title: New vertebral compression fractures after prophylactic vertebroplasty in osteoporotic patients.
abstract: OBJECTIVE
  Previous studies have shown the possible efficacy of prophylactic cement injection for nonfractured vertebrae during percutaneous vertebroplasty for compression fractures. The purpose of this study was to investigate risk factors for subsequent fractures after prophylactic percutaneous vertebroplasty.
  
  
  METHODS
  This retrospective study included 116 patients with osteoporotic compression fractures who underwent prophylactic percutaneous vertebroplasty. The patients were monitored with physical examinations and radiographs at 1 day and at 3 and 12 months after percutaneous vertebroplasty, and if back pain recurred. We analyzed the following multiple covariates to determine whether they were associated with recurrence: age, sex, steroid use, and the preoperative number of unhealed or chronic compression fractures.
  
  
  RESULTS
  Subsequent fractures in any vertebra occurred within 3 months after the procedure at 26 vertebrae in 21 patients (18.1%), and 36 occurred in 28 patients (24.1%) within 12 months. The occurrence of subsequent fractures within 12 months depended on the preoperative number of unhealed vertebrae: the occurrence rate was 16.9% (11/65) for one vertebra, 27.0% (10/37) for two vertebrae, and 50.0% (7/14) for three or more vertebrae. The incidence of subsequent fractures was significantly higher in patients with three or more fractures than in those with one fracture (p < 0.05). There were no statistically significant differences for the other factors.
  
  
  CONCLUSIONS
  Patients with three or more fractures tended to have subsequent fractures, despite undergoing prophylactic percutaneous vertebroplasty. However, there was no increased risk of subsequent fractures related to prophylactic percutaneous vertebroplasty.
authors.affiliation: Department of Radiology, St Luke's International Hospital, Tokyo, Japan. kamano@med.kyushu-u.ac.jp
authors.forename: Hironori
authors.initials: H
authors.lastname: Kamano
authors.forename: Akio
authors.initials: A
authors.lastname: Hiwatashi
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Sokun
authors.initials: S
authors.lastname: Fuwa
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahashi
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Saida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Numaguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D050815:Fractures, Compression / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements