J Korean Orthop Assoc.  2019 Feb;54(1):24-29. 10.4055/jkoa.2019.54.1.24.

Early Onset Subsequent Vertebral Compression Fracture after Percutaneous Verteroplasty

• Kim JK
• Choi BY
• Park YC
• Kim DH

• KMID: 2438954
• DOI: http://doi.org/10.4055/jkoa.2019.54.1.24

Abstract

PURPOSE
To evaluate the characteristics and the risk factors of early onset subsequent vertebral compression fractures after percutaneous vertebroplasty.
MATERIALS AND METHODS
A total of 44 patients, who had a new subsequent vertebral fracture after percutaneous vertebroplasty for an osteoporotic vertebral compression fracture between January 2013 and December 2015, were recruited. The patients were divided into two groups according to the onset period of subsequent fracture. The number of patients who had a fracture within 3 months following vertebroplasty were 22 cases (Group A); after 3 months were 22 cases (Group B). Variables, including age, sex, bone mineral density (BMD), body mass index (BMI), preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, injected cement volume, restoration of vertebral body height, and correction of kyphosis, in the two groups were analyzed and compared retrospectively.
RESULTS
The age, sex, BMD, BMI, preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, and correction of kyphosis were similar in the two groups. Both a greater volume of bone cement injected and a greater degree of vertebral height restoration contributed significantly to the risk of fracture within 3 months.
CONCLUSION
The cement volume and degree of height restoration are risk factors for early onset fracture at the adjacent vertebrae after percutaneous vertebroplasty and close attention is needed during the follow-up period.

Keyword

osteoporosis; compression fractures; risk factors; vertebroplasty

MeSH Terms

Body Height
Body Mass Index
Bone Density
Follow-Up Studies
Fractures, Compression*
Humans
Kyphosis
Osteoporosis
Retrospective Studies
Risk Factors
Spine
Vertebroplasty

Figure

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  Figure 1 A 73-year-old female. Plain radiograph shows T11 compression fracture (A) and treated via percutaneous vertebroplasty (B). Total volume of cement inejected was 8 ml and restoration of anterior body height was 40%. T1-sagittal magnetic resonance image 4 weeks after vertebroplasty shows new compression fracture in T12 vertebra (C) and treated via vertebroplasty again (D). The patient developed severe recurrent back pain at 10 days after second vertebroplasty. (E) Adjacent-level fracture was noted at L1. The patient refused suqbequent vertebroplasty and was treated conservatively for new fracture.

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