Conflicts of Interest: None.
Risk Factors of Subsequent Vertebral Compression Fractures After Vertebroplasty
Version of Record online: 5 JAN 2012
Wiley Periodicals, Inc.
Volume 13, Issue 3, pages 376–382, March 2012
How to Cite
Lu, K., Liang, C.-L., Hsieh, C.-H., Tsai, Y.-D., Chen, H.-J. and Liliang, P.-C. (2012), Risk Factors of Subsequent Vertebral Compression Fractures After Vertebroplasty. Pain Medicine, 13: 376–382. doi: 10.1111/j.1526-4637.2011.01297.x
- Issue online: 16 MAR 2012
- Version of Record online: 5 JAN 2012
- Compression Fracture;
- Bone Mineral Density;
Objective. To elucidate the risk factors for a subsequent vertebral compression fracture following percutaneous vertebroplasty, we analyzed the potential predictors of vertebral compression fractures adjacent to or remote from fractures previously treated with percutaneous vertebroplasty.
Design. This is a retrospective cohort study.
Background. A major concern after percutaneous vertebroplasty in patients with osteoporosis is the occurrence of subsequent vertebral compression fractures in the untreated vertebral bodies. The risk factors for the development of subsequent vertebral compression fractures after percutaneous vertebroplasty are unclear.
Methods. Two hundred four consecutive patients underwent percutaneous vertebroplasty for acute vertebral compression fractures between January 2007 and December 2008. Forty-nine patients were excluded. Subsequent vertebral compression fractures were diagnosed by bone edema changes on magnetic resonance imaging. Patient's demographic data were used for univariate and multivariable binary logistic regression analyses.
Results. Forty-three (27.7%) of the 155 patients had subsequent vertebral compression fractures within 2 years of percutaneous vertebroplasty, with 21 (48.8%) of these patients having fractures detected within 3 months. Adjacent vertebral compression fractures tended to occur sooner, although not significantly (log-rank test, P = 0.112). On multivariate analyses, only the T-score of bone mineral density was significantly associated with subsequent vertebral compression fractures (P < 0.0001; odds ratio = 0.27; 95% confidence interval, 0.15–0.49).
Conclusions. The only risk factor significantly associated with subsequent vertebral compression fractures following percutaneous vertebroplasty was a low bone mineral density T-score. Patients with lower bone mineral density have a higher incidence of vertebral compression fractures and thus need more intensive clinical and radiological follow-up.