Risk Factors of New Symptomatic Fractures after Vertebroplasty: A Retrospective Cohort Study of 268 Patients with Painful Osteoporotic Vertebral Compression Fracture

Shi-Tong Feng; Yong Yang; Xiang Li; Wei-Yang Zuo; Hai-Bo Sun

doi:10.1016/j.wneu.2024.05.007

Risk Factors of New Symptomatic Fractures after Vertebroplasty: A Retrospective Cohort Study of 268 Patients with Painful Osteoporotic Vertebral Compression Fracture

World Neurosurg. 2024 May 9:S1878-8750(24)00760-5. doi: 10.1016/j.wneu.2024.05.007. Online ahead of print.

Authors

Shi-Tong Feng¹, Yong Yang², Xiang Li², Wei-Yang Zuo³, Hai-Bo Sun⁴

Affiliations

¹ Department of Orthopedics, Civil Aviation General Hospital, Chaoyang District, Beijing, 100123, China.
² Department of Orthopedics, Beijing Friendship Hospital Capital Medical University , No.95, Yong'an Road, Xicheng District, Beijing, China, 100050.
³ Department of Emergency, Beijing Friendship Hospital Capital Medical University, No.95, Yong'an Road, Xicheng District, Beijing, China, 100050.
⁴ Department of Orthopedics, Beijing Friendship Hospital Capital Medical University , No.95, Yong'an Road, Xicheng District, Beijing, China, 100050. Electronic address: spinesurgeon_sun@163.com.

PMID: 38734168
DOI: 10.1016/j.wneu.2024.05.007

Abstract

Objectiv: To evaluate the risk factors of new osteoporotic vertebral compression fractures (OVCFs) after percutaneous vertebroplasty (PVP).

Methods: From January 2016 to November 2019, patients suffering from OVCFs were retrospectively reviewed. The independent influence factors for new OVCFs after PVP were assessed, from following variables: age, sex, BMI, BMD, history of alcoholism, smoking, hypertension, diabetes, glucocorticoid use, and prior vertebral fractures, the number of initial fractures, mean cement volume, method of puncture, D-type of cement leakage and regular anti-osteoporosis treatment.

Results: A total of 268 patients with 347 levels met the inclusion criteria and were finally included in this study. 49 levels of new OVCFs among 33 patients (12.31%) were observed during the follow-up period. It indicated that female (Adjusted OR: 6.812, 95%CI: [1.096, 42.337], P = 0.040), lower BMD (Adjusted OR: 0.477, 95%CI: [0.300, 0.759], P = 0.002), prior vertebral fractures (Adjusted OR: 16.145, 95%CI: [5.319, 49.005], P = 0.000), and regular anti-osteoporosis treatment (Adjusted OR: 0.258, 95%CI: [0.086, 0.774], P = 0.016) were independent influence factors for new OVCF. The cut-off value of BMD to reach new OVCF was -3.350, with a sensitivity of 0.660 and a specificity of 0.848.

Conclusion: Female, lower BMD (T- score of lumbar), prior vertebral fractures and regular anti-osteoporosis treatment were independent influencing factors. BMD (T- score of lumbar) lower than -3.350 would increase risk for new OVCF, and none osteoporotic treatment has detrimental effect on new onset fractures following PVP.

Keywords: new symptomatic fractures; risk factor; vertebral compression fractures; vertebroplasty.