Prophylactic vertebroplasty: cement injection into non-fractured vertebral bodies during percutaneous vertebroplasty.
OBJECTIVE
We investigated the efficacy of prophylactic cement injection into the vertebral body adjacent to fractured vertebra to prevent new fractures after percutaneous vertebroplasty (PV).


METHODS
Between February 2002 to August 2004, PV was performed for osteoporotic compression fractures in 89 consecutive patients. All patients underwent PV for only fractured vertebrae. Between September 2004 and October 2006, we performed prophylactic cement injection for 155 patients, with cement injected into the non-fractured vertebra adjacent to the fractured vertebra, immediately above the fractured vertebra in the same procedure. We evaluated the frequency of new vertebral fractures and the efficacy of prophylactic therapy.


RESULTS
In the non-prophylactic group, 15 of 89 patients (16.8%) developed new fractures within 3 months and 20 of 89 patients (22.4%) developed new painful compression fractures within a year after the first PV. These fractures occurred mostly in adjacent vertebra, particularly in the vertebra immediately superior to the treated one and occurred in the lower thoracic and upper lumbar spine. In the prophylactic group, 7 of 155 patients (4.5%) developed new compression fractures within 3 months and 15 of 155 patients (9.7%) developed new compression fractures within 1 year. Statistical analysis showed that fewer new fractures developed in the prophylactic group than in the non-prophylactic group at both 3 months (P = .0020, Fisher's exact test) and 1 year (P = .0079).


CONCLUSIONS
Prophylactic cement injection into non-fractured vertebrae adjacent to fractured vertebrae may prevent new compression fractures after vertebroplasty for osteoporotic patients.
Kobayashi
Nobuo
N
Department of Radiology, St Luke's International Hospital, Tokyo, Japan. nobkob@luke.or.jp
Numaguchi
Yuji
Y
Fuwa
Sokun
S
Uemura
Akihiro
A
Matsusako
Masaki
M
Okajima
Yuka
Y
Ishiyama
Mitsutomi
M
Takahashi
Osamu
O
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000517:prevention & control* / Q000601:surgery*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*; D055815:Young Adult
D001843:Bone Cements