Long Term Follow Up Of The Patient With Osteoporotic Vertebral Compression Fracture Undergone Percutaneous Vertebroplasty

Objective: The purpose of this study was to evaluate and analyze the radiological outcomes of osteoporotic vertebral compression fractures(OVCFs)occurring after percutaneous vertebroplasty(PVP)over long-term follow-up and to determine the frequency of new OVCFs in relation to different factor after PVP.Methods and Materials: In total 350 patients suffering from symptomatic OVCFs undergone PVP procedure were included in our study between age ranges 45-90 years.Their radiological images including X-ray,CT scan and MRI images were followed from January 2008 to January2017.The major complications occurring after PVP procedure were evaluated.New vertebral fracture(adjacent or non-adjacent),condition of injected cement and stability of the vertebra were analyzed.Also the relation of adjacent fracture with age,gender,stability of the vertebra,cement leakage and the incidence of new vertebral fracture occurring within a year and after a following year were evaluated.Results: In 350 patients,65(18.5%)patients developed new vertebral fracture.The new vertebral fracture occurring in 65 patients was either adjacent or non-adjacent vertebral fracture,there was no patient with both adjacent and non-adjacent vertebral fracture at the same time.Among 65 patients,205 new vertebral fractures occurred,47 patients got adjacent vertebral fractures and 18 patients got non-adjacent vertebral fracture.Our study showed that there were not major complications like pulmonary embolism,neurological deficits,paraplegia and cardiac perforation.The complication mainly includes the occurrence of new VCFs affecting 176 adjacent vertebras(85.8%)and 29 non adjacent vertebras(14.6%).The adjacent fractures among these patients were not dependent on age,gender,stability and cement leakage(p value >0.05)but it was dependent on fracture occurring after 1 year(p value <0.05)which indicate that the adjacent fracture was more after 1 year.Also the odd ratio of the fracture occurring after 1 year was 0.416(95% CI: 0.219-0.788)which indicate that,as number of fracture increases,risk of adjacent fracture decreases.Conclusion: PVP is a safe and effective approach for OVCFs for long term management.However,after PVP risk of new vertebral fracture increases especially adjacent vertebral fracture.The incidence of new adjacent vertebral fracture was higher with the extension of time,and the risk of adjacent fracture decreases,as the number of fracture increases,which may change the mechanical structure of the spine.