Analysis of Risk Factors for New Vertebral Fracture After Percutaneous Vertebroplasty

Borensztein, Matias; Camino-Willhuber, Gastón; Posadas‐Martinez, María Lourdes; Gruenberg, Marcelo; Solá, Carlos; Velán, Osvaldo

doi:10.1177/2192568217732988

Cited by 23 publications

(17 citation statements)

References 21 publications

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“…osteoporosis medication [7,11,15,24]. The technical factors associated with recollapse include a larger or smaller volume of injected cement and performing percutaneous balloon kyphoplasty instead of PVP [7,10]. Statistically significant radiographic risk factors have also been identified, including higher local kyphosis, intravertebral instability, and presence of the IVC sign with pseudarthrosis [6,7,10,13].…”

Section: A B C D a B Cmentioning

confidence: 99%

“…Nevertheless, the recollapse of cemented vertebrae or cement loosening seldom occurs and is accompanied by the recurrence of back pain following cement augmentation [6][7][8][9]. Previous studies have identified the risk factors for the recollapse of the vertebra, namely, low bone mineral density (BMD), older age, intradiscal cement leakage, presence of multiple preexisting vertebral fractures, intravertebral vacuum cleft (IVC) sign, and fracture at the thoracolumbar junction [6,7,[10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Sagittal Imbalance and Recollapse after Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture: A Multivariate Study of Risk Factors

et al. 2022

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This study aimed to assess the clinical significance of sagittal balance for predicting and managing the recollapse of cemented vertebra following percutaneous vertebroplasty (PVP) in patients with thoracolumbar osteoporotic vertebral fracture (OVF). Overview of Literature: Recently, the recollapse of cemented vertebra following PVP for OVF has been reported. Although the risk factors for recollapse have been determined, the association between sagittal spinopelvic parameters and sagittal imbalance with recollapse has not been established. Methods: Ambulatory patients who underwent single-level PVP for thoracolumbar OVF with a follow-up of at least 24 months were retrospectively reviewed. The patients were divided into two groups depending on the presence of symptomatic recollapse at the cemented vertebra: (1) recollapsed (RC) group and (2) noncollapsed (NC) group. The patient characteristics and radiographic measurements associated with sagittal imbalance were analyzed at each follow-up visit. Results: Overall, 134 patients (RC group, n=28; NC group, n=106) were enrolled. The mean fracture-free interval was 3.2 months (range, 1.2-25.1 months). The multivariate binary logistic regression analysis identified low bone mineral density (p=0.047), degree of dynamic mobility within the vertebra (p=0.025), and sagittal imbalance as significant risk factors for recollapse (p=0.013; odds ratio, 5.405). The progression of sagittal imbalance and thoracolumbar kyphosis (T10-L2) was more significant in the RC and sagittal imbalance groups than in the NC group (both p=0.000). Conclusions: Sagittal imbalance, lower bone mineral density, and dynamic mobility within the vertebra are associated with the recollapse of cemented vertebrae following PVP. Sagittal imbalance, rather than local kyphosis or thoracolumbar kyphosis, is particularly significant in that it results in more progressive collapse and sagittal deformity and is accompanied by substantial back pain and neurological deficits. Therefore, a stricter and more active management, including anti-osteoporosis medication, is required for the treatment of OVF with sagittal imbalance of the spine.

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Section: A B C D a B Cmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlation of Sagittal Imbalance and Recollapse after Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture: A Multivariate Study of Risk Factors

et al. 2022

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“…Venous PMMA embolization is rare, although there have been reports of pulmonary embolism 22,23. Potential negative mechanical effects of cemented vertebrae upon adjacent osteoporotic levels has been described by previous studies,9–12 with reports of new VCF incidence being extremely variable (8%–52%). Nevertheless the debate on whether PV causes an increased risk of adjacent VCFs is still open.…”

Section: Evidence In the Literaturementioning

confidence: 69%

<p>Vertebroplasty in the treatment of osteoporotic vertebral compression fractures: patient selection and perspectives</p>

Martikos¹,

Greggi²,

Vommaro³

et al. 2019

OARRR

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Osteoporotic vertebral fractures represent a constantly increasing pathology that may compromise life quality and general health. Among various treatment options, percutaneous vertebroplasty has been used widely over the past 20 years. Although there is a vast amount of retrospective reports in the literature, high-level evidence has emerged only recently. In this paper, the authors provide a synopsis of the current literature on the efficacy and safety of percutaneous vertebroplasty while also presenting a step-by-step description of the surgical procedure, focusing on details that may help in optimizing quality and safety.

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“…At present, it is uncertain whether PKP / PVP increases the risk of vertebral fractures, especially adjacent vertebral bodies [29]. It has been reported in previous literature that the strength of the vertebral body and the physiological invagination of endplate are aggravated by injecting bone cement into injured vertebrae, which increases the pressure of the intervertebral disc, transfers the load to adjacent vertebrae, and increases the risk of fracture of the adjacent vertebral body [30][31][32]. In this study, the incidence of adjacent vertebral fractures in the surgical treatment group was 7.89%, which was not signi cantly different from that in the conservative treatment group (6.25%) (P > 0.05).…”

Section: Incidence Of Adjacent Vertebral Fracturesmentioning

confidence: 99%

Application of ASTLOF Scoring System in the Treatment of Acute Symptomatic Thoracolumbar Compression Fractures

Yang

Jiang

et al. 2020

Preprint

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Background: Osteoporotic vertebral compression fracture (OVCF) is a common injury in the elderly, often caused by low-energy injuries. Improper treatment will not only affect the stability and balance of the spine, but in severe cases will lead to neurological damage and increase the risk of death. This retrospective study aims to explore the principles of treatment of patients with the assessment system of thoracolumbar osteoporotic fracture (ASTLOF) in acute symptomatic thoracolumbar compression fractures when the ASTLOF score = 4 points.Methods: The clinical data of patients with acute symptomatic thoracolumbar compression fractures admitted from February 2018 to February 2020 were retrospectively analyzed. Each patient was evaluated according to the ASTLOF scoring system, and patients with ASTLOF score = 4 were selected, a total of 108 patients. According to different treatment methods, they were divided into 32 cases in the non-surgical treatment (NST) group and 76 cases in the surgical treatment (ST)group. The visual analog score (VAS), Oswestry disability index (ODI), the recovery of injured vertebral body height, and the incidence of adjacent segment fractures were used for comprehensive evaluation.Results: During the follow-up, the VAS score and ODI score showed that the early pain relief and functional improvement of the surgical treatment group were better than those of the conservative treatment group (P<0.05); the Cobb angle of the surgical treatment group was 3 months and 6 months after the operation, and the vertebral body was injured. The degree of improvement of margin height was better than that of the conservative treatment group (all P<0.05); in the surgical treatment group, 6 cases of adjacent vertebral fractures occurred after surgery, accounting for 7.89%, and 2 cases of the conservative treatment group had adjacent vertebral fractures, accounting for 6.25% There was no statistically significant difference between the two groups (P>0.05).Conclusions: When the ASTLOF scoring system is used in the treatment of acute symptomatic thoracolumbar compression fractures, patients with ASTLOF score =4 should be treated with surgery in time, which can relieve pain early and quickly, perform functional exercises as soon as possible, and reduce complications related to long-term bed rest. Whether it increases the risk of adjacent vertebral fractures requires long-term follow-up studies in a large number of cases.

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Analysis of Risk Factors for New Vertebral Fracture After Percutaneous Vertebroplasty

Cited by 23 publications

References 21 publications

Correlation of Sagittal Imbalance and Recollapse after Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture: A Multivariate Study of Risk Factors

Correlation of Sagittal Imbalance and Recollapse after Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture: A Multivariate Study of Risk Factors

<p>Vertebroplasty in the treatment of osteoporotic vertebral compression fractures: patient selection and perspectives</p>

Application of ASTLOF Scoring System in the Treatment of Acute Symptomatic Thoracolumbar Compression Fractures

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