• Hung Yang Chien, Yao Chun Yang, Min Hong Hsieh, and Chang Chen Yang.
• Department of Orthopedics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi, Taiwan.
• World Neurosurg. 2021 Dec 1; 156: e283-e290.

BackgroundPercutaneous vertebroplasty (PVP) is widely used for treatment of osteoporotic vertebral compression fractures (VCFs). However, the influence of PVP timing (early vs. late) on development of adjacent vertebral fractures has rarely been discussed. This retrospective cohort study aimed to evaluate bone-cement binding for thoracolumbar fractures (T8-L3) using a new assessment method to predict risk for adjacent vertebral fractures.MethodsPatients with a single-level T-score ≤ -1.0 of lumbar bone mineral density and a primary osteoporotic VCF in the thoracolumbar region (T8-L3) who underwent PVP from October 2016 to February 2018 at our medical university-affiliated hospital were included. Patients were divided into refracture and non-refracture groups. All patients underwent computed tomography after vertebroplasty. Bone-cement distribution patterns were evaluated using standardized axial computed tomography images of each cemented vertebra by 4 independent observers with ImageJ software. The smoothness index was calculated as a percentage of smooth margins.ResultsOf 51 VCFs, 15 (29.4%) and 36 (70.6%) were refracture and non-refracture VCFs, respectively. The mean smoothness index (MSI) was higher in the refracture group than in the non-refracture group (P < 0.01), with an increased refracture risk that corresponded to increased MSI values (P = 0.004). Spearman correlation coefficient (0.375) showed a positive correlation between the fracture-vertebroplasty interval and MSI (P = 0.01).ConclusionsAxial computed tomography images were used to characterize bone-cement binding properties. Patients who underwent early PVP had a lower MSI, better bone-cement integration, and fewer adjacent fractures.Copyright © 2021 Elsevier Inc. All rights reserved.

31 keywords...

hide…