Risk Prediction of New Adjacent Vertebral Fractures After PVP for Patients with Vertebral Compression Fractures: Development of a Prediction Model
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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.
Materials and 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.
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.
The PNAV score is an objective and easy approach to predict the risk of new AVCFs.
KeywordsOsteoporotic vertebral compression fractures Percutaneous vertebroplasty New vertebral fracture Adjacent Risk prediction Validation
This study was funded by the National Basic Research Program of China (973 Program # 2013CB733800, 2013733803), the National High-tech Research Foundation of China (863 project #2012AA022701), the National Scientific and Technical Achievement Translation Foundation (258), the Jiangsu Provincial Special Program of Medical Science (BL2013029), and the National Natural Science Foundation of China (81230034, 81171434). Funding sources had no involvement in the financial support for the conduct of the research and preparation of the article.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.