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Risk Factors Associated with Adjacent and Remote- Level Pathologic Vertebral Compression Fracture Following Balloon
Michael J Faloon1, Mark Ruoff2, Chetan Deshpande1
1Seton Hall University School of Health and Medical Science, Department of Orthopaedic Surgery, South Orange, New Jersey.
Journal of Long-Term Effects of Medical Implants
|February 9, 2016
Summary
Balloon kyphoplasty with cement augmentation for vertebral compression fractures showed a lower risk of subsequent fractures compared to conservative treatment. This finding suggests kyphoplasty may be a more effective intervention for preventing further spinal fractures.
Area of Science:
- Orthopedics
- Spinal Surgery
- Geriatric Medicine
Background:
- Vertebral compression fractures cause significant pain, morbidity, and mortality.
- Balloon kyphoplasty is a popular treatment for these fractures.
- Long-term effects of cement augmentation on adjacent spinal segments require investigation.
Purpose of the Study:
- To compare the risk of subsequent adjacent and remote vertebral compression fractures in patients treated with conservative measures versus balloon kyphoplasty.
- To assess the impact of polymethylmethacrylate cement augmentation on fracture risk.
Main Methods:
- Retrospective chart review of 258 patients with osteoporosis-related vertebral compression fractures.
- Comparison of outcomes between nonoperative treatment and balloon kyphoplasty with cement augmentation.
- Multivariate analysis of patient comorbidities and fracture risk at a minimum of 2 years follow-up.
Main Results:
- Nonoperative treatment was a significant independent risk factor for subsequent vertebral compression fractures (OR, 2.28).
- The kyphoplasty cohort had a lower risk of subsequent fractures compared to the nonoperative cohort.
- No individual comorbidity was solely attributable for increased risk of subsequent fractures.
Conclusions:
- Nonoperative management of vertebral compression fractures is associated with a significantly higher risk of subsequent fractures compared to balloon kyphoplasty.
- Balloon kyphoplasty with polymethylmethacrylate cement augmentation may reduce the risk of further vertebral compression fractures.
