Incidence of Subsequent Vertebral Fracture after Kyphoplasty

作者：David Fribourg, Chris Yuk Kwan Tang, Parveen Sra, Rick B. Delamarter, Hyun W. Bae · 发表于：Spine · 年份：2004 · DOI：10.1097/01.brs.0000142469.41565.2a · 被引用次数：424 · 研究领域：Spinal Fractures and Fixation Techniques、Cervical and Thoracic Myelopathy、Scoliosis diagnosis and treatment

STUDY DESIGN: A retrospective review of charts and radiographs of all consecutive patients who underwent kyphoplasty at the authors' center from the initial procedure in September 2000 to the end of the collection period in July 2002. SUMMARY OF BACKGROUND DATA: The best available natural history data would suggest that after experiencing an osteoporotic vertebral compression fracture, patients have a 19% incidence of subsequent fracture in the following year when no surgical intervention is performed. When kyphoplasty is performed, there are conflicting data regarding the incidence of subsequent fracture, ranging anywhere from 3 to 29%. These fractures occur at adjacent levels between 30 and 90% of the time, with no clear explanation for the wide variation in the results of three different studies. There are biomechanical data to suggest that injection of cement does increase the stiffness of the treated vertebra and that this increases strain on adjacent vertebrae, especially in forward bending. METHODS: A database was created containing patient age, gender, height, weight, medication history, comorbidities, fracture levels, and pain level before and after surgery. Subsequent fractures were confirmed with radiographs and MRI. Statistical analysis was performed. RESULTS: Thirty-eight patients (10 men and 28 women) were treated for 47 levels initially. L1 and L2 were the most common level of fracture managed initially. The gender, smoking and medication history, location of f...