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Nam, Park, Kim, Chi, and Kim: The Effect of Trauma in Osteoporotic Vertebral Compression Fractures Treated by Percutaneous Vertebroplasty: A Comparison of Radiological Features in Presence or Absence of Trauma

Clinical Article

Journal of Korean Neurotraumatology Society 2011; 7(1): 29-34.

Published online: 30 April 2011

DOI: https://doi.org/10.13004/jknts.2011.7.1.29

The Effect of Trauma in Osteoporotic Vertebral Compression Fractures Treated by Percutaneous Vertebroplasty: A Comparison of Radiological Features in Presence or Absence of Trauma

Dong Hyuk Nam, MD, Kwan Ho Park, MD, Tae Wan Kim, MD, Moon Pyo Chi, MD, Jae O Kim, MD

Department of Neurosurgery, Seoul Veterans Hospital, Seoul, Korea.

Address for correspondence: Kwan Ho Park, MD. Department of Neurosurgery, Seoul Veterans Hospital, 27 Iljasan-gil, Gangdong-gu, Seoul 134-791, Korea. Tel: +82-2-2225-1363, Fax: +82-2-2225-1366, spineho@naver.com

Received 15 March 2011 Revised 17 March 2011 Accepted 20 April 2011

Abstract

Objective

The purpose of this study is to evaluate the effect of trauma in osteoporotic vertebral compression fractures (OVCFs) treated by percutaneous vertebroplasty (PVP). We compare radiographic features of OVCFs with trauma to those without trauma.

Methods

The medical records and radiographic findings of 111 consecutive patients treated with PVP between January 2008 and June 2009 were retrospectively reviewed. A total of 111 patients with 122 painful vertebral fractures was identified based on clinical and radiological findings. The patients were divided into two groups according to the cause of the OVCFs. Group A contained 81 patients with a history of trauma. They included slip, sprain, and fall. 30 patients with no history of trauma were categorized into group B. Differences in radiographic features and occurrence rates of new compression fractures were examined and compared for both groups. The following factors were analyzed on radiographs, dual bone densitometry, CT, and MRI: pre-existing vertebral compression fracture (VCF), bone mineral density (BMD), anatomical location of the vertebral fracture, type and grading of fracture, intravertebral cleft (IVC), and new VCF.

Results

There were 111 patients, with a mean age of 74.6 years (range, 65-86 years). Group A showed 81 patients with a mean age of 74.8±6.2 and 30 patients with a mean age of 73.8±6.4 in group B. In group A, body mass index (BMI) was 22.4±3.9 and 22.5±6.5 in group B. There were no significance differences in age, gender, and BMI. Mean follow-up period was 12 months (range, 3-24 months). The most common location of fractured vertebrae is thoracolumbar levels (T11-L2) in both groups. Mild deformity and wedged fractures are most common in both groups. Pre-existing VCF, BMD, anatomical location of the vertebral fracture, type and grading of fracture, IVC, and amount of cement injected have no statistically significant difference between group A and group B. In group A, the new VCF occurred in 17 patients (20.0%) and 8 (26.7%) in group B. The radiographic features of OVCF and occurrence rate of new VCF have no significant difference in both groups.

Conclusion

The etiology of OVCF is multifactorial. This condition may be caused by mainly osteoporosis and trauma. There is no great difference between the two groups in radiographic features of OVCF. The history of trauma is not aggravating the situation and progress of OVCF.

Keywords: Osteoporotic vertebral compression fracture, Trauma, Percutaneous vertebroplasty, New compression fracture

Figures and Tables

TABLE 1

Demographics of the both study groups

T: thoracic, L: lumbar, No: number, BMD: bone mineral density, PMMA: polymethylmetacrylate, VCF: vertebral compression fracture

Notes

The authors have no financial conflicts of interest.

References

1. Ahn Y, Lee JH, Lee HY, Lee SH, Keem SH. Predictive factors for subsequent vertebral fracture after percutaneous vertebroplasty. J Neurosurg Spine. 2008; 9:129–136.

2. Ananthakrishnan D, Berven S, Deviren V, Cheng K, Lotz JC, Xu Z, et al. The effect on anterior column loading due to different vertebral augmentation techniques. Clin Biomech (Bristol, Avon). 2005; 20:25–31.

3. Barr JD, Barr MS, Lemley TJ, McCann RM. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976). 2000; 25:923–928.

4. Berlemann U, Ferguson SJ, Nolte LP, Heini PF. Adjacent vertebral failure after vertebroplasty. A biomechanical investigation. J Bone Joint Surg Br. 2002; 84:748–752.

5. Briggs AM, Greig AM, Wark JD. The vertebral fracture cascade in osteoporosis: a review of aetiopathogenesis. Osteoporos Int. 2007; 18:575–584.

6. Genant HK, Wu CY, van Kuijk C, Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993; 8:1137–1148.

7. Hodler J, Peck D, Gilula LA. Midterm outcome after vertebroplasty: predictive value of technical and patient-related factors. Radiology. 2003; 227:662–668.

8. Kaufmann TJ, Trout AT, Kallmes DF. The effects of cement volume on clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2006; 27:1933–1937.

9. Kim SH, Kang HS, Choi JA, Ahn JM. Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty. Acta Radiol. 2004; 45:440–445.

10. Lane JI, Maus TP, Wald JT, Thielen KR, Bobra S, Luetmer PH. Intravertebral clefts opacified during vertebroplasty: pathogenesis, technical implications, and prognostic significance. AJNR Am J Neuroradiol. 2002; 23:1642–1646.

11. Lin EP, Ekholm S, Hiwatashi A, Westesson PL. Vertebroplasty: cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR Am J Neuroradiol. 2004; 25:175–180.

12. Lindsay R, Burge RT, Strauss DM. One year outcomes and costs following a vertebral fracture. Osteoporos Int. 2005; 16:78–85.

13. Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001; 285:320–323.

14. Lunt M, O'Neill TW, Felsenberg D, Reeve J, Kanis JA, Cooper C, et al. Characteristics of a prevalent vertebral deformity predict subsequent vertebral fracture: results from the European Prospective Osteoporosis Study (EPOS). Bone. 2003; 33:505–513.

15. Maldague BE, Noel HM, Malghem JJ. The intravertebral vacuum cleft: a sign of ischemic vertebral collapse. Radiology. 1978; 129:23–29.

16. Ross PD, Davis JW, Epstein RS, Wasnich RD. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med. 1991; 114:919–923.

17. Ross PD, Genant HK, Davis JW, Miller PD, Wasnich RD. Predicting vertebral fracture incidence from prevalent fractures and bone density among non-black, osteoporotic women. Osteoporos Int. 1993; 3:120–126.

18. Shiraki M, Ito H, Fujimaki H, Higuchi T. Relation between body size and bone mineral density with special reference to sex hormones and calcium regulating hormones in elderly females. Endocrinol Jpn. 1991; 38:343–349.

19. Trout AT, Kallmes DF, Kaufmann TJ. New fractures after vertebroplasty: adjacent fractures occur significantly sooner. AJNR Am J Neuroradiol. 2006; 27:217–223.

20. Wang HK, Lu K, Liang CL, Weng HC, Wang KW, Tsai YD, et al. Comparing clinical outcomes following percutaneous vertebroplasty with conservative therapy for acute osteoporotic vertebral compression fractures. Pain Med. 2010; 11:1659–1665.

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