This Article Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal My Folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Berlemann, U. Articles by Heini, P. F. Search for Related Content PubMed PubMed Citation Articles by Berlemann, U. Articles by Heini, P. F.

Adjacent vertebral failure after vertebroplasty

A BIOMECHANICAL INVESTIGATION

¹ Department of Orthopaedic Surgery, Spine Service, Inselspital Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
² M. E. Müller Institute for Biomechanics, University of Bern, Murtenstrasse 35, PB 30, CH-3010 Bern, Switzerland.

Correspondence should be sent to Dr S. J. Ferguson.

Vertebroplasty, which is the percutaneous injection of bone cement into vertebral bodies has recently been used to treat painful osteoporotic compression fractures. Early clinical results have been encouraging, but very little is known about the consequences of augmentation with cement for the adjacent, non-augmented level.

We therefore measured the overall failure, strength and structural stiffness of paired osteoporotic two-vertebra functional spine units (FSUs). One FSU of each pair was augmented with polymethyl-methacrylate bone cement in the caudal vertebra, while the other served as an untreated control.

Compared with the controls, the ultimate failure load for FSUs treated by injection of cement was lower. The geometric mean treated/untreated ratio of failure load was 0.81, with 95% confidence limits from 0.70 to 0.92, (p < 0.01). There was no significant difference in overall FSU stiffness. For treated FSUs, there was a trend towards lower failure loads with increased filling with cement (r² = 0.262, p = 0.13).

The current practice of maximum filling with cement to restore the stiffness and strength of a vertebral body may provoke fractures in adjacent, non-augmented vertebrae. Further investigation is required to determine an optimal protocol for augmentation.

This article has been cited by other articles:

				A. G. Hadjipavlou, M. N. Tzermiadianos, P. G. Katonis, and M. Szpalski Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours J Bone Joint Surg Br, December 1, 2005; 87-B(12): 1595 - 1604. [Full Text] [PDF]