Repeated and multiple new vertebral compression fractures after percutaneous transpedicular vertebroplasty.

Study Design: A retrospective study to detect patients with new-onset compression fractures following vertebroplasty.

Objective: To investigate the characteristics and associated risk factors of new-onset vertebral compression fractures after vertebroplasty.

Summary Of Background Data: Percutaneous vertebroplasty is a well-established technique for treating osteoporotic compression fractures. Short-term results are promising, but longer-term studies have suggested a possible accelerated failure rate in the adjacent vertebral body. METHODS.: We retrospectively reviewed patients with osteoporotic compression fractures from January 2000 to June 2006. The patients received percutaneous vertebroplasty with bone cement augmentation. Long-term follow-up radiographically identified the occurrence of vertebral fracture (minimum follow-up 24 months) after an initial vertebral fracture.

Results: In 852 patients (1131 vertebrae), 58.8% to 63.8% of new compression fractures after vertebroplasty were adjacent compression fractures. Adjacent fractures occurred much sooner than nonadjacent fractures; (71.9 +/- 71.8 days vs. 286.8 +/- 232.8 days, P < 0.001). In patients who experienced vertebral compression fractures 2 or more times, older age, lower baseline bone mineral density (BMD), and more pre-existing vertebral compression fractures were demonstrated in this study (P < 0.005). The gender and amount of cemented polymethyl methacrylate were not statistically different between Groups A (1 vertebral compression fracture) and B (vertebral compression fracture > or =2 times).

Conclusion: New-onset vertebral compression fractures occurred repeatedly within a few years after vertebroplasty. New-onset adjacent-level fractures occurred sooner and were more predominate than nonadjacent level fractures. The results of this study suggest that older patient age, lower baseline BMD, and more pre-existing vertebral fractures were found to be risk factors for multiple vertebral compression fractures.