J Korean Fract Soc.  2015 Apr;28(2):110-117. 10.12671/jkfs.2015.28.2.110.

Vertebral Recompression after Vertebroplasty or Kyphoplasty

• Jun DS
• Moon DH
• Ko YK
• Choi JS
• An BK
• Paik JW
• Park MH

• KMID: 2044018
• DOI: http://doi.org/10.12671/jkfs.2015.28.2.110

Abstract

PURPOSE
The purpose of this study was to examine incidence of recompression and risk factors in the patients with osteoporotic vertebral compression fracture (OVCF) after vertebroplasty or kyphoplasty.
MATERIALS AND METHODS
This study was conducted on 179 vertebral bodies of 126 patients who underwent vertebroplasty or kyphoplasty on OVCF from January 2004 to August 2013.
RESULTS
When anterior vertebral height of fractured vertebrae declined by more than 3 mm from the height immediately after vertebroplasty or kyphoplasty, it was judged that recompression had occurred. Recompression was observed in a total of 58 vertebrae (32.4%). Recompression occurrences were found to be decreasing significantly when fractured vertebrae were the thoracic spine. In addition, osteonecrosis occurred in the preoperative vertebrae and restoration degree of anterior vertebral height immediately after vertebroplasty or kyphoplasty affected recompression occurrences significantly. The other factors (age, sex, bone mineral density, steroid medication history, follow-up duration, cement volume, vertebroplasty or kyphoplasty, and approach method) were compared, but no statistical significance was found.
CONCLUSION
The risk of vertebral recompression is more common, especially when osteonecrosis occurred in preoperative vertebrae or when vertebroplasty or kyphoplasty achieved remarkable restoration of anterior vertebra height. When performing vertebroplasty or kyphoplasty, such conditions should be considered carefully.

Keyword

Osteoporotic fractures; Fracture; Vertebroplasty; Kyphoplasty

MeSH Terms

Bone Density
Follow-Up Studies
Fractures, Compression
Humans
Incidence
Kyphoplasty*
Osteonecrosis
Osteoporotic Fractures
Risk Factors
Spine
Vertebroplasty*

Figure

• 

  Fig. 1 Sagittal thoracic vertebra (T2)-weigted magnetic resonance imaging showing (A) the intervertebral cleft with surrounding bone edema signal intensity, (B) high signal lesion (fluid collection).

• 

  Fig. 2 A 65-year-old female with lumbar vertebra (L1) osteoporotic vertebral compression fracture (dual energy x-ray absorptiometry T-score: -4.4). (A) Initial lateral radiograph. (B) Sagittal thoracic vertebra (T2)-weighted magnetic resonance imaging (MRI) shows intervertebral cleft (osteonecrosis). (C) Immediately postoperative lateral radiograph. (D) At 6 weeks after vertebroplasty, lateral dynamic radiograph (flexion and extension) shows recompression with resorption of the inferior portion of the vertebral body. (E) Postoperative sagittal T2-weighted MRI shows fluid collection around cement. (F) Postoperative (2nd vertebroplasty) radiograph.

• 

  Fig. 3 A 60-year-old male with thoracic vertebra (T8, 9) osteoporotic vertebral compression fracture (dual energy x-ray absorptiometry T-score: -3.2). (A) Postoperative (vertebroplasty T8) lateral radiograph. (B) Postoperative (vertebroplasty T9) lateral radiograph. (C) At 2 years after 2nd vertebroplasty, local kyphotic angle was 55° with severe back pain. (D) Postoperative sagittal T2-weighted magnetic resonance imaging shows fluid collection around cement. (E) Postoperative radiograph.

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