title: Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty.
abstract: BACKGROUND
  Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are effective procedures to alleviate pain caused by osteoporotic vertebral compression fractures (VCFs). New vertebral compression fracture (NVCF) has been noted as a potential late sequela of the procedures. The incidence of NVCFs and affecting risk factors were investigated.
  
  
  METHODS
  The authors retrospectively analyzed the occurrence of NVCFs in 147 patients treated with PVP or PKP for osteoporotic VCFs. Possible risk factors, such as age, gender, body mass index, bone mineral density (BMD), location of treated vertebra, treatment modality, amount of bone cement injected, anterior-posterior ratio of the fractured vertebra, cement leakage into the disc space, and pattern of cement distribution, were assessed.
  
  
  RESULTS
  Twenty-seven patients (18.4%) had subsequent symptomatic NVCFs with a median time to new fracture was of 70 days. The 1-year symptomatic fracture-free rate was 85.0% by the Kaplan-Meier estimate. Eighteen (66.7%) of the 27 patients had an NVCF on the adjacent vertebra. Significant differences (P < 0.05) were found between the NVCF and control groups in regard to age, treatment modality, BMD, and the proportion of cement leakage into the disc space. Discal cement leakage and low BMD affected on adjacent NVCFs.
  
  
  CONCLUSIONS
  The most important risk factors affecting NVCFs were osteoporosis and intervertebral discal cement leakage.
authors.affiliation: Department of Neurosurgery, Konkuk University School of Medicine, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea.
authors.forename: Young-Joon
authors.initials: YJ
authors.lastname: Rho
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Choe
authors.forename: Young Il
authors.initials: YI
authors.lastname: Chun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000453:epidemiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D058498:Kyphoplasty / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013124:Spinal Injuries / Q000453:epidemiology*; D013131:Spine / Q000000981:diagnostic imaging; D054854:Vertebroplasty / Q000009:adverse effects*
chemical_list: D001843:Bone Cements