The risk of stroke after percutaneous vertebroplasty for osteoporosis: a population-based cohort study.
OBJECTIVE
To investigate the incidence and risk of stroke after percutaneous vertebroplasty in patients with osteoporosis.


METHODS
A group of 334 patients with osteoporosis, and who underwent percutaneous vertebroplasty during the study period, was compared to 1,655 age-, sex- and propensity score-matched patients who did not undergo vertebroplasty. All demographic covariates and co-morbidities were deliberately matched between the two groups to avoid selection bias. Every subject was followed-up for up to five years for stroke. Adjustments using a Cox regression model and Kaplan-Meier analyses were conducted.


RESULTS
A total of 1,989 osteoporotic patients were followed up for 3,760.13 person-years. Overall, the incidence rates of any stroke, hemorrhagic stroke and ischemic stroke were 22.6, 4.2 and 19.6 per 1,000 person-years, respectively. Patients who underwent vertebroplasty were not more likely to have any stroke (crude hazard ratio = 1.13, p = 0.693), hemorrhagic stroke (HR = 2.21, p = 0.170), or ischemic stroke (HR = 0.96, p = 0.90). After adjusting for demographics, co-morbidities and medications, the vertebroplasty group had no significant difference with the comparison group in terms of any, hemorrhagic and ischemic strokes (adjusted HR = 1.22, 3.17, and 0.96, p = 0.518, 0.055, and 0.91, respectively).


CONCLUSIONS
Osteoporotic patients who undergo percutaneous vertebroplasty are not at higher risk of any stroke in the next five years after the procedure.
Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Ching-Lan
CL
Wu
Jau-Ching
JC
Wu
Wen-Cheng
WC
Huang
Hung-Ta H
HT
Wu
Hong-Jen
HJ
Chiou
Laura
L
Liu
Yu-Chun
YC
Chen
Tzeng-Ji
TJ
Chen
Henrich
H
Cheng
Cheng-Yen
CY
Chang
D000368:Aged; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology* / Q000601:surgery*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D013624:Taiwan / Q000453:epidemiology; D054854:Vertebroplasty / Q000009:adverse effects*