title: New Levels of Vertebral Compression Fractures after Percutaneous Kyphoplasty: Retrospective Analysis of Styles and Risk Factors.
abstract: BACKGROUND
  The causes of subsequent vertebral fractures after kyphoplasty are debated. It is reported that most new vertebral fractures after kyphoplasty develop in adjacent vertebrae.
  
  
  OBJECTIVE
  We explored whether kyphoplasty increases the incidence of adjacent vertebral fractures and identified risk factors for new vertebral compression fractures (VCFs) after kyphoplasty.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Inpatient population of a single center.
  
  
  METHODS
  We studied 356 patients treated with kyphoplasty from January 2008 to March 2012. Among those patients, there were 35 new VCFs after kyphoplasty. Subsequently, these patients were divided into 2 groups: an "adjacent fracture" group and a "nonadjacent fracture" group. In addition, all patients treated with kyphoplasty were further assigned to either a "new fracture" group or a "no fracture" group.
  
  
  RESULTS
  The occurrence of new VCFs in the "nonadjacent fracture" group was significantly higher than that in the "adjacent fracture" group. The average bone mineral density (BMD) of the spine was -3.95 in the "new fracture" group and -2.86 in the "no fracture" group. The risk of new vertebral fracture increased as the bone mineral density decreased (P < 0.05). The morbidity of women was significantly higher in the "new fracture" group (94.29%) than in the "no fracture" group (77.88%) (P = 0.025).
  
  
  CONCLUSIONS
  Retrospective study at a single center.
  
  
  CONCLUSIONS
  New VCFs after kyphoplasty occurred most often in nonadjacent vertebrae. VCFs after kyphoplasty were common in patients with low bone mineral density and in women, suggesting that osteoporosis is an underlying mechanism. INSTITUTIONAL REVIEW: This study was approved by the institutional review board.
authors.affiliation: Zhejiang University Hangzhou, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ning
authors.forename: Shuanglin
authors.initials: S
authors.lastname: Wan
authors.affiliation: Zhejiang University Hangzhou, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.affiliation: Zhejiang University Hangzhou, China.
authors.forename: Zhaobo
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Zhejiang University Hangzhou, China.
authors.forename: Hongxin
authors.initials: H
authors.lastname: Cai
authors.affiliation: Zhejiang University Hangzhou, China.
authors.forename: Shunwu
authors.initials: S
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D050815:Fractures, Compression / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D058498:Kyphoplasty / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D016103:Spinal Fractures / Q000453:epidemiology / Q000209:etiology*; D016019:Survival Analysis