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Association between opportunistic vertebral bone density measurements and new vertebral fractures after percutaneous vertebral cementoplasty: a case-control study

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Abstract

Objectives

To study the relationship between opportunistic CT bone density measurements and the occurrence of new vertebral fractures after percutaneous vertebral cementoplasty (PVC) of osteoporotic vertebral compression fractures (OVCF).

Methods

A prospective analysis of retrospective data of 275 patients with OVCF treated by PVC between 2014 and 2019 with a clinico-radiological follow-up one year after treatment was conducted. Opportunistic bone density measurements were obtained at the trabecular bone of the L1 or an adjacent vertebra in Hounsfield units performed on the preoperative CT study. These density measurements values ​​were then compared between patients with and without new OCVF and in various population subgroups.

Results

There were 275 patients included, with 53 (19%) presenting a new OCVF and 24 (9%) developing a fracture cascade. The median opportunistic density measurements ​​in patients with recurrent OCVF were lower than those without (median 52[40.5]) HU and 77[49] HU)(p < 0.00001). Among the patients with new OVCF the median opportunistic density measurements in patients with fracture cascades were also lower than those without (44 HU and 62 HU, respectively) (p < 0.0096). Patients with density measurements under 61 HU were 3.6 times more likely to present recurrent fractures and those with density under 54 HU were 9.8 times more likely to develop a fracture cascade. The 36 HU threshold yielded a high specificity (90-91%) for the prediction of recurrent fractures and fracture cascade but with low sensitivity (respectively 26% and 37%).

Conclusion

Low opportunistic vertebral density measurements are associated with a higher risk of OVCF and fracture cascades after PVC.

Key points

• Low opportunistic density measurements are associated with a higher risk of OVCF and fracture cascades after PVC.

• Measuring bone density before performing a PVC could help predict the risk of new vertebral fracture after treatment

• Patient management could be adapted according to bone density

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Abbreviations

OVCF:

Osteoporotic vertebral compression fracture

PVC:

Percutaneous vertebral cementoplasty

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Acknowledgements

We are indebted to Ms Demange-Viardin for relentless efforts in supporting this project.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Guilloz Imaging Department, Central Hospital, University Hospital of Nancy (CHRU-Nancy), 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy Cedex, France

    François-Matthieu Seuvic, Romain Gillet, Matthias Louis, Édouard Germain, Charles Lombard, Alain Blum & Pedro Augusto Gondim Teixeira

Authors
  1. François-Matthieu Seuvic
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  2. Romain Gillet
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  3. Matthias Louis
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  4. Édouard Germain
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  5. Charles Lombard
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  6. Alain Blum
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  7. Pedro Augusto Gondim Teixeira
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Corresponding author

Correspondence to François-Matthieu Seuvic.

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Guarantor

The scientific guarantor of this publication is Pr. Pedro Augusto Gondim Teixeira MD, PhD

Central Hospital, Regional University Hospital Center of Nancy (CHRU-Nancy)

29 avenue du Maréchal de Lattre de Tassigny, 54035 NANCY CEDEX, FRANCE

Phone : 0033 3 83 85 18 11

Fax : 0033 3 83 85 97 25

E-mail : ped_gt@hotmail.com

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Doctor Gabriela HOSSU with a PhD in statistics kindly provided statistical support for this manuscript.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was not required because in our institution, retrospective studies with fully anonymized patient data do not require institutional review board (IRB) approval.

Methodology

• retrospective

• case-control study

• performed at one institution

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Seuvic, FM., Gillet, R., Louis, M. et al. Association between opportunistic vertebral bone density measurements and new vertebral fractures after percutaneous vertebral cementoplasty: a case-control study. Eur Radiol 33, 106–115 (2023). https://doi.org/10.1007/s00330-022-08946-6

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  • DOI: https://doi.org/10.1007/s00330-022-08946-6

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