title: Recurrent fracture after vertebral kyphoplasty.
abstract: BACKGROUND
  Osteoporotic compression fractures cause great morbidity to the aging population. Various percutaneous methods have been developed to aid in treatment, including vertebral kyphoplasty. Biomechanical studies and recent published data relate concerns about adjacent fracture.
  
  
  OBJECTIVE
  This study investigated the incidence of recurrent fracture after the kyphoplasty procedure.
  
  
  METHODS
  Retrospective review of kyphoplasty procedures preformed by a single surgeon.
  
  
  METHODS
  A total of 109 procedures in 94 patients were reviewed.
  
  
  METHODS
  Patient medical records were reviewed as well as the radiology database at two major regional hospitals.
  
  
  METHODS
  Patient records were reviewed for fracture recurrence.
  
  
  RESULTS
  Confounding factors of age at procedure, sex, and chronic steroid use were also considered and found to have no statistically significant difference between those with fracture recurrence and those without fracture recurrence (p=.1979, p=.2058, p=.4684, respectively). Eleven kyphoplasty procedures resulted in a recurrent fracture after kyphoplasty within the first 90 days (34+/-19). After the first 90 days, five recurrent fractures occurred (459+/-101). The number of vertebral levels treated was found to be related to incidence of recurrent fracture with a p value of .0005 via chi-square testing. Patients who sustained a recurrent fracture tended to have a higher number of vertebral levels treated. There was no statistically significant difference between the survival time of kyphoplasty procedures that resulted in recurrent adjacent versus distant vertebral body fracture (survival time 112+/-145 vs. 237+/-268, p value .2362).
  
  
  CONCLUSIONS
  The incidence of recurrent fracture after kyphoplasty is substantial at 10% within the first 90 days. It is difficult to determine if this fracture rate is the result of surgical intervention or the natural history of the patient's osteoporosis.
authors.affiliation: Department of Orthopedic Surgery, Albany Medical College, 1367 Washington Ave., Albany, NY 12206, USA. lavellwf@yahoo.com
authors.forename: William F
authors.initials: WF
authors.lastname: Lavelle
authors.forename: Robert
authors.initials: R
authors.lastname: Cheney
mesh_terms: D000368:Aged; D019299:Decompression, Surgical; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009518:New York / Q000453:epidemiology; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology* / Q000601:surgery