Risk Prediction of New Adjacent Vertebral Fractures After PVP for Patients with Vertebral Compression Fractures: Development of a Prediction Model.
OBJECTIVE
We aim to determine the predictors of new adjacent vertebral fractures (AVCFs) after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fractures (OVCFs) and to construct a risk prediction score to estimate a 2-year new AVCF risk-by-risk factor condition.


METHODS
Patients with OVCFs who underwent their first PVP between December 2006 and December 2013 at Hospital A (training cohort) and Hospital B (validation cohort) were included in this study. In training cohort, we assessed the independent risk predictors and developed the probability of new adjacent OVCFs (PNAV) score system using the Cox proportional hazard regression analysis. The accuracy of this system was then validated in both training and validation cohorts by concordance (c) statistic.


RESULTS
421 patients (training cohort: n = 256; validation cohort: n = 165) were included in this study. In training cohort, new AVCFs after the first PVP treatment occurred in 33 (12.9%) patients. The independent risk factors were intradiscal cement leakage and preexisting old vertebral compression fracture(s). The estimated 2-year absolute risk of new AVCFs ranged from less than 4% in patients with neither independent risk factors to more than 45% in individuals with both factors.


CONCLUSIONS
The PNAV score is an objective and easy approach to predict the risk of new AVCFs.
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Bin-Yan
BY
Zhong
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Shi-Cheng
SC
He
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Hai-Dong
HD
Zhu
Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yi Shan Road, Shanghai, 200233, China.
Chun-Gen
CG
Wu
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Wen
W
Fang
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Li
L
Chen
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Jin-He
JH
Guo
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Gang
G
Deng
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China.
Guang-Yu
GY
Zhu
Department of Radiology, Medical School, Zhongda Hospital, Southeast University, 87 DingjiaqiaoRoad, Nanjing, 210009, China. gjteng@vip.sina.com.
Gao-Jun
GJ
Teng
D000368:Aged; D005260:Female; D050815:Fractures, Compression / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000150:complications* / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D054854:Vertebroplasty / Q000379:methods*
Adjacent; New vertebral fracture; Osteoporotic vertebral compression fractures; Percutaneous vertebroplasty; Risk prediction; Validation