Repeated and multiple new vertebral compression fractures after percutaneous transpedicular vertebroplasty.
METHODS
A retrospective study to detect patients with new-onset compression fractures following vertebroplasty.


OBJECTIVE
To investigate the characteristics and associated risk factors of new-onset vertebral compression fractures after vertebroplasty.


BACKGROUND
Percutaneous vertebroplasty is a well-established technique for treating osteoporotic compression fractures. Short-term results are promising, but longer-term studies have suggested a possible accelerated failure rate in the adjacent vertebral body. METHODS.: We retrospectively reviewed patients with osteoporotic compression fractures from January 2000 to June 2006. The patients received percutaneous vertebroplasty with bone cement augmentation. Long-term follow-up radiographically identified the occurrence of vertebral fracture (minimum follow-up 24 months) after an initial vertebral fracture.


RESULTS
In 852 patients (1131 vertebrae), 58.8% to 63.8% of new compression fractures after vertebroplasty were adjacent compression fractures. Adjacent fractures occurred much sooner than nonadjacent fractures; (71.9 +/- 71.8 days vs. 286.8 +/- 232.8 days, P < 0.001). In patients who experienced vertebral compression fractures 2 or more times, older age, lower baseline bone mineral density (BMD), and more pre-existing vertebral compression fractures were demonstrated in this study (P < 0.005). The gender and amount of cemented polymethyl methacrylate were not statistically different between Groups A (1 vertebral compression fracture) and B (vertebral compression fracture > or =2 times).


CONCLUSIONS
New-onset vertebral compression fractures occurred repeatedly within a few years after vertebroplasty. New-onset adjacent-level fractures occurred sooner and were more predominate than nonadjacent level fractures. The results of this study suggest that older patient age, lower baseline BMD, and more pre-existing vertebral fractures were found to be risk factors for multiple vertebral compression fractures.
Tseng
Yuan-Yun
YY
Department of Neurosurgery, Shuang Ho Hospital Taipei, Taipei Medical University, No. 291 Jhongjheng Rd., Jhonghe City, Taipei 235, Taiwan.
Yang
Tao-Chieh
TC
Tu
Po-Hsun
PH
Lo
Yang-Lan
YL
Yang
Shun-Tai
ST
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D050815:Fractures, Compression / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D008297:Male; D010024:Osteoporosis / Q000150:complications; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000175:diagnosis* / Q000209:etiology; D013997:Time Factors; D054854:Vertebroplasty / Q000379:methods*