title: ANVCFV Score System: Assessment for Probability of New Vertebral Compression Fractures after Percutaneous Vertebroplasty in Patients with Vertebral Compression Fractures.
abstract: BACKGROUND
  Percutaneous vertebroplasty (PVP) is widely used for the treatment of painful vertebral compression fractures (VCFs). However, new VCFs occur frequently after PVP.
  
  
  OBJECTIVE
  We aim to establish an objective risk score system to assess the possibility of new vertebral fractures in patients with VCFs undergoing PVP.
  
  
  METHODS
  This study was a retrospective study, and it was approved by the Institutional Review Board of our 2 institutions.
  
  
  METHODS
  This study consists of patients from 2 large academic centers.
  
  
  METHODS
  Patients with VCFs who underwent their first PVP and met the inclusion criteria between January 2007 and December 2013 at Hospital A (training cohort) and Hospital B (validation cohort) were included. In the training cohort, the independent risk factors for new VCFs after PVP were identified by multivariate stepwise backward Cox regression analysis from the risk factors selected by univariate analysis and Harrell's C-statistics and used to develop the score system (assessment for new VCFs after PVP [ANVCFV]) to predict the probability of new VCFs.
  
  
  RESULTS
  In total, 397 patients (training cohort: n = 241; validation cohort: n = 156) were included in this study. In the training cohort, the ANVCFV score was developed based on 5 independent risk factors for the new VCFs after PVP, including lower computed tomography (CT) values, pre-existing old VCFs, intradiscal cement leakage, more than one vertebra treated, and superior or inferior marginal cement distribution in the vertebra. The patients were divided into 2 groups by the ANVCFV score of -1.5 to 8.5 vs. > 8.5 points in the probability of new VCFs (median fracture-free time: 1846 vs. 732 days; P < 0.001) in the training cohort. The accuracy of this score system was 77.4% for the training cohort and 85.3% for the validation cohort.
  
  
  CONCLUSIONS
  The main limitations of this study are that it is a retrospective study and that there is a significant difference of the treated vertebrae of PVP per session between the 2 cohorts.
  
  
  CONCLUSIONS
  Patients who underwent their first PVP with an ANVCFV score > 8.5 points may exhibit an increased chance of suffering from new VCFs.
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Bin-Yan
authors.initials: BY
authors.lastname: Zhong
authors.affiliation: Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai 200233, China.
authors.forename: Chun-Gen
authors.initials: CG
authors.lastname: Wu
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Shi-Cheng
authors.initials: SC
authors.lastname: He
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Hai-Dong
authors.initials: HD
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Li
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Jin-He
authors.initials: JH
authors.lastname: Guo
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Deng
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Guang-Yu
authors.initials: GY
authors.lastname: Zhu
authors.affiliation: Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China.
authors.forename: Gao-Jun
authors.initials: GJ
authors.lastname: Teng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements