Spine Fracturing Worse Right After Cement Repair

A treatment to stabilize spinal fractures, called kyphoplasty, may actually increase the risk of additional fractures in the weeks following the procedure, new research suggests.

Compression fractures of the vertebrae are a common problem in elderly people that usually result from the bone-thinning disease osteoporosis. Kyphoplasty, a relatively recent treatment for such fractures, involves the expansion of the compressed vertebra with a balloon, followed by injection of bone cement, to restore the bone’s normal shape. Although the reason why kyphoplasty may transiently increase the risk of fracture is unclear, it may be because restoring one vertebra places further stress on the vertebrae above and below it, Dr. David Fribourg and colleagues, from St. John’s Health Center in Santa Monica, California, note. After kyphoplasty, an increase in back pain, particular in the next two months, should raise suspicions that another vertebral fracture has occurred, the researchers state. The findings, which appear in the medical journal Spine, are based on a study of 38 patients — 28 women and 10 men — who underwent kyphoplasty for one or more vertebral fractures. After 8 months, 10 of the patients had sustained additional fractures. This rate is higher than would be expected if the patients had not had their initial fractures treated. In eight patients, the fractures occurred within 2 months of kyphoplasty and involved a vertebra that was above or below the vertebra initially treated. “Kyphoplasty is an effective treatment for painful osteoporotic compression fractures,” the investigators conclude. “However, patients who undergo kyphoplasty procedure should be informed of the significant risk of adjacent-level fractures over the next 60 days.” (SOURCE: Reuters, Spine, October, 2004.)