The Incidence of New Vertebral Compression Fractures in Women after Kyphoplasty and Factors Involved.
10.3349/ymj.2007.48.4.645
- Author:
Eun Su MOON
1
;
Hak Sun KIM
;
Jin Oh PARK
;
Seong Hwan MOON
;
Hwan Mo LEE
;
Dong Eun SHIN
;
Jung Won HA
;
Eun Kyoung AHN
;
Dong Jun SHIM
;
Jun Young CHUNG
Author Information
1. Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. haksunkim@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Kyphoplasty;
compression fracture;
influencing factor
- MeSH:
Aged;
Aged, 80 and over;
Bone Cements;
Female;
Follow-Up Studies;
Fractures, Compression/epidemiology/*surgery;
Humans;
Incidence;
Middle Aged;
Orthopedic Procedures;
Postoperative Complications;
Recurrence;
Risk Factors;
Spinal Fractures/epidemiology/*surgery;
Surgical Procedures, Minimally Invasive;
Treatment Outcome
- From:Yonsei Medical Journal
2007;48(4):645-652
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To identify the incidence of new vertebral compression fractures in women after kyphoplasty and to analyze influential factors in these patients. MATERIALS AMD METHODS: One hundred and eleven consecutive female patients with osteoporotic vertebral compression fractures (VCFs) underwent kyphoplasty at 137 levels. These patients were followed for 15.2 months postoperatively. For the survey of new vertebral compression fractures, medical records and x-rays were reviewed, and telephone interviews were conducted with all patients. RESULTS: During that time 20 (18%) patients developed new VCFs. The rate of occurrence of new VCFs in one year was 15.5% using a Kaplan-Meier curve. Body mass index (BMI), symptom duration and kyphoplasty level were the statistically significant factors between the patient groups both with and without new VCFs after kyphoplasty. In the comparison between the adjacent and remote new VCF groups, the adjacent new VCF group showed a larger amount of polymethyl methacrylate (PMMA) use during kyphoplasty (p<0.05). Before kyphoplasty, 9.9% of the patients had been prescribed medication for osteoporosis, and 93.7% of the patients started or continued medication after kyphoplasty. The development of new VCFs was affected by the number of vertebrae involved in the kyphoplasty. However, the lower incidence rate (15.5%) of new compression fractures might be due to a greater percentage (93.7% in our study) of patients taking anti-osteoporotic medication before and/or after kyphoplasty. CONCLUSION: When kyphoplasty is planned for the management of patients with osteoporotic VCFs, the application of a small amount of PMMA can be considered in order to lower the risk of new fractures in adjacent vertebrae. The postoperative use of anti- osteoporotic medication is recommended for the prevention of new VCFs.
