By Will Boggs, MD

NEW YORK (Reuters Health) Jan 24 - Vertebroplasty is associated with an accelerated rate of fractures in adjacent vertebrae, according to report in the January 2006 American Journal of Neuroradiology.

 

"There may be an increased risk for developing new vertebral fractures following the vertebroplasty procedure and patients should be warned of this risk," Dr. Andrew T. Trout from the Mayo Clinic College of Medicine, Rochester, Minnesota told Reuters Health. "The development of these new fractures may cause a return of the patient's pain and disability, and thus the patient and physician should balance this risk against the benefits of the procedure."

 

Dr. Trout and colleagues performed a retrospective review of 432 patients treated with vertebroplasty at Mayo Clinic between 1999 and 2004.

 

During this interval, 86 patients developed 186 vertebral fractures a median 78 days after vertebroplasty, the authors report. Seventy-seven (41.4%) of these fractures occurred in vertebrae adjacent to the treated vertebral body.

 

The median time to diagnosis of an adjacent-level fracture was 55 days, compared with 127 days to diagnosis of a nonadjacent-level fracture, the results indicate.

There was a 4.62-fold higher risk of fracture of adjacent vertebrae compared with the risk of fracture of nonadjacent vertebrae, the researchers note.

 

"Our study was retrospective in nature so it cannot be taken as proof that vertebroplasty causes new fractures," Dr. Trout explained. "Rather, these data should be taken as an indication of a relationship between the vertebroplasty procedure and the development of new fractures, particularly in the vertebrae immediately adjacent to the treated level." [email interview]

 

He concluded: "There is a great deal of additional research that needs to go on to clearly define the risks and benefits of the procedure."

Am J Neuroradiol 2006;27:217-223.