Subsequent Fractures Post–Vertebral Augmentation: Analysis of a Prospective Randomized Trial in Osteoporotic Vertebral Compression Fractures

American Journal of Neuroradiology

Download figure
Open in new tab
Download powerpoint
Fig 1.
Participant flow. HNP indicates herniated nucleus pulposus.

Table 1:

Previous fractures

	Cortoss (n = 162)	PMMA (n = 94)	Total (n = 256)
No. of patients with any previous fractures^{^a}	56 (34.6%)	31 (33.0%)	87 (34.0%)
Total no. of levels with previous fractures^{^b}	106	60	166
No. of patients with any previous fractures (treated)^{^c}	20 (12.3%)	13 (13.8%)	33 (12.9%)
Total no. of levels with previous fractures (treated)	33	25	58
No. of patients with any previous fractures (untreated)^{^d}	39 (24.1%)	21 (22.3%)	60 (23.4%)
Total no. of levels with previous fractures (untreated)^{^e}	73	35	108

↵a Excludes pre-existing untreated fractures that were treated along with the acute fracture in the current study. Includes treated and untreated fractures other than the index treated levels.
↵b Includes all levels with previously treated fractures and all levels with previous untreated fractures, excluding those levels treated in the current study.
↵c No. and percentage of patients with any previous fractures treated with vertebral augmentation.
↵d Excludes untreated levels treated in the current study.
↵e Excludes levels treated in the current study.

Table 2:

New fracture classification

Time Period	Cortoss				PMMA
Time Period	Adjacent Fracture	Non-Adjacent Fracture	Treatment-Level Fracture^{^a}	Total	Adjacent Fracture	Non-Adjacent Fracture	Treatment-Level Fracture^{^a}	Total
No. (%) of patients with ≥1 additional fracture^{^b}	30 (18.5%)	26 (16.0%)	3 (1.9%)	45 (27.8%)	19 (20.2%)	16 (17.0%)	2 (2.1%)	30 (31.9%)
No. of fractures	43	32	4	79	21	24	2	47
<30 days	13 (30.2%)	7 (21.9%)	1 (25.0%)	21 (26.6%)	6 (28.6%)	4 (16.7%)	2 (100.0%)	12 (25.5%)
30 days to 1 yr (day 365)	28 (65.1%)	21 (65.6%)	3 (75.0%)	52 (65.8%)	12 (57.1%)	12 (50.0%)	0 (0.0%)	24 (51.1%)
1 yr (day 366) to 2 yr (day 730)	1 (2.3%)	2 (6.3%)	0 (0.0%)	3 (3.8%)	3 (14.3%)	7 (29.2%)	0 (0.0%)	10 (21.3%)
>2 yr	1 (2.3%)	2 (6.3%)	0 (0.0%)	3 (3.8%)	0 (0.0%)	1 (4.2%)	0 (0.0%)	1 (2.1%)
No. (%) of first-time patients with ≥1 additional fracture^{^c}	7 (10.3%)	6 (8.8%)	2 (2.9%)	12 (17.6%)	8 (18.2%)	6 (13.6%)	1 (2.3%)	12 (27.3%)

↵a Further collapse of treated fracture.
↵b Patients experiencing ≥1 additional fracture are counted once within each fracture category.
↵c Patients originally treated at 1 level who had not had previous fractures (Cortoss, n = 68; PMMA, n = 44).

Table 3:

Subsequent fracture incidence stratified

Subsequent Fractures	Cortoss		PMMA
Subsequent Fractures	Adjacent	Non-Adjacent	Adjacent	Non-Adjacent
No. (%) of patients with ≥1 Fx	30 (18.5%)	26 (16.0%)	19 (20.2%)	16 (17.0%)
No. (%) of first-time patients with Fx^{^a}	7 (10.3%)	6 (8.8%)	8 (18.2%)	6 (13.6%)
% Difference C < P	43.4%	35.3%

Note:—Fx indicates fracture; C, Cortoss; P, PMMA.
↵a Patients originally treated at 1 level with no previous fractures: C = 68, P = 44.