Table 1:

Summary of incident fractures reported in the vertebroplasty literature

StudyNo. of Patients/Fractures TreatedNo. of Incident Fractures/Patients with Incident Fractures (% of Treated Patients)Adjacent? (%)Follow-upNotes
Alvarez et al52260/42315 patients (6%)
Amar et al5397/25821 patients (22%)14.7 moOsteoporosis and malignancy-induced fractures
Barr et al1738/701/1 (3%)Yes (100)18 moProphylactic treatment of T9, T10, L1, L2
Chen et al5427 patients2 patients (7%)Yes (—*)1 yPatients with intraosseus clefts; scheduled imaging follow-up; only reported adjacent fractures
Cortet et al4516/200/0 (0%)6 moProspective study, no control
Cyteval et al5520/205/5 pts (25%)1 (20)6 moStudy design not indicated
Diamond et al4655/713 patients (5%)No (0)215 dProspective study, controlled, nonrandomized
Diamond et al1126 patients (88 VP)40 (29 VP)/30 (21 VP–27%)Yes (43)629 dExtension of Diamond et al46; 21 patients died, 7 lost to follow-up (% based on patients with maximal follow-up)
Do et al2167/26429 patients (17%)Yes (62)6–36 moProspective study, no control; no significant difference in likelihood of incident fracture occurring above or below treated level
Grados et al325/3434/13 (52%)48 mo
Grohs et al5623/291/1 (4%)Yes (—*)2 yProspective, nonrandomized comparison of kyphoplasty and vertebroplasty; only reported adjacent fractures
Heini et al417/452/2 (12%)2 (100)1 yProspective, no control; scheduled imaging follow-up
Jensen and Dion5109/17427/19 (17%)
Kallmes and Jensen658 patientsYes (50)
Kim et al18106/21272 fracturesSome RR of fracture at adjacent level = 3.0336 moOnly looked at the 5 vertebrae immediately above and below the treated level; scheduled imaging follow-up
Kobayashi et al7175/25036/31 (18%)21 (58)15.3 moProspective study, no control
Legroux-Gerot et al816/2112/7 (44%)3 nonadjacent; 3 (25%) adjacent to untreated fxs; 6 (50%) adjacent to treated fxs35 moProspective study, no control
Lin et al4038/9622/14 (37%)11 (50%): 8 (73%) were fractures of the endplate immediately abutting the cement leakage12 moStudy of relationship between cement leakage and incident fractures
McKiernan et al5744/664/3 (8%)2 (50)6 moProspective study, no control; 5 patients died within 6 mo
Perez-Higueras et al913/274/3 (23%)2 (50)5 yProspective study, no control; scheduled imaging follow-up
Syed et al10253/511121/55 (11%)60 (49.6)1 y“Many patients experienced incident fractures after 1 yr”, but these were excluded
Syed et al41308 patients78 fractures41 (52.5%)36.5 wkStudy of the relationship between cement leakage and incident fracture; osteoporosis and malignancy-induced fractures
Tanigawa et al1176/20656/28 (37%)38 (67.8)11.5 moProspective study, no control; scheduled imaging follow-up
Uppin et al12177 patients36/22 (12%)24 (67)
Voormolen et al3566/10226/16 (24%)14 (53.8)1 yProspective study, no control; scheduled imaging follow-up
Yu et al1368/687 patients (10%)Yes (—*)13 moStudy design not indicated; only reported adjacent fractures
Zoarski et al1430/543 patients (13%)15–18 moStudy 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).