Risk factors for the development of vertebral fractures after percutaneous vertebroplasty
ABSTRACT We have recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) versus conservative treatment in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the devel...
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| Veröffentlicht in: | Journal of bone and mineral research 2013-08, Vol.28 (8), p.1821-1829 |
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| creator | Martinez‐Ferrer, Angeles Blasco, Jordi Carrasco, Josep LI Macho, Juan M Román, Luis San López, Antonio Monegal, Ana Guañabens, Nuria Peris, Pilar |
| description | ABSTRACT
We have recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) versus conservative treatment in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients. We evaluated risk factors including age, gender, bone mineral density, the number, type, and severity of vertebral deformities at baseline, the number of vertebral bodies treated, the presence and location of disk cement leakage, bone remodeling (determining bone turnover markers) and 25 hydroxyvitamin D [25(OH)D] levels at baseline in all patients. Twenty‐nine radiologically new VF were observed in 17 of 57 patients undergoing VP, 72% adjacent to the VP. Patients developing VF after VP showed an increased prevalence of 25(OH)D deficiency ( |
| doi_str_mv | 10.1002/jbmr.1899 |
| format | Article |
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We have recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) versus conservative treatment in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients. We evaluated risk factors including age, gender, bone mineral density, the number, type, and severity of vertebral deformities at baseline, the number of vertebral bodies treated, the presence and location of disk cement leakage, bone remodeling (determining bone turnover markers) and 25 hydroxyvitamin D [25(OH)D] levels at baseline in all patients. Twenty‐nine radiologically new VF were observed in 17 of 57 patients undergoing VP, 72% adjacent to the VP. Patients developing VF after VP showed an increased prevalence of 25(OH)D deficiency (<20 ng/mL) and higher P1NP values. The principal factor related to the development of VF after VP in multivariate analysis was 25(OH)D levels < 20 ng/mL (RR, 15.47; 95% CI, 2.99–79.86, p < 0.0001), whereas age >80 years (RR, 3.20; 95% CI, 1.70–6.03, p = 0.0007) and glucocorticoid therapy (RR, 3.64; 95% CI, 1.61–8.26, p = 0.0055) constituted the principal factors in the overall study population. Increased risk of VF after VP was also associated with cement leakage into the inferior disk (RR, 6.14; 95% CI, 1.65–22.78, p = 0.044) and more than one vertebral body treated during VP (RR, 4.19; 95% CI, 1.03–34.3, p = 0.044). In conclusion, nearly 30% of patients with osteoporotic VF treated with VP had a new VF after the procedure. Age, especially >80 years, the presence of inferior disk cement leakage after the procedure, the number of cemented vertebrae, and low 25(OH)D serum levels were related to the development of new VF in these patients, with the latter indicating the need to correct vitamin D deficiency prior to performing VP.</description><identifier>ISSN: 0884-0431</identifier><identifier>EISSN: 1523-4681</identifier><identifier>DOI: 10.1002/jbmr.1899</identifier><identifier>PMID: 23427068</identifier><identifier>CODEN: JBMREJ</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Aged, 80 and over ; Bone density ; Female ; FRAGILITY FRACTURE ; Humans ; Male ; Multivariate Analysis ; Older people ; OSTEOPOROTIC FRACTURE ; Risk Factors ; Spinal Fractures - diagnostic imaging ; Spinal Fractures - etiology ; Spinal Fractures - surgery ; Tomography, X-Ray Computed ; VERTEBRAL FRACTURE ; VERTEBROPLASTY ; Vertebroplasty - adverse effects</subject><ispartof>Journal of bone and mineral research, 2013-08, Vol.28 (8), p.1821-1829</ispartof><rights>Copyright © 2013 American Society for Bone and Mineral Research</rights><rights>Copyright © 2013 American Society for Bone and Mineral Research.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4879-baaf90d9ca6fc22a2259da5233c4c2863efea9165c5815dc572ce07629c6c44d3</citedby><cites>FETCH-LOGICAL-c4879-baaf90d9ca6fc22a2259da5233c4c2863efea9165c5815dc572ce07629c6c44d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjbmr.1899$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjbmr.1899$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23427068$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martinez‐Ferrer, Angeles</creatorcontrib><creatorcontrib>Blasco, Jordi</creatorcontrib><creatorcontrib>Carrasco, Josep LI</creatorcontrib><creatorcontrib>Macho, Juan M</creatorcontrib><creatorcontrib>Román, Luis San</creatorcontrib><creatorcontrib>López, Antonio</creatorcontrib><creatorcontrib>Monegal, Ana</creatorcontrib><creatorcontrib>Guañabens, Nuria</creatorcontrib><creatorcontrib>Peris, Pilar</creatorcontrib><title>Risk factors for the development of vertebral fractures after percutaneous vertebroplasty</title><title>Journal of bone and mineral research</title><addtitle>J Bone Miner Res</addtitle><description>ABSTRACT
We have recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) versus conservative treatment in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients. We evaluated risk factors including age, gender, bone mineral density, the number, type, and severity of vertebral deformities at baseline, the number of vertebral bodies treated, the presence and location of disk cement leakage, bone remodeling (determining bone turnover markers) and 25 hydroxyvitamin D [25(OH)D] levels at baseline in all patients. Twenty‐nine radiologically new VF were observed in 17 of 57 patients undergoing VP, 72% adjacent to the VP. Patients developing VF after VP showed an increased prevalence of 25(OH)D deficiency (<20 ng/mL) and higher P1NP values. The principal factor related to the development of VF after VP in multivariate analysis was 25(OH)D levels < 20 ng/mL (RR, 15.47; 95% CI, 2.99–79.86, p < 0.0001), whereas age >80 years (RR, 3.20; 95% CI, 1.70–6.03, p = 0.0007) and glucocorticoid therapy (RR, 3.64; 95% CI, 1.61–8.26, p = 0.0055) constituted the principal factors in the overall study population. Increased risk of VF after VP was also associated with cement leakage into the inferior disk (RR, 6.14; 95% CI, 1.65–22.78, p = 0.044) and more than one vertebral body treated during VP (RR, 4.19; 95% CI, 1.03–34.3, p = 0.044). In conclusion, nearly 30% of patients with osteoporotic VF treated with VP had a new VF after the procedure. Age, especially >80 years, the presence of inferior disk cement leakage after the procedure, the number of cemented vertebrae, and low 25(OH)D serum levels were related to the development of new VF in these patients, with the latter indicating the need to correct vitamin D deficiency prior to performing VP.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bone density</subject><subject>Female</subject><subject>FRAGILITY FRACTURE</subject><subject>Humans</subject><subject>Male</subject><subject>Multivariate Analysis</subject><subject>Older people</subject><subject>OSTEOPOROTIC FRACTURE</subject><subject>Risk Factors</subject><subject>Spinal Fractures - diagnostic imaging</subject><subject>Spinal Fractures - etiology</subject><subject>Spinal Fractures - surgery</subject><subject>Tomography, X-Ray Computed</subject><subject>VERTEBRAL FRACTURE</subject><subject>VERTEBROPLASTY</subject><subject>Vertebroplasty - adverse effects</subject><issn>0884-0431</issn><issn>1523-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqN0c9LwzAUB_AgipvTg_-ABLzooVuSpmly1OFPFGHowVPJ0hfcbJeatJP993Z28yAInt7lw5f33hehY0qGlBA2mk9LP6RSqR3UpwmLIy4k3UV9IiWPCI9pDx2EMCeEiESIfdRjMWcpEbKPXiez8I6tNrXzAVvncf0GOIclFK4qYVFjZ_ESfA1TrwtsfSsbDwFrW4PHFXjT1HoBrglb5qpCh3p1iPasLgIcbeYAvVxfPY9vo4enm7vxxUNkuExVNNXaKpIro4U1jGnGEpXr9ojYcMOkiMGCVlQkJpE0yU2SMgMkFUwZYTjP4wE663Ir7z4aCHVWzoKBoui2yiiPiUyE4uoflFIRE56Klp7-onPX-EV7SKsISVMq2scO0HmnjHcheLBZ5Wel9quMkmxdTbauJltX09qTTWIzLSH_kdsuWjDqwOesgNXfSdn95ePkO_ILynqZNA</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Martinez‐Ferrer, Angeles</creator><creator>Blasco, Jordi</creator><creator>Carrasco, Josep LI</creator><creator>Macho, Juan M</creator><creator>Román, Luis San</creator><creator>López, Antonio</creator><creator>Monegal, Ana</creator><creator>Guañabens, Nuria</creator><creator>Peris, Pilar</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TS</scope><scope>K9.</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201308</creationdate><title>Risk factors for the development of vertebral fractures after percutaneous vertebroplasty</title><author>Martinez‐Ferrer, Angeles ; Blasco, Jordi ; Carrasco, Josep LI ; Macho, Juan M ; Román, Luis San ; López, Antonio ; Monegal, Ana ; Guañabens, Nuria ; Peris, Pilar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4879-baaf90d9ca6fc22a2259da5233c4c2863efea9165c5815dc572ce07629c6c44d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bone density</topic><topic>Female</topic><topic>FRAGILITY FRACTURE</topic><topic>Humans</topic><topic>Male</topic><topic>Multivariate Analysis</topic><topic>Older people</topic><topic>OSTEOPOROTIC FRACTURE</topic><topic>Risk Factors</topic><topic>Spinal Fractures - diagnostic imaging</topic><topic>Spinal Fractures - etiology</topic><topic>Spinal Fractures - surgery</topic><topic>Tomography, X-Ray Computed</topic><topic>VERTEBRAL FRACTURE</topic><topic>VERTEBROPLASTY</topic><topic>Vertebroplasty - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martinez‐Ferrer, Angeles</creatorcontrib><creatorcontrib>Blasco, Jordi</creatorcontrib><creatorcontrib>Carrasco, Josep LI</creatorcontrib><creatorcontrib>Macho, Juan M</creatorcontrib><creatorcontrib>Román, Luis San</creatorcontrib><creatorcontrib>López, Antonio</creatorcontrib><creatorcontrib>Monegal, Ana</creatorcontrib><creatorcontrib>Guañabens, Nuria</creatorcontrib><creatorcontrib>Peris, Pilar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Journal of bone and mineral research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martinez‐Ferrer, Angeles</au><au>Blasco, Jordi</au><au>Carrasco, Josep LI</au><au>Macho, Juan M</au><au>Román, Luis San</au><au>López, Antonio</au><au>Monegal, Ana</au><au>Guañabens, Nuria</au><au>Peris, Pilar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for the development of vertebral fractures after percutaneous vertebroplasty</atitle><jtitle>Journal of bone and mineral research</jtitle><addtitle>J Bone Miner Res</addtitle><date>2013-08</date><risdate>2013</risdate><volume>28</volume><issue>8</issue><spage>1821</spage><epage>1829</epage><pages>1821-1829</pages><issn>0884-0431</issn><eissn>1523-4681</eissn><coden>JBMREJ</coden><abstract>ABSTRACT
We have recently observed an increased risk for vertebral fractures (VF) in a randomized controlled trial comparing the analgesic effect of vertebroplasty (VP) versus conservative treatment in symptomatic VF. The aim of the present study was to evaluate the risk factors related to the development of VF after VP in these patients. We evaluated risk factors including age, gender, bone mineral density, the number, type, and severity of vertebral deformities at baseline, the number of vertebral bodies treated, the presence and location of disk cement leakage, bone remodeling (determining bone turnover markers) and 25 hydroxyvitamin D [25(OH)D] levels at baseline in all patients. Twenty‐nine radiologically new VF were observed in 17 of 57 patients undergoing VP, 72% adjacent to the VP. Patients developing VF after VP showed an increased prevalence of 25(OH)D deficiency (<20 ng/mL) and higher P1NP values. The principal factor related to the development of VF after VP in multivariate analysis was 25(OH)D levels < 20 ng/mL (RR, 15.47; 95% CI, 2.99–79.86, p < 0.0001), whereas age >80 years (RR, 3.20; 95% CI, 1.70–6.03, p = 0.0007) and glucocorticoid therapy (RR, 3.64; 95% CI, 1.61–8.26, p = 0.0055) constituted the principal factors in the overall study population. Increased risk of VF after VP was also associated with cement leakage into the inferior disk (RR, 6.14; 95% CI, 1.65–22.78, p = 0.044) and more than one vertebral body treated during VP (RR, 4.19; 95% CI, 1.03–34.3, p = 0.044). In conclusion, nearly 30% of patients with osteoporotic VF treated with VP had a new VF after the procedure. Age, especially >80 years, the presence of inferior disk cement leakage after the procedure, the number of cemented vertebrae, and low 25(OH)D serum levels were related to the development of new VF in these patients, with the latter indicating the need to correct vitamin D deficiency prior to performing VP.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>23427068</pmid><doi>10.1002/jbmr.1899</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Wiley Online Library All Journals |
| subjects | Aged Aged, 80 and over Bone density Female FRAGILITY FRACTURE Humans Male Multivariate Analysis Older people OSTEOPOROTIC FRACTURE Risk Factors Spinal Fractures - diagnostic imaging Spinal Fractures - etiology Spinal Fractures - surgery Tomography, X-Ray Computed VERTEBRAL FRACTURE VERTEBROPLASTY Vertebroplasty - adverse effects |
| title | Risk factors for the development of vertebral fractures after percutaneous vertebroplasty |
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