• Gang Sun, Hai Tang, Min Li, Xunwei Liu, Peng Jin, and Li Li.
• Department of Medical Imaging, Jinan Military General Hospital, No. 25 Shifan Road, Jinan, Shandong, 250031, People's Republic of China, cjr.sungang@vip.163.com.
• Eur Spine J. 2014 Jun 1; 23 (6): 1339-45.

PurposeThe purpose of this study is to identify risk factors related to the development of subsequent fractures after vertebroplasty.MethodA retrospective study was conducted to review 175 patients with a 1-year follow-up who underwent vertebroplasty for first-time and single-level osteoporotic vertebral fractures. Subsequent fractures were diagnosed as recurrent intractable back pain, post-operatively correlated with MR image. Clinical parameters, such as age, gender, baseline VAS-score, lumbar bone mineral density (BMD) T-score, history of use of steroids, bisphosphonate therapy, symptom-free interval, the amount of bone cement injected, vacuum clefts, leakage of cement into the disk space, treated level and the changes of spinal geometry were recorded.ResultsDuring the follow-up period, subsequent fractures developed in 37 (21.1 %) of 175 patients. Significant differences (P < 0.05) were found between the patients with subsequent fractures and the patients without subsequent fractures in regard to their BMD T-score, and treated vertebrae location. Average BMD T-score was -3.4 ± 1.5 in patients with subsequent fractures and -2.9 ± 1.6 in patients without subsequent fractures. The percentage of subsequent fractures was 13.9 % (10 of 72) for treated vertebrae located in non-thoracolumbar junction, and 26.2 % (27 of 103) in the thoracolumbar junction.ConclusionThe most important risk factors affecting subsequent fractures after vertebroplasty were osteoporosis and treated level at the thoracolumbar junction.

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