J Korean Neurosurg Soc.  2012 Oct;52(4):339-345. 10.3340/jkns.2012.52.4.339.

The Analysis of Patterns and Risk Factors of Newly Developed Vertebral Compression Fractures after Percutaneous Vertebroplasty

• Yoo CM
• Park KB
• Hwang SH
• Kang DH
• Jung JM
• Park IS

• KMID: 2190650
• DOI: http://doi.org/10.3340/jkns.2012.52.4.339

Abstract

OBJECTIVE
The purpose of this study was to investigate the patterns and the risk factors of newly developed vertebral compression fractures (VCFs) after percutaneous vertebroplasty (PVP).
METHODS
We performed a retrospective review of the 244 patients treated with PVP from September 2006 to February 2011. Among these patients, we selected 49 patients with newly developed VCFs following PVP as the new VCFs group, and the remaining 195 patients as the no VCFs group. The new VCFs group was further divided into 2 groups : an adjacent fractures group and a nonadjacent fractures group. The following data were collected from the groups : age, gender, body weight/height, body mass index (BMI), bone mineral density (BMD) score of the spine and femur, level of initial fracture, restoration rate of anterior/middle vertebral height, and intradiscal cement leakage, volume of polymethylmethacrylate (PMMA).
RESULTS
Age, gender, mean body height/weight, mean BMI and volume of PMMA of each of the group are not statistically significantly associated with fractures. In comparison between the new VCFs group and the no VCFs group, lower BMD, intradiscal cement leakage and anterior vertebral height restoration were the significant predictive factors of the fracture. In addition, new VCFs occurrence at the adjacent spines was statistically significant, when the initial fracture levels were confined to the thoracolumbar junction, among the subgroups of new VCFs.
CONCLUSION
Lower spinal BMD, the greater anterior vertebral height restoration rate and intradiscal cement leakage were confirmed as risk factors for newly formed VCFs after PVP.

Keyword

Compression fracture; Vertebroplasty; Risk factor; Osteoporosis; Pattern

MeSH Terms

Body Mass Index
Bone Density
Femur
Fractures, Compression
Humans
Osteoporosis
Polymethyl Methacrylate
Retrospective Studies
Risk Factors
Spine
Vertebroplasty
Polymethyl Methacrylate

Figure

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  Fig. 1 Method used for determining vertebral body height restoration rate. Vertebral body height before compression fracture (Y) : Y=(a+b)/2, anterior height restoration (A) : A=[(e-c)/Y]×100 (%), middle height restoration (M) : M=[(f-d)/Y]×100 (%).

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  Fig. 2 The Kaplan-Meier survival curve shows the estimated fracture-free rate of vertebrae after vertebroplasty.

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  Fig. 3 The Kaplan-Meier survival curve shows the estimated fracture-free rate of vertebrae after vertebroplasty by intradiscal cement leakage.

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