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. 2022 Jan 28;11(3):708.
doi: 10.3390/jcm11030708.

Healing of Vertebral Compression Fractures in the Elderly after Percutaneous Vertebroplasty-An Analysis of New Bone Formation and Sagittal Alignment in a 3-Year Follow-Up

Yuh-Ruey Kuo  1 , Ting-An Cheng  1 , Po-Hsin Chou  2   3 , Yuan-Fu Liu  4 , Chao-Jui Chang  1 , Cheng-Feng Chuang  5 , Pei-Fang Su  5 , Ruey-Mo Lin  6 , Cheng-Li Lin  1   7   8   9
Affiliations

Healing of Vertebral Compression Fractures in the Elderly after Percutaneous Vertebroplasty-An Analysis of New Bone Formation and Sagittal Alignment in a 3-Year Follow-Up

Yuh-Ruey Kuo et al. J Clin Med. .

Abstract

Background: Vertebral compression fractures, resulting in significant pain and disability, commonly occur in elderly osteoporotic patients. However, the current literature lacks long-term follow-up information related to image parameters and bone formation following vertebroplasty.

Purpose: To evaluate new bone formation after vertebroplasty and the long-term effect of vertebroplasty.

Methods: A total of 157 patients with new osteoporotic compression fractures who underwent vertebroplasty were retrospectively analyzed. The image parameters, including wedge angles, compression ratios, global alignment, and new bone formation, were recorded before and after vertebroplasty up to three years postoperatively.

Results: The wedge angle improved and was maintained for 12 months. The compression ratios also improved but gradually deteriorated during the follow-up period. New bone formation was found in 40% of the patients at 36 months, and the multivariate analysis showed that this might have been related to the correction of the anterior compression ratio.

Conclusions: Vertebroplasty significantly restored the wedge angles and compression ratios up to one year postoperatively, and new bone formation was noted on plain radiographs, which increased over time. Last, the restoration of vertebral parameters may contribute to new bone formation.

Keywords: new bone formation; osteoporotic vertebral compression fractures; restoration; spine; vertebroplasty.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The measurement of radiographic parameters. The wedge angle is defined as the angle between the superior and inferior endplates of the collapsed vertebra. c and d represent the anterior and middle vertebral height, respectively. The normal vertebral height was defined as (a + b)/2. The anterior and middle compression ratios (ACR and MCR) were calculated as [1 − (ant or mid-height/normal height)] × 100%.
Figure 2
Figure 2
New bone/callus formation. (a) Vertebral compression fracture with the vacuum phenomenon. (b) Bone formation emerging between the affected vertebra and the adjacent vertebrae.
Figure 3
Figure 3
Changes in the wedge angles following vertebroplasty (*** p-value < 0.001, which was compared with preoperative value).
Figure 4
Figure 4
Change in anterior (ACR) and middle (MCR) compression ratios following vertebroplasty (*** p-value < 0.001, ** p-value < 0.01, which were compared with preoperative value).
Figure 5
Figure 5
Changes in spinal alignment following vertebroplasty (* p-value < 0.05, which were compared with preoperative value).
Figure 6
Figure 6
The percentage of new bone formation following vertebroplasty.
Figure 7
Figure 7
Demonstrated case of new bone formation. (a) A case of a T12 compression fracture with a vacuum sign. (b) Immediate postoperative lateral film after PVP. (c) Callus formation observed postoperatively at 12 months.
Figure 8
Figure 8
Demonstrated case of new bone formation. (a) A case of an L2 compression fracture. (b) Immediate postoperative lateral film after PVP. (c) Callus formation observed postoperatively at 24 months.
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