1Maram Alothman, 1Meshal Alshaalan, ( Joint First Authorship), 1Abdulrahman Khawaji, 1Rawan Benkuddah, 1Hala Khalil, Phd, 1Khalid Alismail, 1Waleed Althobaity, 1Saleh Alreshoodi
1King Faisal Specialist Hospital and Research Centre Riyadh, Riyadh, Saudi Arabia
Vertebral osteoporotic fractures are a major cause of morbidity and disability in the elderly population.
This study sought to compare the incidence of new vertebral fractures in patients treated by vertebroplasty with that of those managed conservatively, while also assessing the potential risk factors contributing to the occurrence of these fractures.
Material(s) and Method(s):
The details of a total of 121 eligible subjects with radiologically-proven osteoporotic vertebral fractures were retrieved from our archive between January 2010 and September 2019 and allocated based on the treatment method to percutaneous vertebroplasty (n = 60) or nonsurgical treatment (n = 61).
The difference in the incidence of new fractures was statistically significant (p = 0.001), with rates of 70% (n = 32) in the vertebroplasty patients and 30% (n =14) in the conservatively treated cases reported at a median follow-up time point of approximately four months. The presence of liver disease, a history of transplantation, the use of steroids, a low bone mineral density score, and a higher number of fractures on baseline imaging were associated with a greater risk of subsequent vertebral fractures.
The incidence of acute fractures after percutaneous vertebroplasty is higher than that among patients treated conservatively. Decision-making regarding the adoption of this intervention approach should be tailored to individual cases based on standard appropriateness criteria and while taking into consideration the risk factors leading to a greater risk of subsequent vertebral fractures such as a higher number of fractures at baseline imaging, low bone mineral density score, patient comorbidities, and steroid use.