New vertebral compression fractures after vertebroplasty: association with osteoporosis and spinal sagittal imbalances

doi:10.3969/j.issn.2095-4344.2016.35.014

Abstract

Abstract:

BACKGROUND: Recent report addressing new vertebral fracture after vertebroplasty or balloon kyphoplasty has increased gradually. It remains controversial whether new vertebral fracture is induced by bone cement augmentation or osteoporosis.

OBJECTIVE: To observe new vertebral fracture after conservative treatment and bone cement augmentation for osteoporotic vertebral compression fractures, analyze the relationship between new vertebral fracture and spinal sagittal parameters, and explore the risk factors for new vertebral fracture.

METHODS: From June 2011 to December 2014, 160 patients with osteoporotic vertebral compression fractures in thoracic and lumbar vertebrae were selected from the Department of Spine Surgery, the Affiliated Hospital of Chengde Medical College. According to therapeutic regimen, the patients were divided into two groups. The observation group (n=80) received vertebroplasty or kyphoplasty. The control group (n=80) underwent conservative treatment. At 1 day after surgery in the observation group and after walking in the control group, patients were subjected to anteroposterior and lateral X-ray in the entire length of the spine. Bone mineral density, number and location of new vertebral fractures and sagittal parameters during follow-up were recorded and compared between groups. After final follow-up, according to the appearance of new vertebral fracture, patients in both groups were assigned to two subgroups. The difference in above indicators was compared between the two subgroups. The relationship between new vertebral fracture and spinal sagittal parameters was analyzed.

RESULTS AND CONCLUSION: (1) There were no statistically significant differences in gender, age, body mass index, bone mineral density, pelvic index, sacral slope, pelvic tilt, thoracic kyphotic angle, lumbar lordotic angle, C₇/sacro-femoral distance ratio and occurrence rate of new fractures between the two treated groups (P > 0.05). (2) There were no statistically significant differences in gender, age, body mass index, pelvic index, and lumbar lordotic angle between new vertebral fracture group and non-fracture group. There were statistically significant differences in bone mineral density, sacral slope, pelvic tilt, thoracic kyphotic angle and the C₇/sacro-femoral distance between the new vertebral fracture group and the control group (P < 0.05). (3) Results confirmed that new vertebral compression fractures after vertebroplasty, Kyphoplasty or conservative treatment for osteoporotic vertebral compression fractures were definitely associated with osteoporosis and spinal sagittal imbalance.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Thoracic Vertebrae, Lumbar Vertebrae, Pelvis, Osteoporosis, Fractures, Compression, Vertebroplasty, Tissue Engineering

CLC Number:

R318

Zhang Yi-long, Ren Lei, Sun Zhi-jie, Wang Ya-hui, Sun He. New vertebral compression fractures after vertebroplasty: association with osteoporosis and spinal sagittal imbalances[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(35): 5263-5269.

Figures/Tables 4

References

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