Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty

PURPOSE To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty. MATERIAL AND METHODS The study was conducted on 106 patients in whom 212 vertebroplasties were performed during a period of 3 years. Evaluations of the five vertebrae superior and inferior to the treated vertebra were performed. Consequently, 913 vertebrae were evaluated and the fracture-free interval of the vertebral body adjacent to the treated vertebra was calculated. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression analysis. RESULTS Seventy-two (7.9%) new fractures were revealed. The Kaplan-Meier estimate of the 1-year fracture-free rate was 93.1%. The mean fracture-free interval was 32 months (95% CI, 32 to approximately 33 months). The greater degree of height restoration of the treated vertebra, the location of the adjacent vertebra in the TL junction, and the shorter distance between the treated and the adjacent vertebra increased the risk of new vertebral fractures. CONCLUSION Thoracolumbar junction, shorter distance from the treated vertebrae, and greater degree of height restoration of the cemented vertebrae may increase the fracture risk of vertebrae adjacent to cement vertebrae after vertebroplasty.