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European Spine Journal

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01-04-2015 | Original Article

Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty

Authors: Hai-long Ren, Jian-ming Jiang, Jian-ting Chen, Ji-xing Wang

Published in: European Spine Journal | Issue 4/2015

Abstract

Purpose

This study evaluated the risk factors of new vertebral compression fractures (VCFs) following percutaneous vertebroplasty (PVP).

Methods

From June 2005 to January 2011, patients with osteoporotic VCFs (OVCFs) who were treated with PVP and met this study’s inclusion criteria were retrospectively reviewed. Observed parameters were age, sex, bone mineral density, body mass index, amount of bone cement, cement leakage into the disk, preoperative kyphosis, preoperative degree of anterior vertebral compression, preoperative degree of middle vertebral compression, kyphosis correction, anterior vertebral height restoration, middle vertebral height restoration, and number of initial symptomatic fractures (levels treated). The data were analyzed by univariate and multivariate analysis for the emergence of new fractures after PVP to determine related risk factors.

Results

A total of 182 patients met the inclusion criteria. There were 155 female and 27 male patients with a mean age of 69.7 years (range 49–91 years). The follow-up period was 24–50 months (average 26.4 months). A total of 294 VCFs among 182 patients were observed, 28 new VCFs occurred in 21 patients (21/182, 11.5 %) during the follow-up period. Statistical analysis indicated that higher BMI (P = 0.004) and a greater number of initial symptomatic fractures (P = 0.017) were significantly associated with new VCFs after PVP. It is the most obvious that the risk of new fractures increased 2.518-fold (95 % CI 1.176–5.395), when the number of initial VCFs increased by one level.

Conclusions

The incidence of new symptomatic VCFs after PVP was higher in osteoporotic patients with initial multiple-level fractures.

Lo YP, Chen WJ, Chen LH et al (2008) New vertebral fracture after vertebroplasty. J Trauma 65:1439–1445CrossRefPubMed

Lee WS, Sung KH, Jeong HT et al (2006) Risk factors of developing new symptomatic vertebral compression fractures after percutaneous vertebroplasty in osteoporotic patients. Eur Spine J 15:1777–1783CrossRefPubMed

Klazen CA, Venmans A, de Vries J et al (2010) Percutaneous vertebroplasty is not a risk factor for new osteoporotic compression fractures:results from VERTOS II. Am J Neuroradiol 31:1447–1450CrossRefPubMed

Chosa K, Naito A, Awai K (2011) Newly developed compression fractures after percutaneous vertebroplasty: comparison with conservative treatment. Jpn J Radiol 29:335–341CrossRefPubMed

Tanigawa N, Kariya S, Komemushi A et al (2011) Percutaneous vertebroplasty for osteoporotic compression fractures:long-term evaluation of the technical and clinical outcomes. Am J Roentgenol 196:1415–1418CrossRef

Voormolen MH, Lohle PN, Juttmann JR et al (2006) The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty. J Vasc Interv Radiol 17:71–76CrossRefPubMed

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

Lin WC, Cheng TT, Lee YC et al (2008) New vertebral osteoporotic compression fractures after percutaneous vertebroplasty: retrospective analysis of risk factors. J Vasc Interv Radiol 19:225–231CrossRefPubMed

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

10.

Tseng YY, Yang TC, Tu PH et al (2009) Repeated and multiple new vertebral compression fractures after percutaneous transpedicular vertebroplasty. Spine (Phila Pa 1976) 34:1917–1922CrossRef

11.

Uppin AA, Hirsch JA, Centenera LV et al (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226:119–124CrossRefPubMed

12.

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

13.

Fahim DK, Sun K, Tawackoli W et al (2011) Premature adjacent vertebral fracture after vertebroplasty:a biomechanical study. Neurosurgery 69:733–744CrossRefPubMed

14.

Molloy S, Riley LH 3rd, Belkoff SM (2005) Effect of cement volume and placement on mechanical-property restoration resulting from vertebroplasty. Am J Neuroradiol 26:401–404PubMed

15.

Mudano AS, Bian J, Cope JU et al (2009) Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population -based cohort study. Osteoporos Int 20:819–826CrossRefPubMedCentralPubMed

16.

Molloy S, Mathis JM, Belkoff SM (2003) The effect of vertebral body percentage fill on mechanical behavior during percutaneous vertebroplasty. Spine (Phila Pa 1976) 28:1549–1554

17.

Cyteval C, Thomas E, Solignac D et al (2008) Prospective evaluation of fracture risk in osteoporotic patients after low cement volume vertebroplasty. J Radiol 89:797–801CrossRefPubMed

18.

Boger A, Heini P, Windolf M et al (2007) Adjacent vertebral failure after vertebroplasty: a biomechanical study of low-modulus PMMA cement. Eur Spine J 16:2118–2125CrossRefPubMedCentralPubMed

19.

Al-Ali F, Barrow T, Luke K (2009) Vertebroplasty: what is important and what is not. Am J Neuroradiol 30:1835–1839CrossRefPubMed

20.

Komemushi A, Tanigawa N, Kariya S et al (2006) Percutaneous vertebroplasty for osteoporotic compression fracture:multivariate study of predictors of new vertebral body fracture. Cardiovasc Intervent Radiol 29:580–585CrossRefPubMed

21.

Lin EP, Ekholm S, te Hiwatashi A et al (2004) Vertebroplasty: cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. Am J Neuroradiol 25:175–180PubMed

22.

Chen WJ, Kao YH, Yang SC et al (2010) Impact of cement leakage into disks on the development of adjacent vertebral compression fractures. J Spinal Disord Tech 23:35–39CrossRefPubMed

23.

Rho YJ, Choe WJ, Chun YI (2012) Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J 21:905–911CrossRefPubMedCentralPubMed

24.

Lee KA, Hong SJ, Lee S et al (2011) Analysis of adjacent fracture after percutaneous vertebroplasty: does intradiscal cement leakage really increase the risk of adjacent vertebral fracture. Skeletal Radiol 40:1537–1542CrossRefPubMed

25.

Kim SH, Kang HS, Choi JA et al (2004) Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty. Acta Radiol 45:440–445CrossRefPubMed

26.

Movrin I, Vengust R, Komadina R (2010) Adjacent vertebral fractures after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a comparison of balloon kyphoplasty and vertebroplasty. Arch Orthop Trauma Surg 130:1157–1166CrossRefPubMed

27.

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

28.

Lunt M, O’Neill TW, Felsenberg D et al (2003) European Prospective Osteoporosis Study Group Characteristics of a prevalent vertebral deformity predict subsequent vertebral fracture: results from the European Prospective Osteoporosis Study (EPOS). Bone 33:505–513CrossRefPubMed

29.

Delmas PD, Genant HK, Crans GG et al (2003) Severity of prevalent vertebral fractures and the risk of subsequent vertebral and nonvertebral fractures: results from the MORE trial. Bone 33:522–532CrossRefPubMed

30.

Lu K, Liang CL, Hsieh CH et al (2012) Risk factors of subsequent vertebral compression fractures after vertebroplasty. Pain Med 13:376–382CrossRefPubMed

31.

Li YA, Lin CL, Chang MC et al (2012) Subsequent vertebral fracture after vertebroplasty: incidence and analysis of risk factors. Spine (Phila Pa 1976) 37:179–183CrossRef

32.

Thomas T, Barou O, Vico L et al (1999) Recurrence of vertebral fracture with cyclical etidronate therapy in osteoporosis: histomorphometry and X-Ray microanalysis evaluation. J Bone Miner Res 14:198–205CrossRefPubMed

33.

Zhang Z, Fan J, Ding Q et al (2013) Risk factors for new osteoporotic vertebral compression fractures after vertebroplasty a systematic review and meta-analysis. J Spinal Disord Tech 26:E150–E157CrossRefPubMed

34.

Ahn Y, Lee JH, Lee HY et al (2008) Predictive factors for subsequent vertebral fracture after percutaneous vertebroplasty. J Neurosurg Spine 9:129–136CrossRefPubMed

35.

Tanaka S, Kuroda T, Saito M et al (2013) Overweight/obesity and underweight are both risk factors for osteoporotic fractures at different sites in Japanese postmenopausal women. Osteoporos Int 24:69–76CrossRefPubMed

Title: Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty
Authors: Hai-long Ren
Jian-ming Jiang
Jian-ting Chen
Ji-xing Wang
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 4/2015
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-3786-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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