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2024, Vol. 28 ›› Issue (36): 5884-5891

Risk factors for adjacent vertebral compression fractures after percutaneous vertebroplasty

Liu Dongyuan, Guan Haishan, Shi Haoran, Liu Xiaoliang, Zhou Haosheng   

  1. Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

  • Received:2023-10-08 Accepted:2023-11-29 Online:2024-12-28 Published:2024-02-28

  • Contact: Guan Haishan, Chief physician, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

  • About author:Liu Dongyuan, Master candidate, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

Abstract: BACKGROUND: Percutaneous vertebroplasty is the most widely used method for the treatment of osteoporotic vertebral compression fractures, and most studies have concluded that percutaneous vertebroplasty increases the probability of adjacent vertebral secondary compression fractures in patients with osteoporotic vertebral compression fractures. However, controversy remains regarding the risk factors associated with adjacent vertebral re-fracture caused after percutaneous vertebroplasty.
OBJECTIVE: To summarize the influencing factors of adjacent vertebral compression fractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures, in order to provide a certain reference for reducing the risk of its occurrence as well as formulating the corresponding treatment plan.
METHODS: Using “osteoporosis, fracture, percutaneous vertebroplasty, adjacent vertebral compression fractures, risk factors” as the Chinese search terms, “osteoporosis, osteoporotic vertebral compression fractures, percutaneous vertebroplasty, adjacent vertebral compression fractures, risk factors” as English search terms, computerized searches were conducted on CNKI, Wanfang Medical Network, VIP, PubMed, Springer, ScienceDirect, and Elsevier databases. The search timeframe focuses on January 2018 through September 2023, with the inclusion of a few classic forward literature. The literature was screened by reading the titles and abstracts, and 83 papers were finally included in the review.
RESULTS AND CONCLUSION: (1) Osteoporotic vertebral compression fractures are one of the most common complications of osteoporosis, placing elderly patients at a significant risk of disability and death. Percutaneous vertebroplasty is a practical and effective treatment for osteoporotic vertebral compression fractures. (2) With the popularity of percutaneous vertebroplasty, its secondary vertebral compression fractures have gradually increased, with adjacent vertebral compression fractures being the most common. (3) Previous studies have only discussed the effects of factors such as bone mineral density, multiple vertebral fractures, body mass index, age, sex, amount of bone cement, cement leakage, and anti-osteoporosis treatment on secondary compression fractures of adjacent vertebrae after percutaneous vertebroplasty, and summarized the number of vertebral fractures, timing of the operation, surgical approach, cement material, diffuse distribution of bone cement, recovery height of the injured vertebrae, and wearing of a support after surgery, which is not yet comprehensive. The analysis of the specific mechanisms of risk factor-induced adjacent vertebral fractures is relatively rare. (4) The results of the article showed that low bone mineral density, advanced age, perimenopausal women, multiple vertebral fractures, excessive recovery of the height of the injured vertebrae, cement leakage, comorbid underlying diseases, and poor lifestyle habits were the risk factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty, and that maintaining a normal body mass index, early surgery, bilateral percutaneous vertebroplasty, use of a new type of cement material, an appropriate volume of bone cement injection and uniform cement dispersion, regular anti-osteoporosis treatment, and postoperative brace wearing are protective factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty.

Key words: osteoporosis, fractures, percutaneous vertebroplasty, adjacent vertebral compression fractures, risk factor, bone mineral density, bone cement, advanced age, woman, anti-osteoporosis treatment


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