Journal of Surgery

| Peer-Reviewed |

Analysis of Risk Factors of Recurrent Vertebral Fractures After Percutaneous Vertebroplasty

Received: Nov. 01, 2020    Accepted: Nov. 19, 2020    Published: Nov. 30, 2020
Views:       Downloads:

Share This Article

Abstract

Background: Investigate the risk factors of recurrent vertebral compression fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Method: Data of 401 patients with osteoporotic vertebral compression fractures treated by PVP from March 2013 to June 2018 were retrospectively analyzed, and were divided into re-fracture group and nonre-fracture group according to the postoperative recurrence of vertebral compression fractures. The following parameters were observed, including age, gender, bone mineral density (BMD), correction degree of kyphosis, recovery degree of vertebral height, amount of bone cement injected, Pfirrmann classification of adjacent intervertebral disc of hurt vertebral, and bone cement leakage in intervertebral disc. Then, the above parameters were statistically analyzed by univariate and multivariate analysis to explore the risk factors of vertebral recurrent fracture after PVP. Result: Among 401 patients, 34 (34 /401, 8.4%) recurred OVCF after PVP. Statistical analysis showed that the risk of recurrent vertebral fracture increased by 3.732 times (95% CI 1.107-12.581) when Pfirrmann classification of adjacent intervertebral disc was in degeneration grade. The risk of recurrent vertebral fracture was significantly increased by 31.818 times (95% CI 13.384-75.640) when bone cement leakage occurred in intervertebral disc. Conclusion: Pfirrmann classification of adjacent intervertebral disc and bone cement leakage in intervertebral disc are significantly correlated with the recurrence of vertebral fracture after PVP. In PVP operation, avoiding the bone cement leakage in intervertebral disc can significantly reduce the recurrence of vertebral compression fractures.

DOI 10.11648/j.js.20200806.16
Published in Journal of Surgery ( Volume 8, Issue 6, December 2020 )
Page(s) 204-208
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Percutaneous Vertebroplasty, Osteoporotic Vertebral Compression Fractures, Recurrent Fractures, Risk Factors

References
[1] H. Tang, J. Zhao, and C. Hao. Osteoporotic vertebral compression fractures: surgery versus non-operative management. J Int Med Res, 2011, 39 (4): 1438-47.
[2] Y. J. Rho, W. J. Choe, and Y. I. Chun. Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J, 2012, 21 (5): 905-11.
[3] A. T. Trout and D. F. Kallmes. Does vertebroplasty cause incident vertebral fractures? A review of available data. AJNR Am J Neuroradiol, 2006, 27 (7): 1397-403.
[4] C. W. Pfirrmann, A. Metzdorf, M. Zanetti, J. Hodler, and N. Boos. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976), 2001, 26 (17): 1873-8.
[5] C. M. Yoo, K. B. Park, S. H. Hwang, D. H. Kang, J. M. Jung, and I. S. Park. The analysis of patterns and risk factors of newly developed vertebral compression fractures after percutaneous vertebroplasty. J Korean Neurosurg Soc, 2012, 52 (4): 339-45.
[6] Y. A. Li, C. L. Lin, M. C. Chang, C. L. Liu, T. H. Chen, and S. C. Lai. Subsequent vertebral fracture after vertebroplasty: incidence and analysis of risk factors. Spine (Phila Pa 1976), 2012, 37 (3): 179-83.
[7] A. A. Uppin, J. A. Hirsch, L. V. Centenera, B. A. Pfiefer, A. G. Pazianos, and I. S. Choi. Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology, 2003, 226 (1): 119-24.
[8] J. Zou, X. Mei, X. Zhu, Q. Shi, and H. Yang. The long-term incidence of subsequent vertebral body fracture after vertebral augmentation therapy: a systemic review and meta-analysis. Pain Physician, 2012, 15 (4): E515-22.
[9] X. Ma, D. Xing, J. Ma, J. Wang, Y. Chen, W. Xu, Y. Yang, B. Ma, and S. Zhu. Risk factors for new vertebral compression fractures after percutaneous vertebroplasty: qualitative evidence synthesized from a systematic review. Spine (Phila Pa 1976), 2013, 38 (12): E713-22.
[10] A. Rohlmann, H. N. Boustani, G. Bergmann, and T. Zander. A probabilistic finite element analysis of the stresses in the augmented vertebral body after vertebroplasty. Eur Spine J, 2010, 19 (9): 1585-95.
[11] S. H. Kim, H. S. Kang, J. A. Choi, and J. M. Ahn. Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty. Acta Radiol, 2004, 45 (4): 440-5.
[12] C. Bliemel, L. Oberkircher, B. Buecking, N. Timmesfeld, S. Ruchholtz, and A. Krueger. Higher incidence of new vertebral fractures following percutaneous vertebroplasty and kyphoplasty--fact or fiction? Acta Orthop Belg, 2012, 78 (2): 220-9.
[13] I. Movrin, R. Vengust, and R. Komadina. Adjacent vertebral fractures after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a comparison of balloon kyphoplasty and vertebroplasty. Arch Orthop Trauma Surg, 2010, 130 (9): 1157-66.
[14] T. J. Kaufmann, A. T. Trout, and D. F. Kallmes. The effects of cement volume on clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol, 2006, 27 (9): 1933-7.
[15] C. H. Yen, M. M. Teng, W. H. Yuan, Y. C. Sun, and C. Y. Chang. Preventive vertebroplasty for adjacent vertebral bodies: a good solution to reduce adjacent vertebral fracture after percutaneous vertebroplasty. AJNR Am J Neuroradiol, 2012, 33 (5): 826-32.
[16] A. S. Mudano, J. Bian, J. U. Cope, J. R. Curtis, T. P. Gross, J. J. Allison, Y. Kim, D. Briggs, M. E. Melton, J. Xi, and K. G. Saag. Vertebroplasty and kyphoplasty are associated with an increased risk of secondary vertebral compression fractures: a population-based cohort study. Osteoporos Int, 2009, 20 (5): 819-26.
[17] X. Yi, H. Lu, F. Tian, Y. Wang, C. Li, H. Liu, X. Liu, and H. Li. Recompression in new levels after percutaneous vertebroplasty and kyphoplasty compared with conservative treatment. Arch Orthop Trauma Surg, 2014, 134 (1): 21-30.
[18] E. Ibarz, A. Herrera, Y. Mas, J. Rodriguez-Vela, J. Cegonino, S. Puertolas, and L. Gracia. Development and kinematic verification of a finite element model for the lumbar spine: application to disc degeneration. Biomed Res Int, 2013, 2013: 705185.
[19] N. Inoue and A. A. Espinoza Orias. Biomechanics of intervertebral disk degeneration. Orthop Clin North Am, 2011, 42 (4): 487-99, vii.
[20] T. Hansson and B. Roos. The relation between bone mineral content, experimental compression fractures, and disc degeneration in lumbar vertebrae. Spine (Phila Pa 1976), 1981, 6 (2): 147-53.
[21] V. Kosmopoulos, T. S. Keller, and C. Schizas. Early stage disc degeneration does not have an appreciable affect on stiffness and load transfer following vertebroplasty and kyphoplasty. Eur Spine J, 2009, 18 (1): 59-68.
[22] G. Baroud, J. Nemes, P. Heini, and T. Steffen. Load shift of the intervertebral disc after a vertebroplasty: a finite-element study. Eur Spine J, 2003, 12 (4): 421-6.
[23] Y. C. Sun, M. M. Teng, W. S. Yuan, C. B. Luo, F. C. Chang, J. F. Lirng, W. Y. Guo, and C. Y. Chang. Risk of post-vertebroplasty fracture in adjacent vertebral bodies appears correlated with the morphologic extent of bone cement. J Chin Med Assoc, 2011, 74 (8): 357-62.
[24] J. Lin, L. Zhang, and H. L. Yang. Unilateral versus bilateral balloon kyphoplasty for osteoporotic vertebral compression fractures. Pain Physician, 2013, 16 (5): 447-53.
Cite This Article
  • APA Style

    Jiang Du, Chenhuan Lu, Jing Wang. (2020). Analysis of Risk Factors of Recurrent Vertebral Fractures After Percutaneous Vertebroplasty. Journal of Surgery, 8(6), 204-208. https://doi.org/10.11648/j.js.20200806.16

    Copy | Download

    ACS Style

    Jiang Du; Chenhuan Lu; Jing Wang. Analysis of Risk Factors of Recurrent Vertebral Fractures After Percutaneous Vertebroplasty. J. Surg. 2020, 8(6), 204-208. doi: 10.11648/j.js.20200806.16

    Copy | Download

    AMA Style

    Jiang Du, Chenhuan Lu, Jing Wang. Analysis of Risk Factors of Recurrent Vertebral Fractures After Percutaneous Vertebroplasty. J Surg. 2020;8(6):204-208. doi: 10.11648/j.js.20200806.16

    Copy | Download

  • @article{10.11648/j.js.20200806.16,
      author = {Jiang Du and Chenhuan Lu and Jing Wang},
      title = {Analysis of Risk Factors of Recurrent Vertebral Fractures After Percutaneous Vertebroplasty},
      journal = {Journal of Surgery},
      volume = {8},
      number = {6},
      pages = {204-208},
      doi = {10.11648/j.js.20200806.16},
      url = {https://doi.org/10.11648/j.js.20200806.16},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.20200806.16},
      abstract = {Background: Investigate the risk factors of recurrent vertebral compression fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Method: Data of 401 patients with osteoporotic vertebral compression fractures treated by PVP from March 2013 to June 2018 were retrospectively analyzed, and were divided into re-fracture group and nonre-fracture group according to the postoperative recurrence of vertebral compression fractures. The following parameters were observed, including age, gender, bone mineral density (BMD), correction degree of kyphosis, recovery degree of vertebral height, amount of bone cement injected, Pfirrmann classification of adjacent intervertebral disc of hurt vertebral, and bone cement leakage in intervertebral disc. Then, the above parameters were statistically analyzed by univariate and multivariate analysis to explore the risk factors of vertebral recurrent fracture after PVP. Result: Among 401 patients, 34 (34 /401, 8.4%) recurred OVCF after PVP. Statistical analysis showed that the risk of recurrent vertebral fracture increased by 3.732 times (95% CI 1.107-12.581) when Pfirrmann classification of adjacent intervertebral disc was in degeneration grade. The risk of recurrent vertebral fracture was significantly increased by 31.818 times (95% CI 13.384-75.640) when bone cement leakage occurred in intervertebral disc. Conclusion: Pfirrmann classification of adjacent intervertebral disc and bone cement leakage in intervertebral disc are significantly correlated with the recurrence of vertebral fracture after PVP. In PVP operation, avoiding the bone cement leakage in intervertebral disc can significantly reduce the recurrence of vertebral compression fractures.},
     year = {2020}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Analysis of Risk Factors of Recurrent Vertebral Fractures After Percutaneous Vertebroplasty
    AU  - Jiang Du
    AU  - Chenhuan Lu
    AU  - Jing Wang
    Y1  - 2020/11/30
    PY  - 2020
    N1  - https://doi.org/10.11648/j.js.20200806.16
    DO  - 10.11648/j.js.20200806.16
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 204
    EP  - 208
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20200806.16
    AB  - Background: Investigate the risk factors of recurrent vertebral compression fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Method: Data of 401 patients with osteoporotic vertebral compression fractures treated by PVP from March 2013 to June 2018 were retrospectively analyzed, and were divided into re-fracture group and nonre-fracture group according to the postoperative recurrence of vertebral compression fractures. The following parameters were observed, including age, gender, bone mineral density (BMD), correction degree of kyphosis, recovery degree of vertebral height, amount of bone cement injected, Pfirrmann classification of adjacent intervertebral disc of hurt vertebral, and bone cement leakage in intervertebral disc. Then, the above parameters were statistically analyzed by univariate and multivariate analysis to explore the risk factors of vertebral recurrent fracture after PVP. Result: Among 401 patients, 34 (34 /401, 8.4%) recurred OVCF after PVP. Statistical analysis showed that the risk of recurrent vertebral fracture increased by 3.732 times (95% CI 1.107-12.581) when Pfirrmann classification of adjacent intervertebral disc was in degeneration grade. The risk of recurrent vertebral fracture was significantly increased by 31.818 times (95% CI 13.384-75.640) when bone cement leakage occurred in intervertebral disc. Conclusion: Pfirrmann classification of adjacent intervertebral disc and bone cement leakage in intervertebral disc are significantly correlated with the recurrence of vertebral fracture after PVP. In PVP operation, avoiding the bone cement leakage in intervertebral disc can significantly reduce the recurrence of vertebral compression fractures.
    VL  - 8
    IS  - 6
    ER  - 

    Copy | Download

Author Information
  • Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Orthopedics, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Section