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Percutaneous Vertebroplasty is no Risk Factor for New Vertebral Fractures and Protects Against Further Height Loss (VERTOS IV)

  • Firanescu, Cristina E.1
  • de Vries, Jolanda1, 2
  • Lodder, Paul2
  • Schoemaker, Marinus C.1
  • Smeets, Albert J.1
  • Donga, Esther1
  • Juttmann, Job R.1
  • Klazen, Caroline A. H.3
  • Elgersma, Otto E. H.4
  • Jansen, Frits H.5
  • van der Horst, Irene5
  • Blonk, Marion5
  • Venmans, Alexander1
  • Lohle, Paul N. M.1
  • 1 Elisabeth TweeSteden Hospital, Departments of Radiology and Internal Medicine, Hilvarenbeekseweg 60, Tilburg, 5022 GC, The Netherlands , Tilburg (Netherlands)
  • 2 Tilburg University, Department of Medical and Clinical Psychology, Warandelaan 2, Tilburg, 5037 AB, The Netherlands , Tilburg (Netherlands)
  • 3 Medisch Spectrum Twente, Department of Radiology, Koningsplein 1, Enschede, 7512 KZ, The Netherlands , Enschede (Netherlands)
  • 4 Albert Schweitzer Hospital, Department of Radiology, Albert Schweitzerplaats 25, Dordrecht, 3318 AT, The Netherlands , Dordrecht (Netherlands)
  • 5 Catharina Hospital, Department of Radiology, Michelangelolaan 2, Eindhoven, 5623 EJ, The Netherlands , Eindhoven (Netherlands)
Published Article
CardioVascular and Interventional Radiology
Publication Date
Apr 02, 2019
DOI: 10.1007/s00270-019-02205-w
Springer Nature


BackgroundPercutaneous vertebroplasty (PV) is an alternative option to treat pain after an osteoporotic vertebral compression fracture (OVCF). Controversy exists as to whether PV increases the risk of new OVCFs or prevents further vertebral height loss in treated levels. We assessed both during 1-year follow-up in patients with acute OVCF randomised to PV or a sham procedure.MethodsVERTOS IV is a prospective, multicentre, randomised controlled trial comparing PV with sham therapy in 180 patients. New OVCFs and further vertebral height loss were assessed at 3, 6, and 12 months.ResultsAfter a median follow-up of 12 months (interquartile range (IQR) = 12–12) 31 new fractures were reported in 15 patients from the PV group and 28 new fractures in 19 patients from the sham group. The occurrence of new vertebral fractures did not significantly differ between the groups (χ2(1) = 0.83, p = 0.36, OR = .71, 95%CI = 0.33–1.50). There was no higher fracture risk of adjacent versus distant vertebrae. After sham procedure, further height loss of treated vertebrae occurred more frequently (7 patients (8%) in the PV group and 39 (45%) in the sham group (χ2(1) = 28.85, p < 0.001, OR = 9.84, 95%CI = 4.08–23.73)) and was more severe (p < .001) than after PV.ConclusionsThe risk of further vertebral height loss is significantly lower after PV compared to a sham intervention, i.e. PV protects against progressive vertebral height loss. In addition, PV does not increase the risk of new adjacent and distant OVCFs.Level of EvidenceLevel 1a, therapeutic number, NCT01200277

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