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Trauma

RISK FACTORS FOR NEW ADJACENT VERTEBRAL COMPRESSION FRACTURE AFTER VERTEBROPLASTY OR KYPHOPLASTY FOR OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES IN ASIAN PATIENTS

International Society for Fracture Repair (ISFR)



Abstract

Introduction

The risk factors for new adjacent vertebral compression fracture (NAVCF) after Vertebroplasty (VP) or Kyphoplasty (KP) for osteoporotic vertebral compression fractures (VCFs) were investigated.

Materials and methods

The authors retrospectively analyzed the incidence of NAVCFs in 135 patients treated with VP or KP for osteoporotic VCFs. Study period was from 2004 to 2008 with minimum follow-up of 2 years.

Possible risk factors were documented: age, gender, body mass index, bone mineral density (BMD), co-morbidities, location of treated vertebra, treatment modality and amount of bone cement injected.

Anterior-posterior vertebral body height ratio, intra-discal cement leakage into the disc space and pattern of cement distribution of the initial VCF and adjacent vertebral bodies were assessed on lateral thoracolumbar radiographs by 2 independent assessors.

Results

21 patients (15.6%) had subsequent symptomatic NAVCFs with a median time to new fracture was of 125 days.

There was no difference in incidence of NAVCF between VP and KP groups (P>0.05).

Significant differences were found between patients with and without NAVCF in terms of age, BMD, and the proportion of cement leakage into the disc space (P < 0.05). Greater age, intra-discal cement leakage and low BMD were found in patients with NAVCF.

Conclusion

The most important risk factors affecting NAVCFs were age, osteoporosis and intra-discal cement leakage.