Predictors and prevalence of patients undergoing additional kyphoplasty procedures after an initial kyphoplasty procedure

Robert L. Tatsumi, Alexander C. Ching, Gregory D. Byrd, Jayme Hiratzka, Judson E. Threlkeld, Robert Hart

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background context: Vertebral cement augmentation, including kyphoplasty, has been shown to be a successful treatment for pain relief for vertebral compression fracture (VCF). Patients can sustain additional symptomatic VCFs that may require additional surgical intervention. Purpose: To examine the prevalence and predictors of patients who sustain additional symptomatic VCFs that were treated with kyphoplasty. Study design: A retrospective review of patients who previously underwent kyphoplasty for VCFs and had additional VCFs that were treated with kyphoplasty. Patient sample: A total of 256 patients underwent kyphoplasty for VCFs from 2000 to 2007 at a single medical center. Outcome measures: The outcome measure of interest was the need for an additional kyphoplasty procedure for a symptomatic VCF. Methods: Risk factors such as age, sex, smoking status, and steroid use were assessed, as well as bisphosphonate use. Sagittal spinal alignment via Cobb angles for thoracic, thoracolumbar, and lumbar regions was assessed. Results: About 22.2% of the patients had an additional symptomatic VCF that was treated with a kyphoplasty procedure. Steroid use was the only significant risk factor for predicting patients with additional symptomatic VCFs who underwent additional kyphoplasty. The average time to the second VCF was 33 days. Adjacent-level VCFs were most common in the thoracic and thoracolumbar spine. Bisphosphonate use was not shown to be protective of preventing additional VCFs during this follow-up period. Conclusion: This is the first single-center review of a large cohort of patients who underwent additional-level kyphoplasty for symptomatic VCFs after an index kyphoplasty procedure. Our results suggest that patients with a VCF who use chronic oral steroids should be carefully monitored for the presence of additional symptomatic VCFs that may need surgical intervention. Patients with prior thoracic VCFs who have additional back pain should be reevaluated for a possible adjacent-level fracture.

Original languageEnglish (US)
Pages (from-to)979-986
Number of pages8
JournalSpine Journal
Volume10
Issue number11
DOIs
StatePublished - Nov 2010

Fingerprint

Kyphoplasty
Compression Fractures
Thorax
Steroids
Diphosphonates
Outcome Assessment (Health Care)
Lumbosacral Region
Back Pain
Spine
Smoking

Keywords

  • Additional compression fractures
  • Kyphoplasty
  • Lumbar
  • Steroids
  • Thoracic

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Predictors and prevalence of patients undergoing additional kyphoplasty procedures after an initial kyphoplasty procedure. / Tatsumi, Robert L.; Ching, Alexander C.; Byrd, Gregory D.; Hiratzka, Jayme; Threlkeld, Judson E.; Hart, Robert.

In: Spine Journal, Vol. 10, No. 11, 11.2010, p. 979-986.

Research output: Contribution to journalArticle

Tatsumi, Robert L. ; Ching, Alexander C. ; Byrd, Gregory D. ; Hiratzka, Jayme ; Threlkeld, Judson E. ; Hart, Robert. / Predictors and prevalence of patients undergoing additional kyphoplasty procedures after an initial kyphoplasty procedure. In: Spine Journal. 2010 ; Vol. 10, No. 11. pp. 979-986.
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abstract = "Background context: Vertebral cement augmentation, including kyphoplasty, has been shown to be a successful treatment for pain relief for vertebral compression fracture (VCF). Patients can sustain additional symptomatic VCFs that may require additional surgical intervention. Purpose: To examine the prevalence and predictors of patients who sustain additional symptomatic VCFs that were treated with kyphoplasty. Study design: A retrospective review of patients who previously underwent kyphoplasty for VCFs and had additional VCFs that were treated with kyphoplasty. Patient sample: A total of 256 patients underwent kyphoplasty for VCFs from 2000 to 2007 at a single medical center. Outcome measures: The outcome measure of interest was the need for an additional kyphoplasty procedure for a symptomatic VCF. Methods: Risk factors such as age, sex, smoking status, and steroid use were assessed, as well as bisphosphonate use. Sagittal spinal alignment via Cobb angles for thoracic, thoracolumbar, and lumbar regions was assessed. Results: About 22.2{\%} of the patients had an additional symptomatic VCF that was treated with a kyphoplasty procedure. Steroid use was the only significant risk factor for predicting patients with additional symptomatic VCFs who underwent additional kyphoplasty. The average time to the second VCF was 33 days. Adjacent-level VCFs were most common in the thoracic and thoracolumbar spine. Bisphosphonate use was not shown to be protective of preventing additional VCFs during this follow-up period. Conclusion: This is the first single-center review of a large cohort of patients who underwent additional-level kyphoplasty for symptomatic VCFs after an index kyphoplasty procedure. Our results suggest that patients with a VCF who use chronic oral steroids should be carefully monitored for the presence of additional symptomatic VCFs that may need surgical intervention. Patients with prior thoracic VCFs who have additional back pain should be reevaluated for a possible adjacent-level fracture.",
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AU - Ching, Alexander C.

AU - Byrd, Gregory D.

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AU - Threlkeld, Judson E.

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N2 - Background context: Vertebral cement augmentation, including kyphoplasty, has been shown to be a successful treatment for pain relief for vertebral compression fracture (VCF). Patients can sustain additional symptomatic VCFs that may require additional surgical intervention. Purpose: To examine the prevalence and predictors of patients who sustain additional symptomatic VCFs that were treated with kyphoplasty. Study design: A retrospective review of patients who previously underwent kyphoplasty for VCFs and had additional VCFs that were treated with kyphoplasty. Patient sample: A total of 256 patients underwent kyphoplasty for VCFs from 2000 to 2007 at a single medical center. Outcome measures: The outcome measure of interest was the need for an additional kyphoplasty procedure for a symptomatic VCF. Methods: Risk factors such as age, sex, smoking status, and steroid use were assessed, as well as bisphosphonate use. Sagittal spinal alignment via Cobb angles for thoracic, thoracolumbar, and lumbar regions was assessed. Results: About 22.2% of the patients had an additional symptomatic VCF that was treated with a kyphoplasty procedure. Steroid use was the only significant risk factor for predicting patients with additional symptomatic VCFs who underwent additional kyphoplasty. The average time to the second VCF was 33 days. Adjacent-level VCFs were most common in the thoracic and thoracolumbar spine. Bisphosphonate use was not shown to be protective of preventing additional VCFs during this follow-up period. Conclusion: This is the first single-center review of a large cohort of patients who underwent additional-level kyphoplasty for symptomatic VCFs after an index kyphoplasty procedure. Our results suggest that patients with a VCF who use chronic oral steroids should be carefully monitored for the presence of additional symptomatic VCFs that may need surgical intervention. Patients with prior thoracic VCFs who have additional back pain should be reevaluated for a possible adjacent-level fracture.

AB - Background context: Vertebral cement augmentation, including kyphoplasty, has been shown to be a successful treatment for pain relief for vertebral compression fracture (VCF). Patients can sustain additional symptomatic VCFs that may require additional surgical intervention. Purpose: To examine the prevalence and predictors of patients who sustain additional symptomatic VCFs that were treated with kyphoplasty. Study design: A retrospective review of patients who previously underwent kyphoplasty for VCFs and had additional VCFs that were treated with kyphoplasty. Patient sample: A total of 256 patients underwent kyphoplasty for VCFs from 2000 to 2007 at a single medical center. Outcome measures: The outcome measure of interest was the need for an additional kyphoplasty procedure for a symptomatic VCF. Methods: Risk factors such as age, sex, smoking status, and steroid use were assessed, as well as bisphosphonate use. Sagittal spinal alignment via Cobb angles for thoracic, thoracolumbar, and lumbar regions was assessed. Results: About 22.2% of the patients had an additional symptomatic VCF that was treated with a kyphoplasty procedure. Steroid use was the only significant risk factor for predicting patients with additional symptomatic VCFs who underwent additional kyphoplasty. The average time to the second VCF was 33 days. Adjacent-level VCFs were most common in the thoracic and thoracolumbar spine. Bisphosphonate use was not shown to be protective of preventing additional VCFs during this follow-up period. Conclusion: This is the first single-center review of a large cohort of patients who underwent additional-level kyphoplasty for symptomatic VCFs after an index kyphoplasty procedure. Our results suggest that patients with a VCF who use chronic oral steroids should be carefully monitored for the presence of additional symptomatic VCFs that may need surgical intervention. Patients with prior thoracic VCFs who have additional back pain should be reevaluated for a possible adjacent-level fracture.

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KW - Lumbar

KW - Steroids

KW - Thoracic

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