New fractures more likely after spine procedure

"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."

Trout and colleagues reviewed the records of 432 patients treated with vertebroplasty at Mayo Clinic between 1999 and 2004. The findings are published in the American Journal of Neuroradiology.

During this interval, 86 patients developed 186 vertebral fractures an average of 78 days after vertebroplasty, the authors report. Seventy-seven of these fractures occurred in vertebrae adjacent to the treated vertebral body.

The average time to diagnosis of an adjacent fracture was 55 days, compared with 127 days to diagnosis of a nonadjacent 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.

Because the study was based on a review of patient records only, the findings "cannot be taken as proof that vertebroplasty causes new fractures," 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 fractures in adjacent vertebrae.

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."

SOURCE: American Journal of Neuroradiology, January 2006.