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The risk of stroke after percutaneous vertebroplasty for osteoporosis: a population-based cohort study
Ching-Lan Wu1, Jau-Ching Wu, Wen-Cheng Huang
1Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
Insights
Percutaneous vertebroplasty for osteoporosis does not increase stroke risk. This study found no significant difference in stroke incidence between patients who underwent the procedure and a matched control group over five years.
Area of Science:
- Orthopedics and Neurology
- Vascular Surgery
- Geriatric Medicine
Background:
- Osteoporosis is a common condition leading to fractures.
- Percutaneous vertebroplasty is a procedure used to treat osteoporotic fractures.
- The potential risk of stroke following vertebroplasty requires investigation.
Purpose of the Study:
- To determine the incidence and risk of stroke after percutaneous vertebroplasty in patients with osteoporosis.
- To compare stroke risk in patients who underwent vertebroplasty versus a matched control group.
Main Methods:
- A cohort of 334 osteoporotic patients undergoing vertebroplasty was compared to 1,655 matched controls.
- Propensity score matching was used to control for demographic and comorbidity differences.
- Patients were followed for up to five years, with stroke incidence analyzed using Cox regression and Kaplan-Meier methods.
Main Results:
- The overall incidence rates for any stroke, hemorrhagic stroke, and ischemic stroke were 22.6, 4.2, and 19.6 per 1,000 person-years, respectively.
- Patients undergoing vertebroplasty showed no increased likelihood of any stroke (crude HR=1.13, p=0.693).
- Adjusted analyses confirmed no significant difference in stroke risk between the vertebroplasty and control groups (adjusted HR for any stroke=1.22, p=0.518).
Conclusions:
- Percutaneous vertebroplasty in osteoporotic patients is not associated with an elevated risk of stroke within five years post-procedure.
- The findings suggest the procedure is safe concerning cerebrovascular events.
- This study provides evidence to support the use of vertebroplasty in managing osteoporotic fractures without undue stroke concerns.
Purpose:
To investigate the incidence and risk of stroke after percutaneous vertebroplasty in patients with osteoporosis.
Methods:
A group of 334 patients with osteoporosis, and who underwent percutaneous vertebroplasty during the study period, was compared to 1,655 age-, sex- and propensity score-matched patients who did not undergo vertebroplasty. All demographic covariates and co-morbidities were deliberately matched between the two groups to avoid selection bias. Every subject was followed-up for up to five years for stroke. Adjustments using a Cox regression model and Kaplan-Meier analyses were conducted.
Results:
A total of 1,989 osteoporotic patients were followed up for 3,760.13 person-years. Overall, the incidence rates of any stroke, hemorrhagic stroke and ischemic stroke were 22.6, 4.2 and 19.6 per 1,000 person-years, respectively. Patients who underwent vertebroplasty were not more likely to have any stroke (crude hazard ratio = 1.13, p = 0.693), hemorrhagic stroke (HR = 2.21, p = 0.170), or ischemic stroke (HR = 0.96, p = 0.90). After adjusting for demographics, co-morbidities and medications, the vertebroplasty group had no significant difference with the comparison group in terms of any, hemorrhagic and ischemic strokes (adjusted HR = 1.22, 3.17, and 0.96, p = 0.518, 0.055, and 0.91, respectively).
Conclusions:
Osteoporotic patients who undergo percutaneous vertebroplasty are not at higher risk of any stroke in the next five years after the procedure.
