European Spine Journal

, Volume 23, Issue 6, pp 1339–1345

Analysis of risk factors of subsequent fractures after vertebroplasty

  • Gang Sun
  • Hai Tang
  • Min Li
  • Xunwei Liu
  • Peng Jin
  • Li Li
Original Article



The purpose of this study is to identify risk factors related to the development of subsequent fractures after vertebroplasty.


A retrospective study was conducted to review 175 patients with a 1-year follow-up who underwent vertebroplasty for first-time and single-level osteoporotic vertebral fractures. Subsequent fractures were diagnosed as recurrent intractable back pain, post-operatively correlated with MR image. Clinical parameters, such as age, gender, baseline VAS-score, lumbar bone mineral density (BMD) T-score, history of use of steroids, bisphosphonate therapy, symptom-free interval, the amount of bone cement injected, vacuum clefts, leakage of cement into the disk space, treated level and the changes of spinal geometry were recorded.


During the follow-up period, subsequent fractures developed in 37 (21.1 %) of 175 patients. Significant differences (P < 0.05) were found between the patients with subsequent fractures and the patients without subsequent fractures in regard to their BMD T-score, and treated vertebrae location. Average BMD T-score was −3.4 ± 1.5 in patients with subsequent fractures and −2.9 ± 1.6 in patients without subsequent fractures. The percentage of subsequent fractures was 13.9 % (10 of 72) for treated vertebrae located in non-thoracolumbar junction, and 26.2 % (27 of 103) in the thoracolumbar junction.


The most important risk factors affecting subsequent fractures after vertebroplasty were osteoporosis and treated level at the thoracolumbar junction.


Risk factor Subsequent vertebral fractures Vertebroplasty Polymethylmethacrylate Osteoporosis 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Gang Sun
    • 1
  • Hai Tang
    • 2
  • Min Li
    • 1
  • Xunwei Liu
    • 1
  • Peng Jin
    • 1
  • Li Li
    • 1
  1. 1.Department of Medical ImagingJinan Military General HospitalJinanPeople’s Republic of China
  2. 2.Department of OrthopedicsBeijing Friendship HospitalBeijingPeople’s Republic of China

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