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Vertebroplasty May Protect Osteoporotic Vertebrae

Procedure may protect adjacent intact vertebrae from fatigue injury

FRIDAY, Feb. 20 (HealthDay News) -- Prophylactic vertebroplasty may protect adjacent intact vertebrae from fatigue injury in some patients with osteoporosis, according to a biomechanical study in the Feb. 15 issue of Spine.

Chun-Kai Chiang, B.S., from National Taiwan University in Taipei, and colleagues performed fatigue loading on 14 fresh human cadaveric thoracic motion segments. The lower level of free vertebrae was artificially injured and augmented with bone cement in all cases (one-level augmented). In half the samples, the intact above vertebra was augmented with bone cement (two-level augmented). Impulse testing and computed tomography scanning were used to measure strain compliance of the cortical shell and height of the vertebral body.

The researchers found that fatigue loading, cement augmentation, and vertebral level had no significant effect on the strain compliance of the cortical shell. However, the cortical strain compliance of the augmented vertebrae was reduced after fatigue loading. The height loss of intact vertebra adjacent to a two-level augmented vertebra was significantly lower than intact vertebra adjacent to a one-level augmented vertebra. There was no association between bone mineral density, cortical strain compliance or vertebral height loss in an osteoporotic vertebra.

"The strain compliance of cortical shell is generally not a sensitive indicator to predict risk of fatigue injury if the fatigue loading is mild," Chiang and colleagues conclude. "It can be cautiously suggested that if the vertebra is osteoporotic and adjacent level is located at pivot or lordotic level of spinal column, the prophylactic augmentation may be an option to prevent the adjacent vertebral failure."

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