Vertebral Compression Fractures Recur in 22 Percent

Steroid use predictor of future fractures; most new T-spine fractures are adjacent

MONDAY, Nov. 22 (HealthDay News) -- More than one in five patients with vertebral compression fractures (VCFs) treated with kyphoplasty will have an additional VCF, with those who are on continued oral steroids at highest risk, according to research published in the November issue of The Spine Journal.

Robert L. Tatsumi, M.D., of Pacific Spine Specialists in Tualatin, Ore., and colleagues conducted a retrospective review of 256 patients from a single practice who previously underwent kyphoplasty for VCFs. The purpose of the study was to assess the prevalence and predictors of additional symptomatic VCFs treated with kyphoplasties.

The researchers found that additional symptomatic VCFs treated with a kyphoplasty procedure occurred in 22.2 percent of patients; adjacent-level VCFs were most common in the thoracic and thoracolumbar spine. The only significant risk factor for VCF with repeat kyphoplasty was steroid use, and bisphosphonate use was not protective. The second VCF occurred, on average, 33 days after the prior VCF.

"Our results suggest that patients with VCF who use chronic oral steroids should be carefully monitored for the presence of additional symptomatic VCFs," the authors conclude. "In the lumbar spine, additional VCFs appear less likely to occur immediately adjacent to a prior vertebral augmentation than in the thoracic or thoracolumbar spines."

Several authors disclosed financial relationships with medical device companies.

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