Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Trout, A.T. Articles by Marx, W.F. Search for Related Content PubMed PubMed Citation Articles by Trout, A.T. Articles by Marx, W.F.

American Journal of Neuroradiology 27:1586-1591, August 2006
© 2006 American Society of Neuroradiology

SPINE

Subsequent Vertebral Fractures after Vertebroplasty: Association with Intraosseous Clefts

A.T. Trout^a, D.F. Kallmes^b, J.I. Lane^b, K.F. Layton^b and W.F. Marx^c

^a Mayo Clinic College of Medicine, Rochester, Minn
^b Mayo Clinic Department of Radiology, Rochester, Minn
^c Asheville Radiology Associates, Asheville, NC

Address correspondence to Andrew T. Trout, Mayo Clinic College of Medicine, 200 First St. Southwest, Rochester, MN 55905; e-mail: trout.andrew{at}mayo.edu

BACKGROUND AND PURPOSE: Patients with vertebral fractures containing intraosseous clefts may represent a distinct subgroup of vertebroplasty patients, yet the development of subsequent vertebral fractures in this population has not been explored. We tested the hypothesis that after vertebroplasty for intraosseous clefts, subsequent fractures would occur earlier and more frequently than after treatment of non–cleft-containing fractures.

METHODS: We retrospectively reviewed 362 patients treated with vertebroplasty for osteoporotic fractures. The location, frequency, and timing of subsequent fractures were compared between 2 subgroups: group 1, patients treated at fractures containing clefts, and group 2, treated patients without clefts. A vertebra-by-vertebra analysis was used to compare the relative risk and timing of subsequent fractures adjacent to vertebrae with or without clefts.

RESULTS: Group 1 included 63 patients treated at 65 vertebrae and group 2 included 250 patients treated at 399 vertebrae. Group 1 demonstrated a nearly twofold increased risk of subsequent fracture (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.04–3.49, P = .037). At the vertebral level, the relative risk of subsequent fracture was 2.02 (95% CI, 1.46–2.58; P = .013) times greater adjacent to a treated cleft. Fractures adjacent to any treated level occurred significantly sooner than nonadjacent fracture (P = .0004). The presence of a cleft was not significantly associated with the timing of subsequent fractures.

CONCLUSIONS: Patients with osteoporotic vertebral fractures containing clefts are at increased risk for subsequent fractures and treatment of these clefts is associated with increased rates of adjacent fracture. There is no significant difference in the timing of subsequent fractures based on the presence of a cleft.

This article has been cited by other articles:

				N. Tanigawa, A. Komemushi, S. Kariya, H. Kojima, Y. Shomura, N. Omura, and S. Sawada Relationship Between Cement Distribution Pattern and New Compression Fracture After Percutaneous Vertebroplasty Am. J. Roentgenol., December 1, 2007; 189(6): W348 - W352. [Abstract] [Full Text] [PDF]

				A.T. Trout and D.F. Kallmes Does Vertebroplasty Cause Incident Vertebral Fractures? A Review of Available Data AJNR Am. J. Neuroradiol., August 1, 2006; 27(7): 1397 - 1403. [Abstract] [Full Text] [PDF]