title: The retrospective analysis of the effect of balloon kyphoplasty to the adjacent-segment fracture in 171 patients.
abstract: METHODS
  Analysis of the adjacent-segment fractures in 171 balloon kyphoplasty (BK)-performed patients.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the risk factors for new symptomatic vertebral compression fractures (VCF) after BK.
  
  
  BACKGROUND
  Although there are many studies about the incidence and possible risk factors for occurrence of adjacent-level fractures, there is no consensus on the increased risk of adjacent-level fractures after BK.
  
  
  METHODS
  We performed a retrospective analysis of 171 patients treated with percutaneous kyphoplasty. The follow-up period was 41.04±21.78 months. The occurrence of new symptomatic VCF was recorded after the procedure. We evaluated the variables of patient age and sex, the amount of injected cement, the initial kyphotic angle (KA) of VCF, the change of the KA after BK, the severity of osteoporosis, and the percentage of height restoration of the vertebral body. Furthermore, possible risk factors were reported for new symptomatic VCFs.
  
  
  RESULTS
  The only 2 factors identified as being significantly associated with adjacent-level fractures were the sex (P=0.001) of the patient and the preoperative KA (P=0.013). The patients with new symptomatic compression fracture had higher initial KA than those without fractures. The female group had higher risk than the male group in occurrence of the new vertebra fractures. The severity of the osteoporosis (low bone mineral density) was not a determinant in occurrence of the new VCF after BK.
  
  
  CONCLUSIONS
  If the patients experience severe or mild back pain with higher preoperative KA, especially in the first 2 months, then they deserve detailed radiologic examination. To avoid subsequent fracture in the same or adjacent level, vertebral body should be filled adequately and sagittal balance should be obtained with KA correction. BK alone did not influence the incidence of subsequent VCF.
authors.forename: Erdinc
authors.initials: E
authors.lastname: Civelek
authors.forename: Tufan
authors.initials: T
authors.lastname: Cansever
authors.forename: Cem
authors.initials: C
authors.lastname: Yilmaz
authors.forename: Serdar
authors.initials: S
authors.lastname: Kabatas
authors.forename: Salih
authors.initials: S
authors.lastname: Gülşen
authors.forename: Fatih
authors.initials: F
authors.lastname: Aydemir
authors.forename: Nur
authors.initials: N
authors.lastname: Altιnörs
authors.forename: Hakan
authors.initials: H
authors.lastname: Caner
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery; D006801:Humans; D058498:Kyphoplasty / Q000009:adverse effects*; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*