title: Role of physical activity in new onset fractures after percutaneous vertebroplasty.
abstract: BACKGROUND
  Increased mobility and physical activity after successful vertebral augmentation procedure might increase the risk of new-onset fractures.
  
  
  OBJECTIVE
  To determine whether new-onset fracture following vertebroplasty is associated with specific type of physical activity.
  
  
  METHODS
  A total of 107 patients underwent at least two procedures of percutaneous vertebroplasty. Among them, 30 patients who sustained a post-vertebroplasty fracture(s), were stratified by fracture-causing activity and examined the incidence of the initial and post-vertebroplasty fractures, time to post-vertebroplasty fractures, duration of anti-osteoporotic therapy, T-score, and body mass index.
  
  
  RESULTS
  The following percentages correspond to patients with fractures sustained pre- and post-vertebroplasty, respectively; spontaneous fractures in 17% and 7% (P = 0.20), sitting in 7% and 3% (P = 0.50), walking or standing in 7% and 20% (P = 0.10), housework in 3% and 3% (P > 0.99), coughing or sneezing in 0% and 20% (P = 0.003), exercise in 7% and 17% (P = 0.20), lifting in 10% and 17% (P = 0.40) and falling in 50% and 13% (P = 0.002). Different levels of activity were not significantly associated with time to incidence of post-vertebroplasty fractures. Anti-osteoporotic medications were administered to 33% of patients before vertebroplasty and 37% after the vertebroplasty (P = 0.78); medications were administered to these groups for 16 and 25 months, respectively (P = 0.39).
  
  
  CONCLUSIONS
  A significantly elevated risk of new onset fracture with increased physical activity was not identified. However, patients should be carefully counseled after vertebroplasty to optimize medical therapy for osteoporosis and also to use extreme care when engaging in even moderate physical activity.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA. arashehteshami@yahoo.com
authors.forename: Arash Ehteshami
authors.initials: AE
authors.lastname: Rad
authors.forename: Leigh A
authors.initials: LA
authors.lastname: Gray
authors.forename: Mehrsheed
authors.initials: M
authors.lastname: Sinaki
authors.forename: David F
authors.initials: DF
authors.lastname: Kallmes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001843:Bone Cements / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010024:Osteoporosis / Q000188:drug therapy; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology*; D013997:Time Factors; D054854:Vertebroplasty
chemical_list: D001843:Bone Cements