Analysis of recurrent fracture of a new vertebral body after percutaneous vertebroplasty in patients with osteoporosis.

OBJECTIVE

To investigate the characteristics of recurrent fracture of a new vertebral body after percutaneous vertebroplasty in patients with osteoporosis.

METHODS

29 postmenopausal osteoporosis patients were divided into two groups: 14 patients with recurrent fracture of a new vertebral body after vertebroplasty comprised the new fracture group and there were 15 patients without recurrent fracture in the control group. The following variables were reviewed: age, body mass index (BMI), history of fractures, history of metabolic disease, anti-osteoporosis therapy, type of back brace used, bone mineral density (BMD) of the lumbar spine and hip, intact parathyroid hormone (iPTH), serum calcium and phosphorus, and time since vertebroplasty.

RESULTS

Compared with the control group, patients in the new fracture group were statistically significantly different with respect to BMI (t = 2.538, P = 0.027), BMD of the lumbar spine (t = 2.761, P = 0.015), BMD of the hip (t = 2.367, P = 0.037) and iPTH (t = 2.711, P = 0.017). Twelve (86%) of the 14 patients' new vertebral fractures occurred within six months after treatment of the initial fracture, and 10 (71%) fractures were adjacent to those previously treated by percutaneous vertebroplasty.

CONCLUSIONS

A substantial number of patients with osteoporosis develop new fractures after vertebroplasty; two-thirds of these new fractures occur in vertebrae adjacent to those previously treated. The following variables influence the outcome: BMI, history of fractures, history of metabolic diseases and medications, BMD of lumbar spine and hip, anti-osteoporosis therapy, and use of back brace.