Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or Vertebroplasty
<b>Objectives:</b> We aimed to analyze potential predictors for the development of metachronous fractures (MFs) after osteoporotic vertebral fractures (OVFs), with particular focus on radiological variables obtained at initial X-rays and computed tomography (CT) examinations, treatment a...
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MDPI AG
2025-01-01
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| author | Fernando Ruiz Santiago Lucía Bueno Caravaca Francisco Garrido Sanz Paula María Jiménez Gutiérrez David Luengo Gómez Mario Rivera Izquierdo José Manuel Benítez Antonio Jesús Láinez Ramos-Bossini |
| author_facet | Fernando Ruiz Santiago Lucía Bueno Caravaca Francisco Garrido Sanz Paula María Jiménez Gutiérrez David Luengo Gómez Mario Rivera Izquierdo José Manuel Benítez Antonio Jesús Láinez Ramos-Bossini |
| author_sort | Fernando Ruiz Santiago |
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| description | <b>Objectives:</b> We aimed to analyze potential predictors for the development of metachronous fractures (MFs) after osteoporotic vertebral fractures (OVFs), with particular focus on radiological variables obtained at initial X-rays and computed tomography (CT) examinations, treatment applied (conservative management [CM] versus percutaneous vertebroplasty [PV]), and fractures located at the thoracolumbar junction (T11-L2). <b>Methods:</b> We conducted a two-center, observational retrospective study, including patients with single-level OVFs treated with CM or VP. We collected socio-demographic, radiological and treatment-related variables. We performed descriptive and contrastive bivariate analyses based on the presence of MFs and univariate and multivariate logistic regression analyses to obtain adjusted and crude odds ratios (aOR and cOR, respectively) for predicting MFs. Finally, we performed receiver-operating characteristic (ROC) curve analyses to determine the discriminative power of the models obtained. <b>Results:</b> Of the 90 patients included, 20 (22.2%) developed one or more MFs (15 in CM and 5 in PV groups, respectively; <i>p</i> = 0.037). The treatment group (aOR for PV, 0.087; 95%CI, 0.015–0.379), presence of intravertebral cleft (aOR, 5.62; 95%CI, 1.84–19.2) and difference in posterior height loss between X-rays and CT (aOR, 0.926; 95%CI, 0.856–0.992) were identified as significant predictors for MFs, while Genant’s numerical classification showed a trend toward significance (aOR, 1.97; 95%CI, 0.983–4.19; <i>p</i> = 0.064). A multivariate model combining these four variables showed optimal fitting and correctly discriminated over 80% of cases (AUC, 0.828; 95%CI, 0.725–0.930). Factors associated with MFs in thoracolumbar junction OVFs were intravertebral cleft, CM, posterior height loss in CT, and DGOU OF3 fractures. <b>Conclusions:</b> The presence of intravertebral cleft, a difference in posterior height loss between X-rays and CT equal to or lower than 2.4%, higher grades of Genant’s numerical classification, and application of CM instead of PV are predictors of MFs. These findings improve our understanding of the factors involved in the development of MFs, but they need to be validated prospectively. |
| format | Article |
| id | doaj-art-5888f44d3f8b4f85ba0b64b1b7c1be41 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Diagnostics |
| spelling | doaj-art-5888f44d3f8b4f85ba0b64b1b7c1be412025-01-24T13:28:57ZengMDPI AGDiagnostics2075-44182025-01-0115216010.3390/diagnostics15020160Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or VertebroplastyFernando Ruiz Santiago0Lucía Bueno Caravaca1Francisco Garrido Sanz2Paula María Jiménez Gutiérrez3David Luengo Gómez4Mario Rivera Izquierdo5José Manuel Benítez6Antonio Jesús Láinez Ramos-Bossini7Department of Musculoskeletal Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, SpainDepartment of Musculoskeletal Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, SpainDepartment of Interventional Radiology, Hospital Universitario San Cecilio, 18007 Granada, SpainAdvanced Medical Imaging Group, Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, SpainDepartment of Musculoskeletal Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, SpainDepartment of Preventive Medicine and Public Health, School of Medicine, University of Granada, 18016 Granada, SpainAdvanced Medical Imaging Group, Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), 18012 Granada, SpainDepartment of Musculoskeletal Radiology, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain<b>Objectives:</b> We aimed to analyze potential predictors for the development of metachronous fractures (MFs) after osteoporotic vertebral fractures (OVFs), with particular focus on radiological variables obtained at initial X-rays and computed tomography (CT) examinations, treatment applied (conservative management [CM] versus percutaneous vertebroplasty [PV]), and fractures located at the thoracolumbar junction (T11-L2). <b>Methods:</b> We conducted a two-center, observational retrospective study, including patients with single-level OVFs treated with CM or VP. We collected socio-demographic, radiological and treatment-related variables. We performed descriptive and contrastive bivariate analyses based on the presence of MFs and univariate and multivariate logistic regression analyses to obtain adjusted and crude odds ratios (aOR and cOR, respectively) for predicting MFs. Finally, we performed receiver-operating characteristic (ROC) curve analyses to determine the discriminative power of the models obtained. <b>Results:</b> Of the 90 patients included, 20 (22.2%) developed one or more MFs (15 in CM and 5 in PV groups, respectively; <i>p</i> = 0.037). The treatment group (aOR for PV, 0.087; 95%CI, 0.015–0.379), presence of intravertebral cleft (aOR, 5.62; 95%CI, 1.84–19.2) and difference in posterior height loss between X-rays and CT (aOR, 0.926; 95%CI, 0.856–0.992) were identified as significant predictors for MFs, while Genant’s numerical classification showed a trend toward significance (aOR, 1.97; 95%CI, 0.983–4.19; <i>p</i> = 0.064). A multivariate model combining these four variables showed optimal fitting and correctly discriminated over 80% of cases (AUC, 0.828; 95%CI, 0.725–0.930). Factors associated with MFs in thoracolumbar junction OVFs were intravertebral cleft, CM, posterior height loss in CT, and DGOU OF3 fractures. <b>Conclusions:</b> The presence of intravertebral cleft, a difference in posterior height loss between X-rays and CT equal to or lower than 2.4%, higher grades of Genant’s numerical classification, and application of CM instead of PV are predictors of MFs. These findings improve our understanding of the factors involved in the development of MFs, but they need to be validated prospectively.https://www.mdpi.com/2075-4418/15/2/160osteoporosisfracturespinepercutaneous vertebroplastyconservative managementrisk factor |
| spellingShingle | Fernando Ruiz Santiago Lucía Bueno Caravaca Francisco Garrido Sanz Paula María Jiménez Gutiérrez David Luengo Gómez Mario Rivera Izquierdo José Manuel Benítez Antonio Jesús Láinez Ramos-Bossini Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or Vertebroplasty Diagnostics osteoporosis fracture spine percutaneous vertebroplasty conservative management risk factor |
| title | Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or Vertebroplasty |
| title_full | Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or Vertebroplasty |
| title_fullStr | Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or Vertebroplasty |
| title_full_unstemmed | Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or Vertebroplasty |
| title_short | Factors Influencing the Development of Metachronous Fractures in Patients with Osteoporotic Vertebral Fractures Treated with Conservative Management or Vertebroplasty |
| title_sort | factors influencing the development of metachronous fractures in patients with osteoporotic vertebral fractures treated with conservative management or vertebroplasty |
| topic | osteoporosis fracture spine percutaneous vertebroplasty conservative management risk factor |
| url | https://www.mdpi.com/2075-4418/15/2/160 |
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