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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2024, Number 4

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Cir Columna 2024; 2 (4)

Is vertebroplasty associated with an increased risk of new fractures? Our experience

Ross JN, Hansen M, Alemán CE, Ibarreta G, De BAJ, Fachinetti D

Language: Spanish
References: 24
Page: 210-216
PDF size: 251.58 Kb.


ABSTRACT

Introduction: there is controversy between the relationship of vertebroplasty and risk fractures. Biomechanical studies predict an increased risk. There is a lack of agreement as to the implied clinical factors. Material and methods: comparative retrospective study. Two groups of patients with ostheoporis related fractures, treated conservatively (n = 46) or with vertebroplasty (n = 53) with at least one year follow up. High energy, kyphoplasty, instrumented and tumoral associated fractures were excluded. Results: 99 patients, 54 were treated with vertebroplasty and 45 conservatively. 66.7% of patients had osteoporosis, 18.4% smoked, 29.9% were obese and 13.1% had diabetes. 60.4% of vertebroplasties were unipedicular and 39.6% were bipedicular. Most new fractures occurred in the thoracolumbar junction for both groups. 30.6% of patients with vertebroplasty had a new fracture compared to 23.5% in the control group. No statistically significant difference was found (p = 0.4783). Odds ratio (OR) values indicated that obesity (OD = 1.50), osteoporosis (OD = 5.91) and bipedicular procedures (OD = 1.60) were risk factors for new fractures. Conclusions: vertebroplasty is an effective treatment for osteoporotic vertebral fractures. Biomechanic studies argue that increased rigidity in a vertebral segment leads to failure of adjacent vertebrae. Our results match previous studies (10 to 52% refracture). We observed that thoracolumbar refractors are 2.7 times more common than other segments. Limitations: sample size (n = 99), retrospective study, lack of data for previous treatments.


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