CardioVascular and Interventional Radiology

, Volume 29, Issue 4, pp 580–585

Percutaneous Vertebroplasty for Osteoporotic Compression Fracture: Multivariate Study of Predictors of New Vertebral Body Fracture

  • Atsushi Komemushi
  • Noboru Tanigawa
  • Shuji Kariya
  • Hiroyuki Kojima
  • Yuzo Shomura
  • Sadao Komemushi
  • Satoshi Sawada
Article

Abstract

Purpose

To investigate the risk factors and relative risk of new compression fractures following vertebroplasty.

Methods

Initially, we enrolled 104 consecutive patients with vertebral compression fractures caused by osteoporosis. A total of 83 of the 104 patients visited our hospital for follow-up examinations for more than 4 weeks after vertebroplasty. Logistic regression analysis of the data obtained from these 83 patients was used to determine relative risks of recurrent compression fractures, using 13 different factors.

Results

We identified 59 new fractures in 30 of the 83 patients: 41 new fractures in vertebrae adjacent to treated vertebrae; and 18 new fractures in vertebrae not adjacent to treated vertebrae. New fractures occurred in vertebrae adjacent to treated vertebrae significantly more frequently than in vertebrae not adjacent to treated vertebrae. Only cement leakage into the disk was a significant predictor of new vertebral body fracture after vertebroplasty (odds ratio = 4.633). None of the following covariates were associated with increased risk of new fracture: age, gender, bone mineral density, the number of vertebroplasty procedures, the number of vertebrae treated per procedure, the cumulative number of vertebrae treated, the presence of a single untreated vertebra between treated vertebrae, the presence of multiple untreated vertebrae between treated vertebrae, the amount of bone cement injected per procedure, the cumulative amount of bone cement injected, cement leakage into the soft tissue around the vertebra, and cement leakage into the vein.

Keywords

Spine fractures Spine interventional procedures Spine therapeutic radiology Spine vertebroplasty 

References

  1. 1.
    Cotten A, Boutry N, Cortet B, et al. (1998) Percutaneous vertebroplasty: State of the art. Radiographics 18:311–323PubMedGoogle Scholar
  2. 2.
    Peh WC, Gilula LA, Peck DD (2002) Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 223:121–126PubMedGoogle Scholar
  3. 3.
    Kallmes DF, Jensen ME (2003) Percutaneous vertebroplasty. Radiology 229:27–36PubMedGoogle Scholar
  4. 4.
    Grados F, Depriester C, Cayrolle G, et al. (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39:1410–1414CrossRefGoogle Scholar
  5. 5.
    Uppin AA, Hirsch JA, Centenera LV, et al. (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226:119–124PubMedGoogle Scholar
  6. 6.
    Lin EP, Ekholm S, Hiwatashi A, et al. (2004) Vertebroplasty: Cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR Am J Neuroradiol 25:175–180PubMedGoogle Scholar
  7. 7.
    Tanigawa N, Komemushi A, Kariya S, et al. (2005) Intraosseous venography with carbon dioxide contrast agent in percutaneous vertebroplasty. AJR Am J Roentgenol 184:567–570PubMedGoogle Scholar
  8. 8.
    Leibold RA, Gilula LA (2002) Sterilization of barium for vertebroplasty: An effective, reliable, and inexpensive method to sterilize powders for surgical procedures. AJR Am J Roentgenol 179:198–200PubMedGoogle Scholar
  9. 9.
    Lindsay R, Silverman SL, Cooper C, et al. (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323PubMedCrossRefGoogle Scholar
  10. 10.
    Delmas PD, Ensrud KE, Adachi JD, et al. (2002) Multiple Outcomes of Raloxifene Evaluation Investigators. Efficacy of raloxifene on vertebral fracture risk reduction in postmenopausal women with osteoporosis: Four-year results from a randomized clinical trial. J Clin Endocrinol Metab 87:3609–3617PubMedCrossRefGoogle Scholar
  11. 11.
    Siris ES, Miller PD, Barrett-Connor E, et al. (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: Results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822PubMedCrossRefGoogle Scholar
  12. 12.
    Cummings SR, Karpf DB, Harris F, et al. (2002) Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs. Am J Med 112:281–289PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Atsushi Komemushi
    • 1
  • Noboru Tanigawa
    • 1
  • Shuji Kariya
    • 1
  • Hiroyuki Kojima
    • 1
  • Yuzo Shomura
    • 1
  • Sadao Komemushi
    • 2
  • Satoshi Sawada
    • 1
  1. 1.Department of RadiologyKansai Medical UniversityMoriguchiJapan
  2. 2.Schoool of AgricultureKinki UniversityNaraJapan

Personalised recommendations