Risk factors of subsequent vertebral compression fractures after vertebroplasty.
OBJECTIVE
To elucidate the risk factors for a subsequent vertebral compression fracture following percutaneous vertebroplasty, we analyzed the potential predictors of vertebral compression fractures adjacent to or remote from fractures previously treated with percutaneous vertebroplasty.


METHODS
This is a retrospective cohort study.


BACKGROUND
A major concern after percutaneous vertebroplasty in patients with osteoporosis is the occurrence of subsequent vertebral compression fractures in the untreated vertebral bodies. The risk factors for the development of subsequent vertebral compression fractures after percutaneous vertebroplasty are unclear.


METHODS
Two hundred four consecutive patients underwent percutaneous vertebroplasty for acute vertebral compression fractures between January 2007 and December 2008. Forty-nine patients were excluded. Subsequent vertebral compression fractures were diagnosed by bone edema changes on magnetic resonance imaging. Patient's demographic data were used for univariate and multivariable binary logistic regression analyses.


RESULTS
Forty-three (27.7%) of the 155 patients had subsequent vertebral compression fractures within 2 years of percutaneous vertebroplasty, with 21 (48.8%) of these patients having fractures detected within 3 months. Adjacent vertebral compression fractures tended to occur sooner, although not significantly (log-rank test, P = 0.112). On multivariate analyses, only the T-score of bone mineral density was significantly associated with subsequent vertebral compression fractures (P < 0.0001; odds ratio = 0.27; 95% confidence interval, 0.15-0.49).


CONCLUSIONS
The only risk factor significantly associated with subsequent vertebral compression fractures following percutaneous vertebroplasty was a low bone mineral density T-score. Patients with lower bone mineral density have a higher incidence of vertebral compression fractures and thus need more intensive clinical and radiological follow-up.
Department of Neurosurgery, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Kang
K
Lu
Cheng-Loong
CL
Liang
Ching-Hua
CH
Hsieh
Yu-Duan
YD
Tsai
Han-Jung
HJ
Chen
Po-Chou
PC
Liliang
D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications; D015331:Cohort Studies; D005260:Female; D050815:Fractures, Compression / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D054854:Vertebroplasty