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Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty

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Abstract

Introduction

Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are effective procedures to alleviate pain caused by osteoporotic vertebral compression fractures (VCFs). New vertebral compression fracture (NVCF) has been noted as a potential late sequela of the procedures. The incidence of NVCFs and affecting risk factors were investigated.

Materials and methods

The authors retrospectively analyzed the occurrence of NVCFs in 147 patients treated with PVP or PKP for osteoporotic VCFs. Possible risk factors, such as age, gender, body mass index, bone mineral density (BMD), location of treated vertebra, treatment modality, amount of bone cement injected, anterior–posterior ratio of the fractured vertebra, cement leakage into the disc space, and pattern of cement distribution, were assessed.

Results

Twenty-seven patients (18.4%) had subsequent symptomatic NVCFs with a median time to new fracture was of 70 days. The 1-year symptomatic fracture-free rate was 85.0% by the Kaplan–Meier estimate. Eighteen (66.7%) of the 27 patients had an NVCF on the adjacent vertebra. Significant differences (P < 0.05) were found between the NVCF and control groups in regard to age, treatment modality, BMD, and the proportion of cement leakage into the disc space. Discal cement leakage and low BMD affected on adjacent NVCFs.

Conclusion

The most important risk factors affecting NVCFs were osteoporosis and intervertebral discal cement leakage.

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References

  1. Baumann C, Fuchs H, Kiwit J, Westphalen K, Hierholzer J (2007) Complications in percutaneous vertebroplasty associated with puncture or cement leakage. CardioVasc Interv Radiol 30:161–168

    Article  Google Scholar 

  2. Berlemann U, Ferguson SJ, Nolte LP, Heini PF (2002) Adjacent vertebral failure after vertebroplasty. A biomechanical investigation. J Bone Joint Surg Br 84:748–752

    Article  PubMed  CAS  Google Scholar 

  3. Cohen JE, Lylyk P, Ceratto R, Kaplan L, Umanskyt F, Gomori JM (2004) Percutaneous vertebroplasty: technique and results in 192 procedures. Neurol Res 26:41–49

    Article  PubMed  Google Scholar 

  4. Fourney DR, Schomer DF, Nader R, Chlan-Fourney J, Suki D, Ahrar K et al (2003) Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients. J Neurosurg 98:21–30

    Article  PubMed  Google Scholar 

  5. Galibert P, Deramond H, Rosat P, Le Gars D (1987) Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 33:166–168

    PubMed  CAS  Google Scholar 

  6. Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39:1410–1414

    Article  CAS  Google Scholar 

  7. Kim SH, Kang HS, Choi JA, Ahn JM (2004) Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty. Acta Radiol 45:440–445

    Article  PubMed  CAS  Google Scholar 

  8. Klotzbuecher CM, Ross PD, Landsmen PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res 15:721–739

    Article  PubMed  CAS  Google Scholar 

  9. Komemushi A, Tanigawa N, Kariya S, Kojima H, Shomura Y, Komemushi S et al (2006) Percutaneous vertebroplasty for osteoporotic compression fractures: multivariate study of predictors of new vertebral body fracture. Cardiovasc intervent Radiol 29:580–585

    Article  PubMed  Google Scholar 

  10. Legroux-Gérot I, Lormeau C, Boutry N, Cotten A, Duquesnoy B, Cortet B (2004) Long-term follow-up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Clin Rheumatol 23:310–317

    Article  PubMed  Google Scholar 

  11. Lee WS, Sung KH, Jeong HT, Sung YS, Hyun YI, Choi JY et al (2006) Risk factors of developing new symptomatic vertebral compression fractures after percutaneous vertebroplasty in osteoporotic patients. Eur Spine J 15:1777–1783

    Article  PubMed  Google Scholar 

  12. Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB et al (2001) Risk of new vertebral fractures in the year following a fracture. JAMA 285:320–323

    Article  PubMed  CAS  Google Scholar 

  13. Lin EP, Ekholm S, Hiwatashi A, Westesson PL (2004) Vertebroplasty cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR 25:175–180

    PubMed  Google Scholar 

  14. Lin WC, Cheng TT, Lee YC, Wang TN, Cheng YF, Lui CC et al (2008) New vertebral osteoporotic compression fractures after percutaneous vertebroplasty: retrospective analysis of risk factors. J Vasc Interv Radiol 19:225–232

    Article  PubMed  Google Scholar 

  15. Moon ES, Kim HS, Park JO, Moon SH, Lee HM, Shin DE et al (2007) The incidence of new vertebral compression fractures in women after kyphoplasty and factors involved. Yonsei Medical J 48:645–652

    Article  Google Scholar 

  16. Nakano M, Hirano N, Ishihara H, Kawaguchi Y, Matsuura K (2005) Calcium phosphate cement leakage after percutaneous vertebroplasty for osteoporotic vertebral fractures: risk factor analysis for cement leakage. J Neurosurg Spine 2:27–33

    Article  PubMed  Google Scholar 

  17. Nevitt MC, Thompson DE, Black DM, Rubin SR, Ensrud K, Yates AJ (2000) Effect of alendronate on limited activity days and bed-disability days caused by back pain in postmenopausal women with existing vertebral fractures. Arch Intern Med 160:77–85

    Article  PubMed  CAS  Google Scholar 

  18. Ooms ME, Lips P, Van Lingen A, Valkenburg HA (1993) Determinants of bone mineral density and risk factors for osteoporosis in healthy elderly women. J Bone Miner Res 8:669–675

    Article  PubMed  CAS  Google Scholar 

  19. Peh WC, Gilula LA, Peck DD (2002) Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 223:121–126

    Article  PubMed  Google Scholar 

  20. Ryu KS, Park CK, Kim MC, Kang JK (2002) Dose-dependent epidural leakage of polymethylmethacrylate after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. J Neurosurg 96:56–61

    PubMed  Google Scholar 

  21. Syed MI, Patel NA, Jan S, Harron MS, Morar K, Shaikh A (2005) New symptomatic vertebral compression fractures within a year following vertebroplasty in osteoporotic women. AJNR 26:1601–1604

    PubMed  Google Scholar 

  22. Tanigawa N, Komemushi A, Kariya S, Kojima H, Shomura Y, Naoto O et al (2007) Relationship between cement distribution pattern and new compression fracture after percutaneous vertebroplasty. AJR 189:W348–W352

    Article  PubMed  Google Scholar 

  23. Trout AT, Kallmes DF, Kaufmann TJ (2006) New fractures after vertebroplasty: adjacent fractures occur significantly sooner. AJNR 27:217–223

    PubMed  CAS  Google Scholar 

  24. Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226:119–124

    Article  PubMed  Google Scholar 

  25. Voormolen MH, Lohle PN, Juttmann JR, van der Graaf Y, Fransen H, Lampmann LE (2006) The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty. J Vasc Interv Radiol 17:71–76

    Article  PubMed  Google Scholar 

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Correspondence to Woo Jin Choe.

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Rho, YJ., Choe, W.J. & Chun, Y.I. Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J 21, 905–911 (2012). https://doi.org/10.1007/s00586-011-2099-5

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  • DOI: https://doi.org/10.1007/s00586-011-2099-5

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