title: Risk Factors of New Adjacent Compression Fracture after Percutaneous Vertebroplasty: Effectiveness of Bisphosphonate in Osteoporotic or Osteopenic Elderly Patients.
abstract: OBJECTIVE
  The purpose of this study is to investigate the incidence of new compression and to analyze factors that influence the fractures in adjacent levels after percutaneous vertebroplasty (PVP).
  
  
  METHODS
  This retrospective study examined 206 patients who had undergone PVP for single level osteoporotic or osteopenic compression fractures during the last seven years in our department. After PVP, the patients were observed for at least over one year, and 29 patients showed new additional compression fractures in adjacent levels. One hundred seventy seven patients who did not show additional compression fractures were analyzed as the control group. Statistical comparisons were performed between the groups, in terms of age, gender, bone mineral density, whether bisphosphonate (BPP) was treated, preoperative kyphosis, preoperative wedge angle, change in wedge angle, amount of bone cement, existence of intradiscal bone cement leakage, and initial fracture levels.
  
  
  RESULTS
  The statistically significant factors that influence new compression fractures in adjacent levels after PVP were as follows: being female, initial thoracolumbar junction fracture, preoperative large kyphotic, preoperative large wedge angle, change in wedge angle, administration of BPP in osteopenia group, and intradiscal cement leakage.
  
  
  CONCLUSIONS
  This study identified many factors that influence newly developed compression fractures in adjacent levels after PVP. Interestingly, the administration of BPP in osteopenia group had positive influence on new fractures in this study. Therefore, we recommend early administration of BPP to patients with osteopenia.
authors.affiliation: Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Seo
authors.affiliation: Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Si-Hyuck
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Kyeong-Wook
authors.initials: KW
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Jung-Ho
authors.initials: JH
authors.lastname: Ko
authors.affiliation: Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Jee Young
authors.initials: JY
authors.lastname: Lee
keywords: Adjacent vertebral fractures; Diphosphonates; Fractures compression; Risk factors; Spinal fractures; Vertebroplasty