Risk Factors Predicting New Compression Fractures in Patients with Osteoporotic Vertebral Compression Fractures

ABSTRACT

STUDY DESIGN: A retrospective study. OBJECTIVES: To investigate the risk factors associated with new compression fractures in patients with osteoporotic vertebral compression fractures. SUMMARY OF LITERATURE REVIEW Previous studies have reported that a history of osteoporotic vertebral fractures and decreased bone mineral density were risk factors for new compression fractures. It is not certain whether vertebroplasty is a risk factor for new compression vertebral fractures. MATERIALS AND METHODS: This retrospective study included a total of 52 patients who were diagnosed with an osteoporotic vertebral compression fracture and could be followed up for at least 1 year. Age, sex, bone mineral density, body mass index, osteoporosis treatment, fat infiltration of the back muscles, the sagittal index, vertebroplasty, and underlying diabetes mellitus or hypertension were compared between patients who developed new compression fractures during 1 year of follow-up and those who did not. For statistical analysis, the t-test and chi-square test were used to analyz ethe relationship of each factor with osteoporotic vertebral compression fracture incidence, and multiple logistic regression analysis was performed to analyze multifactorial explanatory factors. RESULTS: No significant differences were found between the 2 groups regarding sex, underlying disease, the sagittal index, and fat infiltration of the back muscles. Patients who developed a new compression fracture were significantly older (p=0.011), had a lower body mass index (p=0.001), had lower bone mineral density (p=0.008), and were more likely to have taken osteoporosis medication for less than 6 months (including no medication, p=0.019). The logistic regression analysis showed that the risk of developing new compression fractures was significantly elevated in patients with a low body mass index (odds ratio [OR]=0.69, p=0.02), bone mineral density (OR=0.43, p=0.005), and less than 6 months of osteoporosis medication use (including no medication, OR=1.083, p=0.041). CONCLUSIONS: The risk of developing new compression fractures in patients with osteoporotic vertebral compression fractures was associated with body mass index, bone mineral density, and having taken osteoporosis medication for less than 6 months.