Analysis of recurrent fracture of a new vertebral body after percutaneous vertebroplasty in patients with osteoporosis.
OBJECTIVE
To investigate the characteristics of recurrent fracture of a new vertebral body after percutaneous vertebroplasty in patients with osteoporosis.


METHODS
29 postmenopausal osteoporosis patients were divided into two groups: 14 patients with recurrent fracture of a new vertebral body after vertebroplasty comprised the new fracture group and there were 15 patients without recurrent fracture in the control group. The following variables were reviewed: age, body mass index (BMI), history of fractures, history of metabolic disease, anti-osteoporosis therapy, type of back brace used, bone mineral density (BMD) of the lumbar spine and hip, intact parathyroid hormone (iPTH), serum calcium and phosphorus, and time since vertebroplasty.


RESULTS
Compared with the control group, patients in the new fracture group were statistically significantly different with respect to BMI (t = 2.538, P = 0.027), BMD of the lumbar spine (t = 2.761, P = 0.015), BMD of the hip (t = 2.367, P = 0.037) and iPTH (t = 2.711, P = 0.017). Twelve (86%) of the 14 patients' new vertebral fractures occurred within six months after treatment of the initial fracture, and 10 (71%) fractures were adjacent to those previously treated by percutaneous vertebroplasty.


CONCLUSIONS
A substantial number of patients with osteoporosis develop new fractures after vertebroplasty; two-thirds of these new fractures occur in vertebrae adjacent to those previously treated. The following variables influence the outcome: BMI, history of fractures, history of metabolic diseases and medications, BMD of lumbar spine and hip, anti-osteoporosis therapy, and use of back brace.
The Center of Research for Metabolic Bone Disease and The Affiliated Drum Tower Hospital of Medical School, Nanjing University, Nanjing, China. lh2116@126.com
Hua
H
Lin
Li-hua
LH
Bao
Xiu-fen
XF
Zhu
Cheng
C
Qian
Xin
X
Chen
Zu-bin
ZB
Han
D000368:Aged; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D015663:Osteoporosis, Postmenopausal / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010281:Parathyroid Hormone / Q000097:blood; D011184:Postoperative Period; D011859:Radiography; D012008:Recurrence; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries; D054854:Vertebroplasty / Q000009:adverse effects / Q000379:methods*
D050071:Bone Density Conservation Agents; C470125:PTH protein, human; D010281:Parathyroid Hormone