The incidence of new vertebral compression fractures in women after kyphoplasty and factors involved.
OBJECTIVE
To identify the incidence of new vertebral compression fractures in women after kyphoplasty and to analyze influential factors in these patients.


METHODS
One hundred and eleven consecutive female patients with osteoporotic vertebral compression fractures (VCFs) underwent kyphoplasty at 137 levels. These patients were followed for 15.2 months postoperatively. For the survey of new vertebral compression fractures, medical records and x-rays were reviewed, and telephone interviews were conducted with all patients.


RESULTS
During that time 20 (18%) patients developed new VCFs. The rate of occurrence of new VCFs in one year was 15.5% using a Kaplan-Meier curve. Body mass index (BMI), symptom duration and kyphoplasty level were the statistically significant factors between the patient groups both with and without new VCFs after kyphoplasty. In the comparison between the adjacent and remote new VCF groups, the adjacent new VCF group showed a larger amount of polymethyl methacrylate (PMMA) use during kyphoplasty (p<0.05). Before kyphoplasty, 9.9% of the patients had been prescribed medication for osteoporosis, and 93.7% of the patients started or continued medication after kyphoplasty. The development of new VCFs was affected by the number of vertebrae involved in the kyphoplasty. However, the lower incidence rate (15.5%) of new compression fractures might be due to a greater percentage (93.7% in our study) of patients taking anti-osteoporotic medication before and/or after kyphoplasty.


CONCLUSIONS
When kyphoplasty is planned for the management of patients with osteoporotic VCFs, the application of a small amount of PMMA can be considered in order to lower the risk of new fractures in adjacent vertebrae. The postoperative use of anti- osteoporotic medication is recommended for the prevention of new VCFs.
Moon
Eun-Su
ES
Department of Orthopedic Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92 Dogok-dong, Kangnam-gu, Seoul 135-720, Korea.
Kim
Hak-Sun
HS
Park
Jin-Oh
JO
Moon
Seong-Hwan
SH
Lee
Hwan-Mo
HM
Shin
Dong-Eun
DE
Ha
Jung-Won
JW
Ahn
Eun-Kyoung
EK
Shim
Dong-Jun
DJ
Chung
Jun-Young
JY
D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019637:Orthopedic Procedures; D011183:Postoperative Complications; D012008:Recurrence; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome
D001843:Bone Cements