[Frequency of adjacent vertebral fractures following percutaneous vertebroplasty]

Percutaneous vertebroplasty (PVP) proved to be very effective in the treatment of pain caused by osteoporotic vertebral compression fractures. A certain proportion of patients, however, suffer a new fracture after treatment. Our purpose was to analyze the frequency of new fractures, and to estimate the causative role of PVP in the treated population.

The retrospective study reviewed all consecutive patients treated with PVP for osteoporotic compression fractures during a 5.5 years period. The study group comprised those patients, who suffered a new fracture during the follow up. The primary endpoint was the frequency of new fractures. The secondary endpoint was the occurrence of new fractures in a timeframe of 90 days after treatment that were adjacent to the previously treated segments. The causative role of PVP was estimated to be the highest in this subgroup.

Altogether 396 consecutive patients were treated with PVP for osteoporotic compression fractures. Mean age was 68+11 years, and 23% of the population was male. The study group comprised 73 patients (18.4%). In this subgroup the patients had an average of 3.8 vertebral fractures. After PVP, adjacent fractures were significantly more likely, than distal fractures. Altogether 44 patients (11% of the entire population) suffered an adjacent fracture in 90 days after PVP. In this group there were significantly less male patients as compared to the entire population.

After PVP almost every fifth patient is at risk for developing a new fracture, however, it is likely to be related to the vertebral augmentation in every tenth subject only. Female patients with severe osteoporosis are probably facing the highest risk for developing new fractures.