A Study of Risk Factors for Early-Onset Adjacent Vertebral Fractures After Kyphoplasty. Issue 1 (February 2020)

• Record Type: Journal Article
• Authors: Morozumi, Masayoshi; Matsubara, Yuji; Muramoto, Akio; Morita, Yoshinori; Ando, Kei; Kobayashi, Kazuyoshi; Machino, Masaaki; Ota, Kyotaro; Tanaka, Satoshi; Kanbara, Shunsuke; Ito, Sadayuki; Ishiguro, Naoki; Imagama, Shiro
• Is Part Of: Global spine journal. Volume 10:Issue 1(2020)
• Page Start: 13
• Page End: 20
• Publication Date: 2020-02
• Subjects: kyphoplasty -- osteoporosis -- adjacent fracture -- minimally invasive surgery -- complication; Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1177/2192568219834899
• Languages: English
• ISSNs: 2192-5682

Abstract

Study Design: Retrospective study. Objectives: To elucidate risk factors for early-onset (2 months after initial kyphoplasty) adjacent vertebral fracture (EO-AVF) after kyphoplasty. Methods: A total of 108 vertebral bodies (95 patients) were included in this study. We examined patient backgrounds, the spinal level of EO-AVFs, surgery-related factors, and imaging findings. We divided the cases into 2 groups: patients with EO-AVF and patients without EO-AVF. Univariate, correlation, and multivariate analyses were conducted to reveal the risks factors for EO-AVFs for these 2 groups. Results: EO-AVFs developed in 28 vertebral bodies; they did not develop in 80 vertebral bodies. The overall EO-AVF incidence rate was 26%. The spinal level was the thoracolumbar junction for 93% of patients and another level for 7%, thus demonstrating the concentration of EO-AVFs in the thoracolumbar junction. For patients without EO-AVF and those with EO-AVF, there were significant differences in age (76 and 80 years, respectively), preoperative vertebral angles (VAs) (17.8° and 23°, respectively), and corrected VAs (7.3° and 12.7°, respectively). Significant differences were not observed for other factors. Pearson's correlation coefficient was 0.661 ( P < .000), thereby showing a significantly positive correlation between preoperative VAs and corrected VAs. Logistic regression analysis indicated that age (odds ratio, 1.112; 95% CI, 1.025-1.206) and preoperative VAs (odds ratio, 1.08; 95% CI, 1.026-1.135) were covariates and that the presence of an EO-AVF was a dependent variable. Therefore, both were predictable risk factors for EO-AVFs. Conclusion: Age, preoperative VAs, and corrected VAs are risk factors for EO-AVFs after kyphoplasty.