nach oben

10.06.2024 | Original Article

Incidence and risk factors of subsequent vertebral fracture following percutaneous vertebral augmentation in postmenopausal women

verfasst von: Yuanpei Cheng, Xipeng Chen, Yongbo Li, Zhe Tan, Xingchen Yao, Rui Jiang, Han Wu

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Subsequent vertebral fracture (SVF) is a severe advent event of percutaneous vertebral augmentation (PVA). However, the incidence and risk factors of SVF following PVA for OVCF in postmenopausal women remain unclear. This research aims to investigative the incidence and risk factors of SVF after PVA for OVCF in postmenopausal women.

Methods

Women who underwent initial PVA for OVCF between August 2019 and December 2021 were reviewed. Univariate logistic regression analysis was performed to identify possible risk factors of SVF, and independent risk factors were determined by multivariate logistic regression.

Results

A total of 682 women after menopause were enrolled in the study. Of these women, 100 cases had an SVF after PVA, with the incidence of 14.66%. Univariate logistic regression analysis demonstrated that age (p = 0.001), body mass index (BMI) (p < 0.001), steroid use (p = 0.008), history of previous vertebral fracture (p < 0.001), multiple vertebral fracture (p = 0.033), postoperative wedge angle (p = 0.003), and HU value (p < 0.001) were significantly correlated with SVF following PVA. Furthermore, BMI (OR [95%CI] = 0.892 [0.825 − 0.965]; p = 0.004), steroid use (OR [95%CI] = 3.029 [1.211 − 7.574]; p = 0.018), history of previous vertebral fracture (OR [95%CI] = 1.898 [1.148 − 3.139]; p = 0.013), postoperative wedge angle (OR [95%CI] = 1.036 [1.004 − 1.070]; p = 0.028), and HU value (OR [95%CI] = 0.980 [0.971 − 0.990]; p < 0.001) were identified as independent risk factors of SVF after PVA by multivariate logistic regression analysis.

Conclusions

The incidence of SVF following PVA for OVCF in postmenopausal women was 14.66%. BMI, steroid use, history of previous vertebral fracture, postoperative wedge angle, and HU value were independent risk factors of SVF after PVA for OVCF in postmenopausal women.

Rizzoli R (2018) Postmenopausal osteoporosis: assessment and management. Best Pract Res Clin Endocrinol Metab 32(5):739–757PubMedCrossRef

Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8(1):136PubMedPubMedCentralCrossRef

Shim YB, Park JA, Nam JH, Hong SH, Kim JW, Jeong J, Shin JY (2020) Incidence and risk factors of subsequent osteoporotic fracture: a nationwide cohort study in South Korea. Arch Osteoporos 15(1):180PubMedCrossRef

Xie L, Zhao ZG, Zhang SJ, Hu YB (2017) Percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: an updated meta-analysis of prospective randomized controlled trials. Int J Surg 47:25–32PubMedCrossRef

Beall DP, Chambers MR, Thomas S et al (2019) Prospective and multicenter evaluation of outcomes for quality of life and activities of daily living for balloon kyphoplasty in the treatment of vertebral compression fractures: the EVOLVE Trial. Neurosurgery 84(1):169–178PubMedCrossRef

Yang EZ, Xu JG, Huang GZ, Xiao WZ, Liu XK, Zeng BF, Lian XF (2016) Percutaneous vertebroplasty versus conservative treatment in aged patients with acute osteoporotic vertebral compression fractures: a prospective randomized controlled clinical study. Spine 41(8):653–660PubMedCrossRef

Fribourg D, Tang C, Sra P, Delamarter R, Bae H (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29(20):2270–2276 discussion 2277PubMedCrossRef

Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR (2009) Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA 301(5):513–521PubMedCrossRef

Ning L, Zhu J, Tian S, Hu Z, Liu C, Zhao X, Li X, Fan S, Wan S (2021) Correlation analysis between basic diseases and subsequent vertebral fractures after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures. Pain Physician 24(6):E803–E810PubMedCrossRef

10.

Zhang ZL, Yang JS, Hao DJ, Liu TJ, Jing QM (2021) Risk factors for new vertebral fracture after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Clin Interv Aging 16:1193–1200PubMedPubMedCentralCrossRef

11.

Schreiber JJ, Anderson PA, Rosas HG, Buchholz AL, Au AG (2011) Hounsfield units for assessing bone mineral density and strength: a tool for osteoporosis management. J Bone Joint Surg Am 93(11):1057–1063PubMedCrossRef

12.

Tanigawa N, Komemushi A, Kariya S, Kojima H, Shomura Y, Omura N, Sawada S (2007) Relationship between cement distribution pattern and new compression fracture after percutaneous vertebroplasty. AJR Am J Roentgenol 189(6):W348–352PubMedCrossRef

13.

Sadiqi S, Verlaan JJ, Lehr AM et al (2017) Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study. Eur Spine J 26(5):1483–1491PubMedCrossRef

14.

Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS (2003) Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. Radiology 226(1):119–124PubMedCrossRef

15.

Li YA, Lin CL, Chang MC, Liu CL, Chen TH, Lai SC (2012) Subsequent vertebral fracture after vertebroplasty: incidence and analysis of risk factors. Spine 37(3):179–183PubMedCrossRef

16.

Compston JE, Flahive J, Hosmer DW et al (2014) Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the global longitudinal study of osteoporosis in women (GLOW). J Bone Min Res 29(2):487–493CrossRef

17.

De Laet C, Kanis JA, Odén A et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16(11):1330–1338PubMedCrossRef

18.

Lu K, Liang CL, Hsieh CH, Tsai YD, Chen HJ, Liliang PC (2012) Risk factors of subsequent vertebral compression fractures after vertebroplasty. Pain Med 13(3):376–382PubMedCrossRef

19.

Ji C, Rong Y, Wang J et al (2021) Risk factors for refracture following primary osteoporotic vertebral compression fractures. Pain Physician 24(3):E335–e340PubMed

20.

Canalis E (2003) Mechanisms of glucocorticoid-induced osteoporosis. Curr Opin Rheumatol 15(4):454–457PubMedCrossRef

21.

Abtahi S, Driessen JHM, Burden AM, Souverein PC, van den Bergh JP, van Staa TP, Boonen A, de Vries F (2022) Low-dose oral glucocorticoid therapy and risk of osteoporotic fractures in patients with rheumatoid arthritis: a cohort study using the clinical Practice Research Datalink. Rheumatology 61(4):1448–1458PubMedCrossRef

22.

Lindsay R, Silverman SL, Cooper C et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285(3):320–323PubMedCrossRef

23.

Klotzbuecher CM, Ross PD, Landsman PB, Abbott TA 3rd, Berger M (2000) Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Min Res 15(4):721–739CrossRef

24.

Lin T, Lu J, Zhang Y, Wang Z, Chen G, Gu Y, Zhou L, Liu W (2021) Does spinal sagittal imbalance lead to future vertebral compression fractures in osteoporosis patients? Spine J 21(8):1362–1375PubMedCrossRef

25.

Dai J, Yu X, Huang S, Fan L, Zhu G, Sun H, Tang X (2015) Relationship between sagittal spinal alignment and the incidence of vertebral fracture in menopausal women with osteoporosis: a multicenter longitudinal follow-up study. Eur Spine J 24(4):737–743PubMedCrossRef

26.

Asahi R, Nakamura Y, Kanai M, Watanabe K, Yuguchi S, Kamo T, Azami M, Ogihara H, Asano S (2022) Association with sagittal alignment and osteoporosis-related fractures in outpatient women with osteoporosis. Osteoporos Int 33(6):1275–1284PubMedCrossRef

27.

Baek SW, Kim C, Chang H (2015) The relationship between the spinopelvic balance and the incidence of adjacent vertebral fractures following percutaneous vertebroplasty. Osteoporos Int 26(5):1507–1513PubMedCrossRef

28.

Zhao C, Liu X, Wang Y, Guo J, Han S, Zhang H, Chen M, Zhou C, Ma X (2022) The effects of biomechanical factors on adjacent vertebral compression fractures after percutaneous kyphoplasty: a propensity score matching analysis. Osteoporos Int 33(8):1795–1806PubMedCrossRef

29.

Takahashi S, Hoshino M, Yasuda H et al (2019) Development of a scoring system for predicting adjacent vertebral fracture after balloon kyphoplasty. Spine J 19(7):1194–1201PubMedCrossRef

30.

Tao W, Biao W, Xingmei C, Hu Q, Jinpeng S, Yue G, Jun L (2022) Predictive factors for adjacent vertebral fractures after percutaneous kyphoplasty in patients with osteoporotic vertebral compression fracture. Pain Physician 25(5):E725–e732PubMed

31.

Lee BG, Choi JH, Kim DY, Choi WR, Lee SG, Kang CN (2019) Risk factors for newly developed osteoporotic vertebral compression fractures following treatment for osteoporotic vertebral compression fractures. Spine J 19(2):301–305PubMedCrossRef

32.

Gausden EB, Nwachukwu BU, Schreiber JJ, Lorich DG, Lane JM (2017) Opportunistic use of CT imaging for osteoporosis screening and bone density assessment: a qualitative systematic review. J Bone Joint Surg Am 99(18):1580–1590PubMedCrossRef

33.

Pickhardt PJ, Pooler BD, Lauder T, del Rio AM, Bruce RJ, Binkley N (2013) Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med 158(8):588–595PubMedPubMedCentralCrossRef

34.

Lee SJ, Binkley N, Lubner MG, Bruce RJ, Ziemlewicz TJ, Pickhardt PJ (2016) Opportunistic screening for osteoporosis using the sagittal reconstruction from routine abdominal CT for combined assessment of vertebral fractures and density. Osteoporos Int 27(3):1131–1136PubMedCrossRef

35.

Lee SJ, Graffy PM, Zea RD, Ziemlewicz TJ, Pickhardt PJ (2018) Future osteoporotic fracture risk related to lumbar vertebral trabecular attenuation measured at routine body CT. J Bone Min Res 33(5):860–867CrossRef

36.

Lee BJ, Koo HW, Yoon SW, Sohn MJ (2021) Usefulness of trabecular CT attenuation measurement of lumbar spine in predicting osteoporotic compression fracture: is the L4 trabecular region of interest most relevant? Spine 46(3):175–183PubMedCrossRef

37.

Li H, Yang DL, Ma L, Wang H, Ding WY, Yang SD (2017) Risk factors associated with adjacent vertebral compression fracture following percutaneous vertebroplasty after menopause: a retrospective study. Med Sci Monit 23:5271–5276PubMedPubMedCentralCrossRef

38.

Spross C, Aghayev E, Kocher R, Röder C, Forster T, Kuelling FA (2014) Incidence and risk factors for early adjacent vertebral fractures after balloon kyphoplasty for osteoporotic fractures: analysis of the SWISSspine registry. Eur Spine J 23(6):1332–1338PubMedCrossRef

39.

Wang YT, Wu XT, Chen H, Wang C, Mao ZB (2014) Adjacent-level symptomatic fracture after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a retrospective analysis. J Orthop Sci 19(6):868–876PubMedCrossRef

40.

Ren HL, Jiang JM, Chen JT, Wang JX (2015) Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty. Eur Spine J 24(4):750–758PubMedCrossRef

41.

Takahara K, Kamimura M, Moriya H, Ashizawa R, Koike T, Hidai Y, Ikegami S, Nakamura Y, Kato H (2016) Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women. BMC Musculoskelet Disord 17:12PubMedPubMedCentralCrossRef

42.

Bae JS, Park JH, Kim KJ, Kim HS, Jang IT (2017) Analysis of risk factors for secondary new vertebral compression fracture following percutaneous vertebroplasty in patients with osteoporosis. World Neurosurg 99:387–394PubMedCrossRef

43.

Borensztein M, Camino Willhuber GO, Posadas Martinez ML, Gruenberg M, Sola CA, Velan O (2018) Analysis of risk factors for New Vertebral Fracture after Percutaneous Vertebroplasty. Global Spine J 8(5):446–452PubMedCrossRef

44.

Chen C, Fan P, Xie X, Wang Y (2020) Risk factors for cement leakage and adjacent vertebral fractures in kyphoplasty for osteoporotic vertebral fractures. Clin Spine Surg 33(6):E251–e255PubMedCrossRef

45.

Park JS, Park YS (2021) Survival analysis and risk factors of new vertebral fracture after vertebroplasty for osteoporotic vertebral compression fracture. Spine J 21(8):1355–1361PubMedCrossRef

46.

Chen Z, Song C, Chen M, Li H, Ye Y, Liu W (2021) What are risk factors for subsequent fracture after vertebral augmentation in patients with thoracolumbar osteoporotic vertebral fractures. BMC Musculoskelet Disord 22(1):1040PubMedPubMedCentralCrossRef

47.

An Z, Chen C, Wang J, Zhu Y, Dong L, Wei H, Wu L (2021) Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation. J Orthop Surg Res 16(1):374PubMedPubMedCentralCrossRef

48.

Li W, Wang H, Dong S, Tang ZR, Chen L, Cai X, Hu Z, Yin C (2022) Establishment and validation of a nomogram and web calculator for the risk of new vertebral compression fractures and cement leakage after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures. Eur Spine J 31(5):1108–1121PubMedCrossRef

49.

Cheng Y, Cheng X, Wu H (2022) Risk factors of new vertebral compression fracture after percutaneous vertebroplasty or percutaneous kyphoplasty. Front Endocrinol 13:964578CrossRef

Titel: Incidence and risk factors of subsequent vertebral fracture following percutaneous vertebral augmentation in postmenopausal women
verfasst von: Yuanpei Cheng
Xipeng Chen
Yongbo Li
Zhe Tan
Xingchen Yao
Rui Jiang
Han Wu
Publikationsdatum: 10.06.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-024-08331-5

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie erweitert durch Fallbeispiele, Videos und Abbildungen. Zur Fortbildung und Wissenserweiterung, verfasst und geprüft von Expertinnen und Experten der Gesellschaft für Arthroskopie und Gelenkchirurgie (AGA).

Jetzt entdecken!

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Nackenschmerzen nach Bandscheibenvorfall: Muskeltraining hilft!

15.01.2025
Nackenschmerzen
Nachrichten

Bei hartnäckigen Schmerzen aufgrund einer zervikalen Radikulopathie schlägt ein Team der Universität Istanbul vor, lokale Steroidinjektionen mit einem speziellen Trainingsprogramm zur Stabilisierung der Nackenmuskulatur zu kombinieren.

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

12.01.2025
Elektronische Patientenakte
Nachrichten

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Was sich Menschen mit Frozen Shoulder wünschen

10.01.2025
Schultersteife
Nachrichten

Die Capsulitis adhaesiva des Glenohumeralgelenks, auch als Frozen Shoulder bezeichnet, belastet die Betroffenen weit über die körperlichen Beschwerden hinaus, wie eine italienische Studie ergeben hat.

Restriktive Sauerstoffgabe ohne Vorteil bei schwerem Trauma

09.01.2025
Traumatologische Notfallmedizin
Nachrichten

Ob schwer verletzte Personen besser restriktiv oder liberal mit Sauerstoff versorgt werden sollten, hat die Arbeitsgruppe der TRAUMOX2-Studie untersucht – mit klarem Ergebnis.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen