The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty.
OBJECTIVE
To prospectively assess the incidence, location, and possible causative mechanisms of new vertebral compression fractures (VCFs) in 66 symptomatic patients with osteoporotic VCFs treated with percutaneous vertebroplasty (PV) and to study the relation between new VCFs and back pain symptoms.


METHODS
Sixty-six patients with 102 painful symptomatic VCFs were treated with PV. All patients had baseline total spinal magnetic resonance (MR) imaging. Follow-up MR imaging was performed at 3, 6, and 12 months to locate new VCFs. Visual analog scales for pain and pain medication consumption were used to assess clinical outcomes. The following characteristics were compared in patients with new VCFs after PV versus patients without new VCFs: patient age, sex, presence of secondary osteoporosis, bone mineral density, number of preexisting VCFs, shape and grade of VCFs, type of bone cement used for PV, volume of injected cement, and cement leakage in intervertebral disc spaces.


RESULTS
Sixteen of 66 patients had 26 new VCFs during 1 year of follow-up after PV. Most new VCFs occurred within 3 months of PV, half of new VCFs appeared in levels adjacent to treated levels, and half of the new VCFs were symptomatic. The presence of more than two preexisting VCFs was the only independent risk factor for the development of a new VCF.


CONCLUSIONS
New VCFs occurred after PV in 24% of patients. Half of new VCFs occurred in levels adjacent to treated levels and half were symptomatic. The presence of more than two preexisting VCFs was the only independent risk factor for the development of a new VCF.
Voormolen
Maurits H J
MH
Department of Radiology, Algemeen Ziekenhuis St Lucas, Gent, Belgium. mhjoorm@elisabeth.nl
Lohle
Paul N M
PN
Juttmann
Job R
JR
van der Graaf
Yolanda
Y
Fransen
Hendrik
H
Lampmann
Leo E H
LE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001416:Back Pain / Q000601:surgery; D001843:Bone Cements / Q000627:therapeutic use; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate