title: Patients with osteoporosis on steroid medication tend to sustain subsequent fractures.
abstract: OBJECTIVE
  Repeat fractures after percutaneous vertebroplasty can be seen in patients with osteoporotic compression fractures. The purpose of this study was to identify characteristics of patients with new fractures after vertebroplasty.
  
  
  METHODS
  Fifty-five consecutive patients were treated with vertebroplasty for painful osteoporotic compression fractures at our institution. The charts and radiographic studies of all patients were retrospectively reviewed. Special attention was paid to patient age and sex, imaging studies, long-term use of steroid medication, and treatment for osteoporosis. We used logistic regression analysis and the Fisher exact test for statistical evaluation.
  
  
  RESULTS
  Thirty-five patients were treated with vertebroplasty at one time and did not develop new fractures, whereas 20 patients returned with new fractures. Sixteen of 55 patients had been on steroid medication. The incidence of subsequent vertebral compression fractures after vertebroplasty in patients on long-term steroid therapy was 69% (11/16), compared with 23% (9/39) in those with primary osteoporosis (ie, those who were not on steroid therapy). There was a statistically significant association between use of steroids and new fractures (P<.01). No statistically significant difference was noted in patient age, sex, and medication for osteoporosis.
  
  
  CONCLUSIONS
  Patients who are on long-term steroid medication have an elevated risk of developing new fractures after vertebroplasty.
authors.affiliation: Division of Diagnostic and Interventional Neuroradiology, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA. hiwatasi@radiol.med.kyushu-u.ac.jp
authors.forename: A
authors.initials: A
authors.lastname: Hiwatashi
authors.forename: P L
authors.initials: PL
authors.lastname: Westesson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050815:Fractures, Compression / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008768:Methylmethacrylates / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000188:drug therapy; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology*; D013256:Steroids / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D008768:Methylmethacrylates; D013256:Steroids; C506662:vertebroplastic