Nobuo Kobayashi MD, Presenter: Nothing to Disclose

Yuji Numaguchi PhD, MD, Abstract Co-Author: Nothing to Disclose

Sokun Pierre Fuwa MD, Abstract Co-Author: Nothing to Disclose

Akihiro Uemura, Abstract Co-Author: Nothing to Disclose

Yuka Okajima MD, Abstract Co-Author: Nothing to Disclose

Yukihisa Saida MD, Abstract Co-Author: Nothing to Disclose

Masaki Matsusako MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Occurrence of new painful osteoporotic compression fractures after successful percutaneous vertebroplasty (PVP) is problematic and is reported to be around 20 % of patients. We investigated the efficacy of prophylactic cement injection into the vertebral body adjacent to the fractured vertebra to prevent new compression fractures.

Institutional review board approval and written informed consent were obtained. From Feb. 2002 to Dec. 2004, PVP was performed for osteoporotic compression fractures in 89 consecutive patients. All of them underwent PVP only for fractured vertebrae. From Jan. 2005 to Jan. 2006, we prospectively performed prophylactic cement injection for 80 patients. For these patients, cement was injected into non-fractured vertebra immediately above fractured vertebra or into non-fractured vertebra between 2 fractured vertebrae at the same procedures. We evaluated the frequency of new vertebral fractures and the efficacy of the prophylactic therapy. Data were compared between prophylactic group and non-prophylactic group.

Among 89 patients who underwent PVP only for fractured vertebral body or bodies, 20 (22.4%) of 89 developed new painful compression fractures within a year after the first PVP; 15 (16.8%) of them developed new fractures within 3 months just above the treated one. Among 80 patients who underwent prophylactic cement injection adjacent to the treated vertebra, only 5 (6.2%) developed new compression fractures within 3 months. New fractures occurred fewer in prophylactic group than non-prophylactic group. Striking statistical significance was not noted (P = 0.054; relative risk=0.371; 95%CI 0.141-0.974) but there was a strong trend of decreasing new fractures by prophylactic cement injection.

Although the number of our patients is small and follow up period is relatively short, prophylactic cement injection into non-fractured vertebra adjacent to fractured vertebra may justify preventing new painful compression fractures after PVP.

Prophylactic cement injection into non-fractured vertebra adjacent to fractured vertebra may justify preventing new painful compression fractures after vertebroplasty for osteoporotic patients.

Kobayashi, N, Numaguchi, Y, Fuwa, S, Uemura, A, Okajima, Y, Saida, Y, Matsusako, M, et al, , Prophylactic Cement Injection into Non-fractured Vertebral Bodies during Percutaneous Vertebroplasty for Symptomatic Osteoporotic Compression Fractures.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4431465.html