Predictive Risk Factors for Refracture after Percutaneous Vertebroplasty

Abstract

ObjectiveTo identify risk factors for developing a vertebral refracture after percutaneous vertebroplasty.MethodA retrospective analysis of 60 patients who had undergone percutaneous vertebroplasty between January 2008 and April 2010 was conducted. All patients were observed for a 1 year follow-up period, and fracture was defined when it was both clinically reported and radiographically confirmed. Twenty-seven patients with a refractured vertebra and 33 patients without a refracture were included. Of the 60 patients, 20 presented with a refracture from a cemented vertebra, whereas the remaining 40 patients did not. Clinical, imaging and procedure-related factors for each group were analyzed by the Fisher's exact, chi-square, and the Mann-Whitney U-tests.ResultsLocal kyphotic angle and sagittal index were significant as a result of researching various risk factors related to vertebral refracture (p<0.001, p<0.001, respectively) and refracture from a cemented vertebra itself (p=0.004, p<0.001, respectively). Other factors were not significant.ConclusionPatients who had a high preoperative local kyphotic angle and a high sagittal index required a close follow-up and attention.

Anterior spinal fixation for recollapse of cemented vertebrae after percutaneous vertebroplasty

“…However, as with the three cases reported here, the cemented vertebrae can recollapse after PV 10 12 13 16 22 23. Regarding the risk factors for this complication, Kang et al 23 suggested that a higher preoperative local kyphotic angle and a higher sagittal index24 may result in refracture, based on a comparison of patients with or without refracture. Chen et al 16 demonstrated that an MRI finding of preoperative osteonecrosis and a relatively large postoperative restoration of anterior vertebral height without a corresponding correction in the kyphotic angle increased the risk of refracture.…”

Risk factors for new vertebral compression fractures after vertebroplasty: a meta‐analysis

“…After reviewing the full text of the remaining 26 studies, we excluded nine additional full‐text articles. Finally, 17 unique studies with sufficient data were included and analysed in the meta‐analysis . A flow diagram that shows the literature search process is presented in Figure .…”

“…To the best of our knowledge, prior studies have investigated many of the risk factors for the development of new VCFs following vertebroplasty, such as low body mass index (BMI), intradiscal cement leakage, high cement volume, low bone mineral density (BMD) and multiple vertebral levels affected . However, these studies were limited by either a small sample size or a limited number of potential risk factors investigated.…”

Analysis of Risk Factors Causing New Symptomatic Vertebral Compression Fractures After Percutaneous Vertebroplasty for Painful Osteoporotic Vertebral Compression Fractures

“…Factors related to PVP procedures include intradiscal leakage 8,13 and cement distribution. 14 It has also been hypothesized that factors such as the presence of Z2 preexisting vertebral compression fractures 11 and a high preoperative local kyphotic angle and sagittal index 15 affect refracture after PVP.…”