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KMID : 1150120160020010015
Asian Journal of Pain
2016 Volume.2 No. 1 p.15 ~ p.21
Analysis of Subsequent Fractures after Percutaneous Vertebroplasty
Hong Soon-O

Kong Min-Ho
Jang Se-Youn
Kim Jung-Hee
Ha Yoon
Kang Dong-Soo
Song Kwan-Young
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¡¾10.40 months vs. 18.66¡¾22.60 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¡¾1.66 mL vs. 4.96¡¾2.23 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.
KEYWORD
Vertebroplasty, Osteoporosis, Compression fracture, Adjacent segment disease
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