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High preoperative compression ratio, Low BMD, and high preoperative saggital index may be associated with development of SNVCFs.
Skewed bone cement
distribution, a high proportion of bone cement volume to vertebral body volume
and abnormal BMD is considered as the significant risk factors to cause SNVCF
as per the reports a recently published analysis. Secondary new vertebral
compression fractures (SNVCFs) involved two types of fractures; adjacent
vertebral compression fractures (AVCFs) and remote vertebral compression
fractures.
A total of 402
patients were assessed over a minimum follow-up of 4 years after PVP to extract
data regarding the relationship of SNVCFs with radiological, clinical and PVP
procedure-associated morphologic parameters. A three-dimensional voxel-based
analysis was applied to evaluate the procedure-associated morphologic
parameters. Multivariate and univariate regression analyses were directed. On
univariate analysis, both AVCF and SNVCF showed a significant relationship with
preoperative sagittal index (SI), bone mineral density (BMD), intradiscal bone
cement leakage, and preoperative compression ratio, whereas, remote vertebral
compression fracture only correlated with preoperative SI and BMD. Skewed bone
cement distribution along the inferior-to-superior axis and a large proportion
of bone cement volume to vertebral body volume considered as the significant
risk factors for AVCF. On multivariate analysis, AVCF showed considerable
correlation with upper adjacent intradiscal bone cement leakage and SNVCF with
BMD. As per the findings, low BMD, high preoperative compression ratio, and
high preoperative SI are the factors used to predict the SNVCF. The bone cement
should be injected symmetrically and evenly through the inferior-to-superior
axis, and the volume of relative bone cement should not be excessive to avoid
upper adjacent intradiscal leakage. BMD correction should also be considered as
an essential aspect to control SNVCF.
World Neurosurgery
Clinical, Radiographic, Morphometric Risk Factors for Adjacent and Remote Vertebral Compression Fractures over a Minimum Follow-up of 4 Years after Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures: Novel Three-dimensional Voxel-based Morphometric Analysis.
Hong-JaeLee et al.
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