Age was a protective factor for unexpected malignant diagnoses in patients with vertebral compression fracture

Abstract

ObjectiveThe purpose was to investigate the risk factors for unexpected malignant diagnoses in patients with vertebral compression fractures (VCF). MethodsThe clinical data were retrospectively collected from 1396 patients who underwent vertebral augmentation and biopsy between 2012 and 2022. According to the imaging results, the preoperative diagnoses were benign VCF (BVCF) in all these cases. Based on the histological findings, the patients were divided into two groups. In group A, unexpected malignant VCF (MVCF) was identified, while benign VCF (BVCF) was verified in group B. Logistic regression analysis was performed to analyze the risk and protective factors for unexpected malignant diagnoses. ResultsThere were 44 patients in group A and 1352 in group B. The incidence of unexpected MVCF was 3.2 %. Age was significantly lower in group A compared to group B. Additionally, none of the patients in group A were older than 75. Age was associated with unexpected malignant diagnoses, according to the univariate logistic analysis. The multivariate logistic analysis showed that age was a protective factor for unexpected malignant diagnoses (odds ratio = 0.849, 95 % confidence interval: 0.809–0.891, p < 0.01). ConclusionAge was a protective factor for unexpected malignant diagnoses in patients with preoperative diagnosis of BVCF. A routine biopsy is recommended to be performed during vertebral augmentation in young patients without preoperative imaging evidence of MVCF.