Vascular and Interventional Radiology

Occurrence of New Vertebral Body Fracture after Percutaneous Vertebroplasty in Patients with Osteoporosis

PURPOSE: To investigate the prevalence and findings of vertebral body compression fractures adjacent to those previously treated with percutaneous vertebroplasty.

MATERIALS AND METHODS: The findings in 177 patients treated with percutaneous vertebroplasty for more than 2 years were reviewed retrospectively. The following parameters were reviewed: primary diagnosis, patient age and sex, date of treatment with vertebroplasty, vertebral level(s) treated, pedicular approach, and amount of polymethylmethacrylate injected per vertebral body. Patients with acute compression fractures secondary to osteoporosis were selected.

RESULTS: Of 177 patients treated with percutaneous vertebroplasty, 22 (12.4%) developed a total of 36 new vertebral body fractures following treatment. Of the 36 newly documented fractures, 24 (67%) involved vertebrae adjacent to the previously treated vertebral level(s), whereas 12 (33%) involved the collapse of nonadjacent vertebrae. In addition, 24 (67%) of the 36 new vertebral fractures occurred within 30 days after treatment of the initial fracture(s).

CONCLUSION: A substantial number of patients with osteoporosis develop new fractures after undergoing percutaneous vertebroplasty; two-thirds of these new fractures occur in vertebrae adjacent to those previously treated.

© RSNA, 2003

References

  • 1 Deramond H, Depriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate: technique, indications, and results. Radiol Clin North Am 1998; 36:533-546.
  • 2 Gangi A, Kastler BA, Dietemann JL. Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol 1994; 15:83-86.
  • 3 Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 1997; 18:1897-1904.
  • 4 Centenera LV, Choi S, Hirsch JA. Percutaneous vertebroplasty treats compression fractures. Diagn Imaging (San Franc) 2000; 22:147-148, 153.
  • 5 Chiras J, Depriester C, Weill A, Sola-Martinez MT, Deramond H. Percutaneous vertebral surgery: technics and indications. J Neuroradiol 1997; 24:45-59. [French].
  • 6 Cyteval C, Sarrabere MP, Roux JO, et al. Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients. AJR Am J Roentgenol 1999; 173:1685-90.
  • 7 Grados F, Depriester C, Cayrolle G, Hardy N, Deramond H, Fardellone P. Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty. Rheumatology (Oxford) 2000; 39:1410-1414.
  • 8 Barr JD, Barr MS, Lemley TJ, McCann RM. Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 2000; 25:923-928.
  • 9 Tohmeh AG, Mathis JM, Fenton DC, Levine AM, Belkoff SM. Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures. Spine 1999; 24:1772-1776.
  • 10 Dean JR, Ison KT, Gishen P. The strengthening effect of percutaneous vertebroplasty. Clin Radiol 2000; 55:471-476.
  • 11 Belkoff SM, Maroney M, Fenton DC, Mathis JM. An in vitro biomechanical evaluation of bone cements used in percutaneous vertebroplasty. Bone 1999; 25:23S-26S.
  • 12 Cortet B, Cotten A, Boutry N. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 1999; 26:2222-2228.
  • 13 Mathis JM, Petri M, Naff N. Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures. Arthritis Rheum 1998; 41:171-175.
  • 14 Zoarski GH, Snow P, Olan WJ. Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. J Vasc Interv Radiol 2002; 13:139-148.
  • 15 Lindsay R, Silverman S, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA 2001; 285:320-323.
  • 16 Wasnich U. Vertebral fracture epidemiology. Bone 1996; 18:179S-183S.
  • 17 Jensen ME, Dion JE. Percutaneous vertebroplasty in the treatment of osteoporotic compression fractures. Neuroimaging Clin N Am 2000; 10:547-568.

Article History

Published in print: Jan 2003