Risk factors of new vertebral fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures

Abstract

Objective To determine the risk factors for new vertebral fractures following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Methods This retrospective study included 703 patients (133 males and 570 females; 59-88 years, mean 76 years) treated with PVP for OVCF from January 2006 to June 2015. Involved vertebrae included 5 T6,3 T7,19 T8,16 T9,14 T10,46 T11,218 T12,241 L1,137 L2,108 L3,55 L4 and 37 L5. A total of 80 patients were detected with further vertebral fractures (new fracture group) and 623 patients with no new vertebral fractures (control group). Possible risk factors for new vertebral fractures were noted, including age, gender, body mass index (BMI), bone mineral density, involved vertebral segment, amount of cement injection, intradiscal cement leak, and anterior-posterior ratio of the fractured vertebrae. And the fracture group were subdivided into adjacent vertebral fracture group (n=48) and non-adjacent vertebral fracture group (n=32). Results Eighty (11%) of the 703 patients had subsequent vertebral fractures after PVP. Bone mineral density differed significantly between new fracture and control groups [(-3.31±0.74)SD vs. (-2.98±0.86)SD ] (P 0.05). There were no significant differences in all the factors between adjacent vertebral fracture and non-adjacent vertebral fracture groups (P>0.05). Conclusions Severe osteoporosis is the main risk factor of new vertebral fractures after OVCF managed with PVP. Therefore, treatment of osteoporosis is the key point to prevent postoperative new vertebral fractures. Key words: Spinal fractures; Vertebroplasty; Bone density