J Korean Neurotraumatol Soc.  2011 Apr;7(1):29-34. 10.13004/jknts.2011.7.1.29.

The Effect of Trauma in Osteoporotic Vertebral Compression Fractures Treated by Percutaneous Vertebroplasty: A Comparison of Radiological Features in Presence or Absence of Trauma

Affiliations
  • 1Department of Neurosurgery, Seoul Veterans Hospital, Seoul, Korea. spineho@naver.com

Abstract


OBJECTIVE
The purpose of this study is to evaluate the effect of trauma in osteoporotic vertebral compression fractures (OVCFs) treated by percutaneous vertebroplasty (PVP). We compare radiographic features of OVCFs with trauma to those without trauma.
METHODS
The medical records and radiographic findings of 111 consecutive patients treated with PVP between January 2008 and June 2009 were retrospectively reviewed. A total of 111 patients with 122 painful vertebral fractures was identified based on clinical and radiological findings. The patients were divided into two groups according to the cause of the OVCFs. Group A contained 81 patients with a history of trauma. They included slip, sprain, and fall. 30 patients with no history of trauma were categorized into group B. Differences in radiographic features and occurrence rates of new compression fractures were examined and compared for both groups. The following factors were analyzed on radiographs, dual bone densitometry, CT, and MRI: pre-existing vertebral compression fracture (VCF), bone mineral density (BMD), anatomical location of the vertebral fracture, type and grading of fracture, intravertebral cleft (IVC), and new VCF.
RESULTS
There were 111 patients, with a mean age of 74.6 years (range, 65-86 years). Group A showed 81 patients with a mean age of 74.8+/-6.2 and 30 patients with a mean age of 73.8+/-6.4 in group B. In group A, body mass index (BMI) was 22.4+/-3.9 and 22.5+/-6.5 in group B. There were no significance differences in age, gender, and BMI. Mean follow-up period was 12 months (range, 3-24 months). The most common location of fractured vertebrae is thoracolumbar levels (T11-L2) in both groups. Mild deformity and wedged fractures are most common in both groups. Pre-existing VCF, BMD, anatomical location of the vertebral fracture, type and grading of fracture, IVC, and amount of cement injected have no statistically significant difference between group A and group B. In group A, the new VCF occurred in 17 patients (20.0%) and 8 (26.7%) in group B. The radiographic features of OVCF and occurrence rate of new VCF have no significant difference in both groups.
CONCLUSION
The etiology of OVCF is multifactorial. This condition may be caused by mainly osteoporosis and trauma. There is no great difference between the two groups in radiographic features of OVCF. The history of trauma is not aggravating the situation and progress of OVCF.

Keyword

Osteoporotic vertebral compression fracture; Trauma; Percutaneous vertebroplasty; New compression fracture

MeSH Terms

Body Mass Index
Bone Density
Congenital Abnormalities
Densitometry
Follow-Up Studies
Fractures, Compression
Humans
Medical Records
Osteoporosis
Retrospective Studies
Spine
Sprains and Strains
Vertebroplasty
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