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Objective <p>Symptomatic adjacent vertebral fractures (AVF) poses a challenge to patient prognosis in osteoporotic vertebral compressive fractures (OVCF) treated by percutaneous vertebralplasty (PVP). This study aimed to identify potential risk factors for AVF, thereby offering theoretical insights for refining patient management strategies and surgical protocols.</p> Methods <p>Clinical data of PVP patients treated between March 2018 and May 2020 were retrospectively analyzed, with an average follow-up period of 30 months. Patients were stratified into two groups based on the presence or absence of recurrent symptomatic AVF. Demographic characteristics and imaging based parameters were assessed to identify potential risk factors for AVF.</p> Results <p>Demographic parameters, including age, sex, body mass index, and fracture location (junctional or non-junctional), did not significantly differ between the two groups and were not found to be independent risk factors for AVF. However, patients with AVF exhibited significantly lower bone mineral density, as assessed by T-score and Hounsfield unit (HU) values. Notably, lower HU values emerged as an independent risk factor for AVF. Contrary to expectations, larger vertebral distraction and intervertebral disc cement leakage did not trigger higher incidence of AVF.</p> Conclusion <p>Progression of bony density reduction emerged as the primary driver for the heightened incidence of AVF. Accordingly, anti-osteoporosis therapy should be regarded as an effective strategy for mitigating the risk of AVF in patients undergoing PVP.</p>

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Poor bony density can independently trigger higher incidence of adjacent vertebral fracture after percutaneous vertebralplasty: a mono-center retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月4日

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  • Shengyu Wan,
  • Zichuan Wu,
  • Hong Li,
  • Jian Zhang,
  • Xu Lin,
  • Tao Gao,
  • Jingchi Li

摘要

Objective

Symptomatic adjacent vertebral fractures (AVF) poses a challenge to patient prognosis in osteoporotic vertebral compressive fractures (OVCF) treated by percutaneous vertebralplasty (PVP). This study aimed to identify potential risk factors for AVF, thereby offering theoretical insights for refining patient management strategies and surgical protocols.

Methods

Clinical data of PVP patients treated between March 2018 and May 2020 were retrospectively analyzed, with an average follow-up period of 30 months. Patients were stratified into two groups based on the presence or absence of recurrent symptomatic AVF. Demographic characteristics and imaging based parameters were assessed to identify potential risk factors for AVF.

Results

Demographic parameters, including age, sex, body mass index, and fracture location (junctional or non-junctional), did not significantly differ between the two groups and were not found to be independent risk factors for AVF. However, patients with AVF exhibited significantly lower bone mineral density, as assessed by T-score and Hounsfield unit (HU) values. Notably, lower HU values emerged as an independent risk factor for AVF. Contrary to expectations, larger vertebral distraction and intervertebral disc cement leakage did not trigger higher incidence of AVF.

Conclusion

Progression of bony density reduction emerged as the primary driver for the heightened incidence of AVF. Accordingly, anti-osteoporosis therapy should be regarded as an effective strategy for mitigating the risk of AVF in patients undergoing PVP.