Korean J Neurotrauma.  2014 Oct;10(2):86-91. 10.13004/kjnt.2014.10.2.86.

Risk Factors of New Adjacent Compression Fracture after Percutaneous Vertebroplasty: Effectiveness of Bisphosphonate in Osteoporotic or Osteopenic Elderly Patients

• Seo DH
• Oh SH
• Yoon KW
• Ko JH
• Kim YJ
• Lee JY

• KMID: 2256239
• DOI: http://doi.org/10.13004/kjnt.2014.10.2.86

Abstract

OBJECTIVE
The purpose of this study is to investigate the incidence of new compression and to analyze factors that influence the fractures in adjacent levels after percutaneous vertebroplasty (PVP).
METHODS
This retrospective study examined 206 patients who had undergone PVP for single level osteoporotic or osteopenic compression fractures during the last seven years in our department. After PVP, the patients were observed for at least over one year, and 29 patients showed new additional compression fractures in adjacent levels. One hundred seventy seven patients who did not show additional compression fractures were analyzed as the control group. Statistical comparisons were performed between the groups, in terms of age, gender, bone mineral density, whether bisphosphonate (BPP) was treated, preoperative kyphosis, preoperative wedge angle, change in wedge angle, amount of bone cement, existence of intradiscal bone cement leakage, and initial fracture levels.
RESULTS
The statistically significant factors that influence new compression fractures in adjacent levels after PVP were as follows: being female, initial thoracolumbar junction fracture, preoperative large kyphotic, preoperative large wedge angle, change in wedge angle, administration of BPP in osteopenia group, and intradiscal cement leakage.
CONCLUSION
This study identified many factors that influence newly developed compression fractures in adjacent levels after PVP. Interestingly, the administration of BPP in osteopenia group had positive influence on new fractures in this study. Therefore, we recommend early administration of BPP to patients with osteopenia.

Keyword

Spinal fractures; Fractures compression; Adjacent vertebral fractures; Diphosphonates; Risk factors; Vertebroplasty

MeSH Terms

Aged*
Bone Density
Bone Diseases, Metabolic
Diphosphonates
Female
Fractures, Compression*
Humans
Incidence
Kyphosis
Retrospective Studies
Risk Factors*
Spinal Fractures
Vertebroplasty*
Diphosphonates

Figure

• 

  FIGURE 1 The method of estimating wedge angle and kyphotic angle (W: wedge angle, K: kyphotic angle).

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