The Risks Of New Vertebral Compression Fractures Following Percutaneous Vertebroplasty

Objective:1. To investigate associated risk factors of new vertebral compression fractures(VCFs) following percutaneous vertebroplasty (PVP) through a prospective study.2.To clarify the impacts of bone micro-structural changes on the risk of new vertebralfractures by corresponding analysis of local bone micro-structural changes after thetreatment of PVP.Methods:Collected47cases of patients undergoing PVP due to osteoporotic vertebralcompression fractures from2010December to2011December. And during follow-upexaminations,39patients had no new compression fracture termed as group A, whilethe other8patients with new onset compression fracture were termed as group B. Thepatient age, gender, bone mineral density, location of preexisting VCFs, number ofaugmentation vertebral, postoperative vertebral body height restoration on the anteriorborder and in the middle potion, average correction of the Cobb’s angle, location andinterval time of new compression fracture were reviewed for statistical analysisaiming at evaluating associated risk factors of new fracture.9patients with vertebralfractures located to L1were separately researched.6patients had no new compressionfracture termed as group A, while the other3patients with new onset compressionfracture were termed as group B. The cancellous bone with volume about0.6×0.6×0.6cm3were collected by puncture needle going through pedicle of vertebralarch during PVP, then analyze micro-structures of these bone samples.Results:1. All47cases were followed up for average10.3months (3~15months). Theaverage number of augmented vertebrae and postoperative height restoration value in patients with new vertebral fractures is higher than that without new fractures, whichis statistically significant. But there was no significant difference between group Aand group B patients in other factors, such as age, gender, body mass index, bonemineral density and so on.2. In9patients with vertebral fractures located to L1, bonetrabeculae miss continuity in patients with new vertebral fractures, and the differencewas statistically significant compared with that without new fractures.Conclusion:1. The average number of augmented vertebrae and postoperative vertebral bodyheight restoration value may have relations to new vertebral fractures.2. Trabecularnumber、thinckness、separation and degree of anisotropy changes significantly,which are likely to be the most closely related micro-structural parameters to the newvertebral fractures following PVP.