Newly developed compression fractures after percutaneous vertebroplasty: comparison with conservative treatment

Purpose. The aim of this study was to investigate the incidence and timing of subsequent fractures in patients treated with and without percutaneous vertebroplasty (PVP). Materials and methods. We reviewed 794 patients who underwent 1500 PVPs with polymethylmethacrylate (PMMA) at our institution between January 1999 and December 2009. We also reviewed 349 patients with vertebral fractures who underwent conservative treatment without PVP between October 1999 and December 2009 and compared the incidence and timing of subsequent fractures in the two groups. Results. Among the 794 patients treated by PVP, 171 (21.5%) suffered 336 new vertebral fractures. Among the patients not treated by PVP, 82 (23.5%) presented with 154 new fractures. There was no statistically significant difference (P = 0.46). Among the PVP-treated patients, one-half of new fractures occurred at a level adjacent to the treated level, and they occurred significantly sooner than nonadjacent level fractures (log-rank test, P < 0.01). Conclusion. PVP did not increase the incidence of new compression fractures compared with conservative treatment, but half of the new fractures at the adjacent vertebral bodies occurred sooner.