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Case Series
Fractures following percutaneous vertebral augmentation: The procedure or the underlying disease?
1 Associate, Department of Medicine, University of Iowa Health Care, 200 Hawkins Drive, SE 636 GH, Iowa City, Iowa, USA
2 Professor of Medicine, Division of Endocrinology and Metabolism, Department of Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, Connecticut, USA
Address correspondence to:
Hirva Bakeri
MD, Associate, Department of Medicine, University of Iowa Health Care, 200 Hawkins Drive, SE 636 GH, Iowa City, Iowa 52242,
USA
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Article ID: 101089Z01HB2020
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Bakeri H, Taxel P. Fractures following percutaneous vertebral augmentation: The procedure or the underlying disease? Int J Case Rep Images 2020;11:101089Z01HB2020.ABSTRACT
Introduction: We report cases of three patients who had vertebral compression fractures (VCFs) that occurred temporally close to and at levels adjacent to prior percutaneous vertebral augmentation (PVA) of vertebral fractures. Our objective is to evaluate the association between PVA and new/adjacent-level vertebral fractures.
Case Series: Case 1 presented to our Osteoporosis (OP) Clinic with a previous diagnosis of OP, briefly on alendronate. Following this, she had a compression fracture (CF) at L3 followed by balloon kyphoplasty (BK). She was then on teriparatide for two years. Following this, over a span of several months, she had CFs (T8-L2) requiring BK, with seven of those fractures within six months. Case 2 presented for evaluation in the setting of CFs. She had never received antiresorptive therapy. She underwent BK at T12 and L1, and was noted to have a new T11 fracture 3–4 weeks later. Case 3 presented with a prior history of CF at L3 requiring vertebroplasty. Later, over the course of one year, she had a CF of T12 treated with BK, followed by new vertebral fractures at T11 and L1 also treated with BK, and finally CF at T10, which was also treated with BK.
Conclusion: These cases illustrate that new fractures my occur sooner and at adjacent levels following PVA, demonstrating a possible association between the two. Given the mixed data regarding this, we would like to emphasize the need for clinicians to complete a thorough OP work-up and discuss the risks and benefits of these procedures with patients
Keywords: Kyphoplasty, Osteoporosis, Vertebral compression fractures
SUPPORTING INFORMATION
Author Contributions
Hirva Bakeri - Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Pamela Taxel - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten consent was not obtained from the patients as IRB does not require written consents for case series up to 3 patients and all our patients were de-identified. We can obtain written consents, if required.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Hirva Bakeri et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
