title: Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To evaluate risk factors related to the development of new fractures in adjacent vertebrae after percutaneous vertebroplasty.
  
  
  BACKGROUND
  Recent reports indicate that undue numbers of new fractures in adjacent vertebral bodies occur after percutaneous vertebroplasty.
  
  
  METHODS
  One hundred four of 369 patients who underwent percutaneous vertebroplasty were followed for over 1 year. Fifty-four patients (51.9%) subsequently suffered from adjacent vertebral fractures. Age, lumbar lordotic angle, sacral slope, pelvic tilt, pelvic incidence, bone mineral density, amounts of cement injected, the restoration of vertebral height, kyphotic angle differences preexisting fracture, and intradiscal cement leakage were noted.
  
  
  RESULTS
  Average bone mineral density was -3.52 in the fracture group and -2.91 in the fracture-free group; the risk of adjacent vertebral fracture increased as bone mineral density decreased (p < 0.05). Intradiscal cement leakage occurred in 18 patients (33.3%) in the fracture group, indicating that the risk of adjacent vertebral fracture increased with intradiscal cement leakage. In addition, 36 patients (66.7%) in the fracture group had a pre-existing fracture; thus, the presence of a preexisting fracture was found to be significantly associated with an increased risk of an adjacent vertebral fracture (p < 0.05). Higher restoration rates are associated with a greater likelihood of developing adjacent vertebral fractures (p < 0.05).
  
  
  CONCLUSIONS
  The factors found to contribute significantly to new fractures in adjacent vertebral bodies after percutaneous vertebroplasty were a lower bone mineral density, a greater restoration rate of vertebral height, a pre-existing fracture, and intradiscal cement leakage.
authors: Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea.
authors: Myung-Ho
authors: MH
authors: Kim
authors: Andrew S
authors: AS
authors: Lee
authors: Sang-Hyuk
authors: SH
authors: Min
authors: Sung-Hyun
authors: SH
authors: Yoon