J Korean Soc Spine Surg.  2015 Dec;22(4):146-152. 10.4184/jkss.2015.22.4.146.

Potential Risk Factors for Subsequent Fractures according to Treatment of Primary Osteoporotic Vertebral Fractures

• Kim MW
• Yoon DH
• Ahn SH
• Lee JW
• Kim CH
• Choi YS

• KMID: 2150541
• DOI: http://doi.org/10.4184/jkss.2015.22.4.146

Abstract

STUDY DESIGN: A retrospective study.
OBJECTIVES
To investigate the potential risk factors for subsequent vertebral fractures according to the treatment of primary vertebral fractures. SUMMARY OF LITERATURE REVIEW: Many previous studies have been reported on bone mineral density, bone loss, and mechanical properties as risk factors for osteoporotic vertebral fractures. However, few studies have investigated subsequent osteoporotic vertebral fractures.
MATERIALS AND METHODS
57 patients who had undergone follow-up magnetic resonance imaging (MRI) of the spine were divided into two groups depending on the development of subsequent vertebral fractures: the fracture group with 40 cases and the non-fracture group with 17 cases. The patients' clinical and radiographic data including bone mineral density, medication for osteoporosis, body mass index, vertebroplasty of primary vertebral fractures, thoracic kyphotic angle and lumbar lordotic angle, fat infiltration of the back extensor muscle, and primary multiple fractures were examined.
RESULTS
The subsequent new vertebral fractures occurred at a mean of 24 +/- 19 months after primary osteoporotic vertebral fractures. Vertebroplasty for primary fractures was associated with a higher incidence of subsequent new vertebral fractures (p=0.001). There was a significant increase in fat infiltration of the back extensor muscle after the primary vertebral fractures in the fracture group (p=0.001). A multiple logistic regression analysis showed the significance of vertebroplasty (odds' ratio: 4.623, 95% confidence interval: 1.145-18.699, p=0.031).
CONCLUSIONS
These results suggest that vertebroplasty for primary vertebral fractures and increased fat infiltration of the back extensor muscle could be risk factors related to the development of subsequent osteoporotic vertebral fractures.

Keyword

Vertebral fractures; Osteoporosis; Subsequent fractures; Back extensor muscle

MeSH Terms

Body Mass Index
Bone Density
Follow-Up Studies
Humans
Incidence
Logistic Models
Magnetic Resonance Imaging
Osteoporosis
Retrospective Studies
Risk Factors*
Spine
Vertebroplasty

Figure

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  Fig. 1. (A) An 80- years -old female patient with a primary L2 osteoporoti vertebral fracture., The paravertebral muscle sity was measured by using a pseudocoloring tool on the L3 axial image. Muscle densty: 1111.87 (74.6%)., In this case, vertebroplas-trformed. (B) After 18Eighteen months after the primary fracture, a subsequent L4 vertebral frcture occurred. The Pparavertebral muscle density was measured by ug the same method on atthe same level. The Mmuscle denity had decreased to: 924.01 (64.0%).

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