Analysis of Subsequent Fractures after Percutaneous Vertebroplasty

Hong, Soon Oh; Kong, Min Ho; Jang, Se Youn; Kim, Jung Hee; Ha, Yoon; Kang, Dong Soo; Song, Kwan Young

doi:2016.2.1.15

Asian J Pain > Volume 2;2016 > Article

Clinical Article

Asian Journal of Pain 2016;2(1):15-21.
DOI: https://doi.org/10.35353/ajp.2.1.15 Published online April 30, 2016.

Analysis of Subsequent Fractures after Percutaneous Vertebroplasty

Soon Oh Hong¹, Min Ho Kong¹, Se Youn Jang¹, Jung Hee Kim¹, Yoon Ha², Dong Soo Kang¹, Kwan Young Song¹

¹Department of Neurosurgery, Seoul Medical Center, Seoul, Korea
²Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

Correspondence: Min Ho Kong, Tel: 82-2-2276-7881, Fax: 82-2-2276-8537,
Email: davidmhkong@gmail.com

Abstract

Objective
Percutaneous vertebroplasty (PVP) is a useful treatment to patients with painful osteoporotic vertebral compression fracture (VCF), but long-term studies suggested that PVP could accelerate the failure of adjacent vertebrae after PVP. The authors retrospectively reviewed the cases with PVP and investigated the associated risk factors of new VCF after PVP. Material and Methods: In this retrospective study, total 130 patients who underwent PVP from January 2011 to June 2012 with minimum 12 months follow-up periods were enrolled. New VCFs were diagnosed using radiographical criteria. The causative factors of new VCF, such as age, gender, body weight, height, lumbar spine bone mineral density (BMD), treated vertebral level, pre-existing untreated VCF before treatment, osteoporosis treatment, volume of injected cement, and surgical variables were analyzed.
Results
New VCF were observed in 15 cases (11.5%) among 130 patients with PVP. The common levels of new VCF were L1 (33.0%) and T12 level (29.2%). New VCFs were observed more frequently in the adjacent level (9/15 cases) and adjacent level new VCFs were developed earlier than non-adjacent level new VCFs (7.11±10.40 months vs. 18.66±22.60 months, p=0.039). Age, gender, past history, baseline BMD, and T score were not associated with new-onset VCF, but preexisting VCFs history (p=0.011) and larger volume of injected cement (3.21±1.66 mL vs. 4.96±2.23 mL, p=0.049) showed significant difference between the cases with and without new VCF.
Conclusion
New VCF after PVP was observed in 11.5% and it seems to be related to adjacent PVP level, larger amount of injected vertebral cement, and the history of preexisting VCFs.

Key Words: Vertebroplasty; Osteoporosis; Compression fracture; Adjacent segment disease.