Recollapse of previous vertebral compression fracture after percutaneous vertebroplasty.
This study was undertaken to investigate the incidence rate, characteristics, and predisposing factors associated with recollapse of the same vertebrae after percutaneous vertebroplasty (PVP). Recollapse of the same vertebra after PVP is the one of the complications of the procedure, and the incidence rate in our study was 3.21%. The most important predisposing factor was pre-operative osteonecrosis. Recollapse was not related to trauma.


BACKGROUND
PVP using polymethylmethacrylate has become a popular treatment for osteoporotic vertebral compression fracture. Recollapse of the same vertebrae after PVP has rarely been reported. This study was undertaken to investigate the incidence, characteristics, and predisposing factors associated with recollapse of the same vertebrae after PVP.


METHODS
Eleven patients (seven females and four males; mean age, 69.91 +/- 5.49 years), out of a total of 343 patients, developed recollapse of the same vertebra after PVP. The 11 patients who developed recollapse comprised the "recollapse group", while the remaining 332 patients comprised the "well-maintained group".


RESULTS
Pre-operative magnetic resonance imaging revealed that the incidence of osteonecrosis was significantly higher in the recollapse group than the well-maintained group (p < 0.05). The degree of re-expansion of the compressed vertebral body after PVP was significantly higher in the recollapse group than in the well-maintained group (p < 0.05).


CONCLUSIONS
The most important predisposing factor for recollapse was pre-operative osteonecrosis. Recollapse was not related to trauma. Osteoporotic vertebral compression fracture with osteonecrosis or pseudoarthrosis has been regarded as a relative indication for PVP; however, the findings of this study suggest that this disease category may be a relative contraindication for PVP.
Heo
D H
DH
Department of Neurosurgery, Spine and Spinal Cord Institute, Yongdong Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea.
Chin
D K
DK
Yoon
Y S
YS
Kuh
S U
SU
D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000150:complications*; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D013131:Spine / Q000601:surgery; D017211:Treatment Failure; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods
D001843:Bone Cements; D019904:Polymethyl Methacrylate