Progression of the risk factors researches of adjacent vertebral fractures after vertebral augmentation for osteoporotic vertebral compression fracture

Abstract

Vertebral augmentation has been widely used for treating the osteoporotic vertebral compression fractures. However, the occurrence of new fractures in adjacent vertebrae is also common. In order to understand the mechanism of adjacent vertebral fractures to prevent its happening, many scholars have carried out a lot of experiments and clinical studies by different research methods for years. As a result, many theories about the mechanism of adjacent vertebral fracture have been formed. Including the patients' general conditions (age, gender, bone mineral density, body mass index, et al), material characteristics of bone cement, distribution of bone cement (volume of bone cement and under-endplate distribution, acentric or bilateral distribution, compact and solid cement filling pattern, bone cement leakage), factors of spinal sagittal imbalance, factors of anti-osteoporosis treatment and the behavioral therapy, the location of initial injured vertebral level, the degeneration of adjacent disc, all of above were considered as potential risk factors. However, various researches lead to diverse conclusions because of different methods were used and different research factors were included, some conclusions were even opposite. Therefore, it is still controversial that whether some of the risk factors were effective. In this research, the current researches and the reliability and limitations of various research methods were reviewed to put forward a relatively objective interpretation, in order to provide evidences for understanding the risks of adjacent vertebral fracture after vertebral augmentation, and to provide reference for treatment.