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Single-level vertebral kyphoplasty is not associated with an increased risk of symptomatic secondary adjacent osteoporotic vertebral compression fractures: a matched case-control analysis


Teuber, Henrik; Tiziani, Simon; Halvachizadeh, Sascha; Frey, Diana; Sprengel, Kai; Pape, Hans-Christoph; Osterhoff, Georg (2018). Single-level vertebral kyphoplasty is not associated with an increased risk of symptomatic secondary adjacent osteoporotic vertebral compression fractures: a matched case-control analysis. Archives of Osteoporosis, 13(1):82.

Abstract

This matched case-control study compared the rate of symptomatic adjacent-level vertebral compression fractures (VCF) within 1 year in patients operatively treated with kyphoplasty to a control group of non-operatively treated VCFs. The adjacent-level fracture rate did not show a significant difference between groups.
PURPOSE: To compare the rate of new symptomatic adjacent-level fractures within 1 year after an isolated osteoporotic vertebral compression fracture (VCF) treated by either kyphoplasty or non-operative treatment.
METHODS: Patients aged ≥ 50 years with an isolated, fresh, and symptomatic osteoporotic VCF who were treated by kyphoplasty were compared to patients of similar age, gender, vertebral segment, and bone mineral density who were treated non-operatively (n = 98). A matched case-control analysis was conducted by retrospective chart review, and the rate of new adjacent-level symptomatic vertebral fractures, defined as occurring within two segments of the index fracture, within the first year was determined.
RESULTS: Ninety-eight patients (66 female, aged 73.5, SD 9.7 years) were analyzed in this matched case-control study. The adjacent fracture rate within 1 year was not different between the kyphoplasty group and the non-operative group (20.4 vs 18.4%; McNemar, p = 1.0). The time to a new adjacent fracture after the index fracture was significantly shorter in the kyphoplasty (7, SD 8 weeks) versus non-operative group (22, SD 13 weeks).
CONCLUSIONS: Patients with osteoporotic VCFs treated with kyphoplasty did not show an increased rate of additional symptomatic adjacent-level VCFs when compared to a non-operative control group matched for age, gender, fracture level, and bone mineral density.
LEVEL OF EVIDENCE: Level III.

Abstract

This matched case-control study compared the rate of symptomatic adjacent-level vertebral compression fractures (VCF) within 1 year in patients operatively treated with kyphoplasty to a control group of non-operatively treated VCFs. The adjacent-level fracture rate did not show a significant difference between groups.
PURPOSE: To compare the rate of new symptomatic adjacent-level fractures within 1 year after an isolated osteoporotic vertebral compression fracture (VCF) treated by either kyphoplasty or non-operative treatment.
METHODS: Patients aged ≥ 50 years with an isolated, fresh, and symptomatic osteoporotic VCF who were treated by kyphoplasty were compared to patients of similar age, gender, vertebral segment, and bone mineral density who were treated non-operatively (n = 98). A matched case-control analysis was conducted by retrospective chart review, and the rate of new adjacent-level symptomatic vertebral fractures, defined as occurring within two segments of the index fracture, within the first year was determined.
RESULTS: Ninety-eight patients (66 female, aged 73.5, SD 9.7 years) were analyzed in this matched case-control study. The adjacent fracture rate within 1 year was not different between the kyphoplasty group and the non-operative group (20.4 vs 18.4%; McNemar, p = 1.0). The time to a new adjacent fracture after the index fracture was significantly shorter in the kyphoplasty (7, SD 8 weeks) versus non-operative group (22, SD 13 weeks).
CONCLUSIONS: Patients with osteoporotic VCFs treated with kyphoplasty did not show an increased rate of additional symptomatic adjacent-level VCFs when compared to a non-operative control group matched for age, gender, fracture level, and bone mineral density.
LEVEL OF EVIDENCE: Level III.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
04 Faculty of Medicine > University Hospital Zurich > Rheumatology Clinic and Institute of Physical Medicine
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Adjacent vertebral fracture, Adjacent-level vertebral fracture, Bone mineral density, Dual energy X-ray absorptiometry, Kyphoplasty, Osteoporosis, Spinal fracture, Vertebral compression fracture
Language:English
Date:27 July 2018
Deposited On:09 Aug 2018 15:57
Last Modified:09 Aug 2018 15:58
Publisher:Springer
ISSN:1862-3522
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s11657-018-0489-6
PubMed ID:30054751

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