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Percutaneous Vertebroplasty Fracture Risks Uncovered

Adjacent and non-adjacent fractures caused by distinctive mechanisms

THURSDAY, Aug. 7 (HealthDay News) -- The risk of subsequent fractures after percutaneous vertebroplasty can be divided into two types, each with their own predictive risk factors, researchers report in the August issue of the Journal of Neurosurgery: Spine.

Yong Ahn, M.D., and colleagues at Wooridul Spine Hospital in Seoul, Korea, conducted a study of 508 patients who underwent percutaneous vertebroplasty, of whom 45 patients experienced a total of 49 painful vertebral fractures after surgery. The patients were classified according to the location of new fracture with 31 patients with 35 adjacent-level fractures and 14 with 14 non-adjacent-level fractures. A third control group consisted of 50 patients with no evidence of new fracture.

Lower body mass index and intradiscal cement leakage were the most important predictive risk factors for adjacent fractures, whereas non-adjacent-level fractures were associated with lower mobility of the index segment, the researchers report.

"The risk factors and mechanisms of subsequent fracture at adjacent and non-adjacent vertebrae are different," the authors write. "A strength gradient caused by bone cement augmentation may provoke a subsequent adjacent fracture (direct pillar effect), whereas a mobility gradient between neighboring segments may cause a subsequent non-adjacent fracture (dynamic hammer effect)."

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