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| 22KS-010 |
Risk Factors for New Vertebral Compression Fracture After Kyphoplasty: A STROBE-compliant retrospective study
Department
of Anesthesiology and Pain Medicine, Korea University Medical Center, Guro
Hospital
Background
The issue of new vertebral compression fractures (VCFs) after kyphoplasty (KP) has been controversial. Identification of risk factors for the new VCF after KP may help prevent patient experiences associated with the new VCF. This study aimed to retrospectively determine the major risk factors for new VCF after KP, including those with respect to the osteoporosis drugs used after kyphoplasty.
Materials & Methods
Data of 117 patients who underwent single-level KP were reviewed retrospectively. Patients were devided into two groups During the follow-up period of 1 year after KP, the demographic data of these patients were compared by dividing them into two groups: those with new fractures (n=19) and those without new fractures (n=98). We investigated the age, sex, fracture location, medical history, steroid use history, bone mineral density (BMD), type of osteoporosis treatment, period from fracture to KP, KP method (unilateral or bilateral), bone cement dose, intradiscal cement leakage, preoperative and postoperative compression ratio and kyphotic angle (KA), lowest vertebral body height in fractured vertebrae. Based on these, factors related to new VCFs after KP were investigated using univariate and multivariate logistic regression analyses. We also investigated whether there were differences in new VCFs according to the type of osteoporosis treatment.
Results
During the 1-year follow-up period after KP, the rate of new VCFs was 16.2%. Factors related to new VCFs were BMD, intradiscal cement leakage, KA recovery rate after 1 day, and baseline height in univariate and multivariated logistic regression analysis. The group treated with zoledronate after KP tended to show a lower frequency of developing new VCFs than that of the group treated with alendronate (P= .07), calcium (P=0.05), selective estrogen receptor modulator (SERM) (P= .15), and risendronate group (P= .02).
Conclusions
This study showed that for patients with new VCFs after KP, lower BMD, greater intradiscal cement leakage, greater KA recovery rate, and lower baseline vertebral height were the likely risk factors for the development of new VCFs. Additionally, among the drugs used for the treatment of osteoporosis after KP, zoledronate tends to reduce the development of new VCFs compared with other bisphosphonates, SERMs, or calcium.
References
1. Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS. Occurrence of new vertebral body fracture
after percutaneous vertebroplasty in patients with osteoporosis. Radiology 2003; 226:119-124
2. Chen Z, Wu Y, Ning S, Ma T, Wu Z. Risk factors of secondary vertebral compression fracture after percutaneous
vertebroplasty or kyphoplasty: a retrospective study of 650 patients. Med Sci Monit 2019; 25:9255-9261
The issue of new vertebral compression fractures (VCFs) after kyphoplasty (KP) has been controversial. Identification of risk factors for the new VCF after KP may help prevent patient experiences associated with the new VCF. This study aimed to retrospectively determine the major risk factors for new VCF after KP, including those with respect to the osteoporosis drugs used after kyphoplasty.
Materials & Methods
Data of 117 patients who underwent single-level KP were reviewed retrospectively. Patients were devided into two groups During the follow-up period of 1 year after KP, the demographic data of these patients were compared by dividing them into two groups: those with new fractures (n=19) and those without new fractures (n=98). We investigated the age, sex, fracture location, medical history, steroid use history, bone mineral density (BMD), type of osteoporosis treatment, period from fracture to KP, KP method (unilateral or bilateral), bone cement dose, intradiscal cement leakage, preoperative and postoperative compression ratio and kyphotic angle (KA), lowest vertebral body height in fractured vertebrae. Based on these, factors related to new VCFs after KP were investigated using univariate and multivariate logistic regression analyses. We also investigated whether there were differences in new VCFs according to the type of osteoporosis treatment.
Results
During the 1-year follow-up period after KP, the rate of new VCFs was 16.2%. Factors related to new VCFs were BMD, intradiscal cement leakage, KA recovery rate after 1 day, and baseline height in univariate and multivariated logistic regression analysis. The group treated with zoledronate after KP tended to show a lower frequency of developing new VCFs than that of the group treated with alendronate (P= .07), calcium (P=0.05), selective estrogen receptor modulator (SERM) (P= .15), and risendronate group (P= .02).
Conclusions
This study showed that for patients with new VCFs after KP, lower BMD, greater intradiscal cement leakage, greater KA recovery rate, and lower baseline vertebral height were the likely risk factors for the development of new VCFs. Additionally, among the drugs used for the treatment of osteoporosis after KP, zoledronate tends to reduce the development of new VCFs compared with other bisphosphonates, SERMs, or calcium.
References
1. Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS. Occurrence of new vertebral body fracture
after percutaneous vertebroplasty in patients with osteoporosis. Radiology 2003; 226:119-124
2. Chen Z, Wu Y, Ning S, Ma T, Wu Z. Risk factors of secondary vertebral compression fracture after percutaneous
vertebroplasty or kyphoplasty: a retrospective study of 650 patients. Med Sci Monit 2019; 25:9255-9261
