Summary of incident fractures reported in the vertebroplasty literature
| Study | No. of Patients/Fractures Treated | No. of Incident Fractures/Patients with Incident Fractures (% of Treated Patients) | Adjacent? (%) | Follow-up | Notes |
|---|---|---|---|---|---|
| Alvarez et al52 | 260/423 | 15 patients (6%) | |||
| Amar et al53 | 97/258 | 21 patients (22%) | 14.7 mo | Osteoporosis and malignancy-induced fractures | |
| Barr et al17 | 38/70 | 1/1 (3%) | Yes (100) | 18 mo | Prophylactic treatment of T9, T10, L1, L2 |
| Chen et al54 | 27 patients | 2 patients (7%) | Yes (—*) | 1 y | Patients with intraosseus clefts; scheduled imaging follow-up; only reported adjacent fractures |
| Cortet et al45 | 16/20 | 0/0 (0%) | 6 mo | Prospective study, no control | |
| Cyteval et al55 | 20/20 | 5/5 pts (25%) | 1 (20) | 6 mo | Study design not indicated |
| Diamond et al46 | 55/71 | 3 patients (5%) | No (0) | 215 d | Prospective study, controlled, nonrandomized |
| Diamond et al1 | 126 patients (88 VP) | 40 (29 VP)/30 (21 VP–27%) | Yes (43) | 629 d | Extension of Diamond et al46; 21 patients died, 7 lost to follow-up (% based on patients with maximal follow-up) |
| Do et al2 | 167/264 | 29 patients (17%) | Yes (62) | 6–36 mo | Prospective study, no control; no significant difference in likelihood of incident fracture occurring above or below treated level |
| Grados et al3 | 25/34 | 34/13 (52%) | 48 mo | ||
| Grohs et al56 | 23/29 | 1/1 (4%) | Yes (—*) | 2 y | Prospective, nonrandomized comparison of kyphoplasty and vertebroplasty; only reported adjacent fractures |
| Heini et al4 | 17/45 | 2/2 (12%) | 2 (100) | 1 y | Prospective, no control; scheduled imaging follow-up |
| Jensen and Dion5 | 109/174 | 27/19 (17%) | |||
| Kallmes and Jensen6 | 58 patients | Yes (50) | |||
| Kim et al18 | 106/212 | 72 fractures | Some RR of fracture at adjacent level = 3.03 | 36 mo | Only looked at the 5 vertebrae immediately above and below the treated level; scheduled imaging follow-up |
| Kobayashi et al7 | 175/250 | 36/31 (18%) | 21 (58) | 15.3 mo | Prospective study, no control |
| Legroux-Gerot et al8 | 16/21 | 12/7 (44%) | 3 nonadjacent; 3 (25%) adjacent to untreated fxs; 6 (50%) adjacent to treated fxs | 35 mo | Prospective study, no control |
| Lin et al40 | 38/96 | 22/14 (37%) | 11 (50%)†: 8 (73%) were fractures of the endplate immediately abutting the cement leakage | 12 mo | Study of relationship between cement leakage and incident fractures |
| McKiernan et al57 | 44/66 | 4/3 (8%) | 2 (50) | 6 mo | Prospective study, no control; 5 patients died within 6 mo |
| Perez-Higueras et al9 | 13/27 | 4/3 (23%) | 2 (50) | 5 y | Prospective study, no control; scheduled imaging follow-up |
| Syed et al10 | 253/511 | 121/55 (11%) | 60 (49.6) | 1 y | “Many patients experienced incident fractures after 1 yr”, but these were excluded |
| Syed et al41 | 308 patients | 78 fractures | 41 (52.5%) | 36.5 wk | Study of the relationship between cement leakage and incident fracture; osteoporosis and malignancy-induced fractures |
| Tanigawa et al11 | 76/206 | 56/28 (37%) | 38 (67.8) | 11.5 mo | Prospective study, no control; scheduled imaging follow-up |
| Uppin et al12 | 177 patients | 36/22 (12%) | 24 (67) | ||
| Voormolen et al35 | 66/102 | 26/16 (24%) | 14 (53.8) | 1 y | Prospective study, no control; scheduled imaging follow-up |
| Yu et al13 | 68/68 | 7 patients (10%) | Yes (—*) | 13 mo | Study design not indicated; only reported adjacent fractures |
| Zoarski et al14 | 30/54 | 3 patients (13%) | 15–18 mo | Study design not indicated; only 23 respondents at long-term follow-up |
Note:—VP indicates vertebroplasty; fxs, fractures. These data were gathered from the data given in the published manuscripts. Unless otherwise indicated, all studies were retrospective in design.
* Percentage not calculated because only adjacent fractures reported.
† Eleven fractures clearly indicated as adjacent and associated with cement leakage. Data presented are not clear regarding the location of fractures not associated with cement leakage (may be additional adjacent fractures).