Michael Mu Huo Teng MD, Presenter: Nothing to Disclose

Chao-Hsuan Yen MD, Abstract Co-Author: Nothing to Disclose

To evaluate the effects of preventive vertebroplasty (VP) for prevention of post-VP- new-onset adjacent vertebral compression fracture (VCF).

We retrospectively reviewed spine X-ray of patients received non-preventive VP in 146 patients and preventive VP in 91 patients for the presence of post-vertebroplasty new compression fracture. In preventive VP, we injected bone cement into the caudal part of the cephalic adjacent vertebral body and cephalic part of the caudal adjacent vertebral body only. The accumulative post-VP-new-onset fracture numbers and rates in different follow-up lengths (6 months, 1 year, 2 years, 3 years, 4 years) and in different involving conditions (“adjacent VCF only” - involving adjacent vertebrae only, “both adjacent and non-adjacent VCFs” - involving both adjacent and non-adjacent vertebrae, “non-adjacent VCF only” involving non-adjacent vertebrae only) were documented and statistically analyzed. We call “any adjacent VCF” for patients with “adjacent VCF only” or “both adjacent and non-adjacent VCFs”. We call “any VCF” for patients with any post-VP-new-onset VCF – adjacent or non-adjacent.  

The post-VP-new-onset “any VCF” within 1 year and > 4 year was 31%, and 43% without preventive VP, and was 11% and 19% with preventive VP. The > 4 year post-VP-new-onset “any adjacent VCF” in non-preventive group and preventive VP groups were 38% and 10% respectively (p= 0.003). These post-VP-new-onset adjacent VCFs tended to occur early within 1 year or within 6 months after VP in non-preventive group but not in preventive group. The “adjacent VCF only” and “any VCF” also decreased markedly in preventive VP patients. The incidence of post-VP-new-onset “non-adjacent VCF only” was small (<10%) in both non-preventive and preventive groups and show gross even distribution at different follow-up lengths. The rate of adjacent fracture next to the preventively cemented vertebra (3.8%) was lower than the rate of adjacent fracture next to the standard VP treated vertebrae (21%).

Preventive vertebroplasty in adjacent vertebrae effectively reduced post-VP-new-onset adjacent vertebral compression fracture, and overall fracture rate after VP.

Injection of bone cement into the caudal part of the cephalic adjacent vertebral body (VB) and cephalic part of the caudal adjacent VB proved to be useful in reducing propagation of vertebral fracture

Teng, M, Yen, C, The Value of Preventive Vertebroplasty to Reduce Adjacent Vertebral Fracture.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016788.html