Adjacent Level Vertebral Fractures in Patients Operated with Percutaneous Vertebroplasty

Dangol Bijendra,Maharjan Promish,Xiaotao Wu,Lei Zhu,Singh Ratish,Zanli Jiang

doi:10.4236/ojo.2018.83014

Abstract

Percutaneous vertebroplasty is a minimally invasive procedure that involves filling of a fractured vertebral body with bone cement to relieve pain and to restore the vertebral height. It is a safe and effective treatment and is widely used for treating Osteoporotic Vertebral Compression Fracture. Despite of its beneficial advantages over primary conservative managements, adjacent level vertebral compression fracture remains the challenge for surgeons. Adjacent level vertebral compression fracture following percutaneous vertebroplasty using PMMA cement has been reported as a complication. Numerous risk factors have been reported for the occurrence of new adjacent VCFs after PVP. The multiple level osteoporotic vertebral compression fractures and the increasing age of the patients are directly proportional to the risk of developing new symptomatic adjacent vertebral compression fracture after PVP. Moreover, low BMD and cement leakage are other factors that directly affect the incidence of new symptomatic adjacent vertebral fractures. The aim of this review is to evaluate the adjacent level vertebral compression fracture following percutaneous vertebroplasty on the basis of radiographs, Kaplan-Meier Estimation index and also the factors that lead to adjacent level vertebral compression fractures.

Highlights

The multiple level osteoporotic vertebral compression fractures and the increasing age of the patients are directly proportional to the risk of developing new symptomatic adjacent vertebral compression fracture after Percutaneous vertebroplasty (PVP)
Low bone mineral density (BMD) and cement leakage are other factors that directly affect the incidence of new symptomatic adjacent vertebral fractures
The aim of this review is to evaluate the adjacent level vertebral compression fracture following percutaneous vertebroplasty on the basis of radiographs, Kaplan-Meier Estimation index and the factors that lead to adjacent level vertebral compression fractures

Summary

Introduction

Osteoporosis is defined as a skeletal disease condition characterized by low bone mass which precipitates the fracture risk [1]. Osteoporosis may occur due to number of diseases or treatments like alcoholism, anorexia, hyperthyroidism, renal diseases. Anti-seizure medications, chemotherapy, proton pump inhibitors, selective serotonin reuptake inhibitors and glucocorticoids increase the risk of developing osteoporosis. Osteoporosis is defined as a bone density of 2.5 standard derivatives below that of a young adult. This is typically measured by dual energy x-ray absorptiometry (DEXA) scan [3]. Some patients continue to develop severe pain, vertebral compression and kyphotic deformity [5]. OVCF are being increasingly treated with minimally invasive bone augmentation technique like Percutaneous Vertebroplasty

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