Abstract
Summary
This study was undertaken to investigate the incidence rate, characteristics, and predisposing factors associated with recollapse of the same vertebrae after percutaneous vertebroplasty (PVP). Recollapse of the same vertebra after PVP is the one of the complications of the procedure, and the incidence rate in our study was 3.21%. The most important predisposing factor was pre-operative osteonecrosis. Recollapse was not related to trauma.
Introduction
PVP using polymethylmethacrylate has become a popular treatment for osteoporotic vertebral compression fracture. Recollapse of the same vertebrae after PVP has rarely been reported. This study was undertaken to investigate the incidence, characteristics, and predisposing factors associated with recollapse of the same vertebrae after PVP.
Methods
Eleven patients (seven females and four males; mean age, 69.91 ± 5.49 years), out of a total of 343 patients, developed recollapse of the same vertebra after PVP. The 11 patients who developed recollapse comprised the “recollapse group”, while the remaining 332 patients comprised the “well-maintained group”.
Results
Pre-operative magnetic resonance imaging revealed that the incidence of osteonecrosis was significantly higher in the recollapse group than the well-maintained group (p < 0.05). The degree of re-expansion of the compressed vertebral body after PVP was significantly higher in the recollapse group than in the well-maintained group (p < 0.05).
Conclusions
The most important predisposing factor for recollapse was pre-operative osteonecrosis. Recollapse was not related to trauma. Osteoporotic vertebral compression fracture with osteonecrosis or pseudoarthrosis has been regarded as a relative indication for PVP; however, the findings of this study suggest that this disease category may be a relative contraindication for PVP.
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References
Amar AP, Larsen DW, Esnaashari N et al (2001) Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures. Neurosurgery 49:1105–1114
Deramond H, Depriester C, Galibert P et al (1998) Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am 36:533–546
Jensen ME, Evans AJ, Mathis JM et al (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 18:1897–1904
Grados F, Depriester C, Cayrolle G et al (2000) Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 39:1410–1414
Chin DK, Kim YS, Cho YE et al (2006) Efficacy of postural reduction in osteoporotic vertebral compression fractures followed by percutaneous vertebroplasty. Neurosurgery 58:695–700
Schmid KE, Boszczyk BM, Bierschneider M et al (2005) Spondylitis following vertebroplasty: a case report. Eur Spine J 14:895–899
Hulme PA, Krebs J, Ferguson SJ et al (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001
Uppin AA, Hirsch JA, Centenera LV et al (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226:119–124
Lee WS, Sung KH, Jeong HT et al (2006) Risk factors of developing new symptomatic vertebral compression fractures after percutaneous vertebroplasty in osteoporotic patients. Eur Spine J 15:1777–1783
Fribourg D, Tang C, Sra P et al (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29:2270–2276
Komemushi A, Tanigawa N, Kariya S et al (2006) Percutaneous vertebroplasty for osteoporotic compression fracture: multivariate study of predictors of new vertebral body fracture. Cardiovasc Intervent Radiol 29:580–585
Heini PF, Berlemann U, Kaufmann M et al (2001) Augmentation of mechanical properties in osteoporotic vertebral bones–a biomechanical investigation of vertebroplasty efficacy with different bone cements. Eur Spine J 10:164–171
Sun K, Liebschner MA (2004) Evolution of vertebroplasty: a biomechanical perspective. Ann Biomed Eng 32:77–91
Berlemann U, Ferguson SJ, Nolte LP et al (2002) Adjacent vertebral failure after vertebroplasty. A biomechanical investigation. J Bone Joint Surg Br 84:748–752
Syed MI, Patel NA, Jan S et al (2005) New symptomatic vertebral compression fractures within a year following vertebroplasty in osteoporotic women. Am Journal Neuroradiol 26:1601–1604
Tanigawa N, Komemushi A, Kariya S et al (2006) Radiological follow-up of new compression fractures following percutaneous vertebroplasty. Cardiovasc Intervent Radiol 29:92–96
Leslie-Mazwi T, Deen HG (2006) Repeated fracture of a vertebral body after treatment with balloon kyphoplasty: case illustration. J Neurosurg Spine 4:270
Wagner AL, Baskurt E (2006) Refracture with cement extrusion following percutaneous vertebroplasty of a large interbody cleft. AJNR Am J Neuroradiol 27:230–231
Gaughen JR Jr., Jensen ME, Schweickert PA et al (2002) The therapeutic benefit of repeat percutaneous vertebroplasty at previously treated vertebral levels. AJNR Am J Neuroradiol 23:1657–1661
Yu CW, Hsu CY, Shih TT et al (2007) Vertebral osteonecrosis: MR imaging findings and related changes on adjacent levels. AJNR Am J Neuroradiol 28:42–47
Young WF, Brown D, Kendler A et al (2002) Delayed post-traumatic osteonecrosis of a vertebral body (Kummell’s disease). Acta Orthop Belg 68:13–19
Chou LH, Knight RQ (1997) Idiopathic avascular necrosis of a vertebral body. Case report and literature review. Spine 22:1928–1932
Jang JS, Kim DY, Lee SH (2003) Efficacy of percutaneous vertebroplasty in the treatment of intravertebral pseudarthrosis associated with noninfected avascular necrosis of the vertebral body. Spine 28:1588–1592
Hirsch JA, Reddy AS, Linfante I et al (2003) Pseudo-Kümell’s disease: a unique application for vertebroplasty. Pain physician 6:207–211
Kim DY, Lee SH, Jang JS et al (2004) Intravertebral vacuum phenomenon in osteoporotic compression fracture: report of 67 cases with quantitative evaluation of intravertebral instability. J Neurosurg 100:24–31
Wiggins MC, Sehizadeh M, Pilgram TK et al (2007) Importance of intravertebral fracture clefts in vertebroplasty outcome. AJR Am J Roentgenol 188:634–640
Lewis G (1997) Properties of acrylic bone cement: state of the art review. J Biomed Mater Res 38:155–182
Huang KY, Yan JJ, Lin RM (2005) Histopathologic findings of retrieved specimens of vertebroplasty with polymethylmethacrylate cement: case control study. Spine 30:E585–588
Stanczyk M, van Rietbergen B (2004) Thermal analysis of bone cement polymerisation at the cement-bone interface. J Biomech 37:1803–1810
Deramond H, Wright NT, Belkoff SM (1999) Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone 25:17–21S
Li C, Mason J, Yakimicki D (2004) Thermal characterization of PMMA-based bone cement curing. J Mater Sci Mater Med 15:85–89
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Heo, D.H., Chin, D.K., Yoon, Y.S. et al. Recollapse of previous vertebral compression fracture after percutaneous vertebroplasty. Osteoporos Int 20, 473–480 (2009). https://doi.org/10.1007/s00198-008-0682-3
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DOI: https://doi.org/10.1007/s00198-008-0682-3