The Closer Vicinity to Treated Vertebrae in Percutaneous Vertebroplasty, the Higher Rate of New Vertebral Compression Fractures at Follow-up

Objective: To investigate whether risk of new vertebral compression fractures (NVCF) was associated with vicinity to treated vertebrae in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs).

Methods: All OVCFs (T6-L5) patients treated with PVP between January 2016 and December 2020 were retrospectively reviewed. Vicinity to treated vertebrae was defined as the number of vertebrae between an untreated and its closest treated level. The closest treated level was chosen as reference vertebra. Clinical, radiological and surgical parameters were compared between groups of reference vertebrae for each vicinity NVCF.

Results: Totally, 1348 patients with 1592 fractured and 14584 normal vertebrae were enrolled. NVCF was identified in 20.1% (271/1348) patients in 2.2% (319/14584) vertebrae in a mean follow-up time of 24.3±11.9 months. Rate of NVCF in vicinity 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 and 11 level were 4.6% (130/2808), 2.4% (62/2558), 1.8% (42/2365), 1.5% (31/2131), 1.3% (23/1739), 1.3% (17/1298), 0.8% (7/847), 0.9% (4/450), 0.8% (2/245), 0.9% (1/117) and 0% (0/26), respectively. Rate of NVCF in vicinity 1 level was significantly higher than that in vicinity 2, 3, 4, 5, 6, 7, 8 and 9 level, respectively. However, compared to reference vertebrae for vicinity 1 NVCF, any clinical, radiological and surgical parameters were not significantly different in those for vicinity 2, 3 and 4 NVCF, respectively.

Conclusions: The closer vicinity to treated vertebrae in PVP, the higher rate of NVCF at follow-up. However, any clinical, radiological and surgical parameters might not matter in this phenomenon of vicinity-related NVCF.