Repeated and Multiple New Vertebral Compression Fractures After Percutaneous Transpedicular Vertebroplasty

• Published in: Spine (Philadelphia, Pa. 1976) Pa. 1976), 2009-08, Vol.34 (18), p.1917-1922
• Main Authors: TSENG, Yuan-Yun, YANG, Tao-Chieh, TU, Po-Hsun, LO, Yang-Lan, YANG, Shun-Tai
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Bone Density; Cerebrospinal fluid. Meninges. Spinal cord; Female; Fractures, Compression - diagnosis; Fractures, Compression - etiology; Humans; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - metabolism; Lumbar Vertebrae - pathology; Male; Medical sciences; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system (semeiology, syndromes); Neurology; Osteoporosis - complications; Radiography; Retrospective Studies; Risk Factors; Spinal Fractures - diagnosis; Spinal Fractures - etiology; Time Factors; Vertebroplasty - methods
• ISSN: 0362-2436; 1528-1159
• DOI: 10.1097/brs.0b013e3181ac8f07

A retrospective study to detect patients with new-onset compression fractures following vertebroplasty. To investigate the characteristics and associated risk factors of new-onset vertebral compression fractures after vertebroplasty. Percutaneous vertebroplasty is a well-established technique for treating osteoporotic compression fractures. Short-term results are promising, but longer-term studies have suggested a possible accelerated failure rate in the adjacent vertebral body. METHODS.: We retrospectively reviewed patients with osteoporotic compression fractures from January 2000 to June 2006. The patients received percutaneous vertebroplasty with bone cement augmentation. Long-term follow-up radiographically identified the occurrence of vertebral fracture (minimum follow-up 24 months) after an initial vertebral fracture. In 852 patients (1131 vertebrae), 58.8% to 63.8% of new compression fractures after vertebroplasty were adjacent compression fractures. Adjacent fractures occurred much sooner than nonadjacent fractures; (71.9 +/- 71.8 days vs. 286.8 +/- 232.8 days, P < 0.001). In patients who experienced vertebral compression fractures 2 or more times, older age, lower baseline bone mineral density (BMD), and more pre-existing vertebral compression fractures were demonstrated in this study (P < 0.005). The gender and amount of cemented polymethyl methacrylate were not statistically different between Groups A (1 vertebral compression fracture) and B (vertebral compression fracture > or =2 times). New-onset vertebral compression fractures occurred repeatedly within a few years after vertebroplasty. New-onset adjacent-level fractures occurred sooner and were more predominate than nonadjacent level fractures. The results of this study suggest that older patient age, lower baseline BMD, and more pre-existing vertebral fractures were found to be risk factors for multiple vertebral compression fractures.