Safety and therapeutic efficacy of the second treatment for new fractures developed after initial vertebroplasty performed for painful vertebral compression fractures

Abstract

Objectives: There is no report on the safety and therapeutic efficacy of the second treatment for new vertebral fractures developed after vertebroplasty. This study aims to examine the therapeutic effects and clinical characteristics in patients undergoing a second vertebroplasty for these new fractures.Methods: The initial treatment group included 182 patients (276 vertebrae) who underwent vertebroplasty. Among 182 patients, the second treatment group included 34 patients (36 vertebrae) who developed new fractures postoperatively, which were retreated. Analgesic effects on the day following surgery, frequency of new fractures during the 12 month period after surgery, and other clinical characteristics were compared between the initial and second treatment groups. Furthermore, similar comparisons were performed between patients with adjacent and non-adjacent vertebral fractures in the second treatment group.Results: The improvement rates in visual analogue scale (VAS) scores before and after surgery were 83·4% in the initial treatment group and 85·6% in the second treatment group (P = 0·27). The frequencies of new fractures occurring within 12 months after surgery were 20·9% and 20·6%, respectively.Within the second treatment group, the VAS improvement rates were 76·7% in the adjacent and 88·2% in the non-adjacent vertebral fracture groups (P = 0·83). However, the frequencies of subsequent new fractures after the second treatment were 31·6% and 5·9%, respectively, being significantly higher in the adjacent vertebral fracture group (P < 0·05).Conclusions: Additional vertebroplasty for new fractures exerts analgesic effects similar to those of the initial procedure. However, we must note that the second treatment for new adjacent vertebral fractures frequently causes more subsequent new fractures in comparison with non-adjacent fractures.