Open AccessRisk Factors of Subsequent Vertebral Compression Fractures After Vertebroplasty
Author(s) -
Lu Kang,
Liang ChengLoong,
Hsieh ChingHua,
Tsai YuDuan,
Chen HanJung,
Liliang PoChou
Publication year - 2012
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2011.01297.x
Subject(s) - medicine , compression (physics) , vertebral compression fracture , radiology , surgery , vertebral body , materials science , composite material
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.