Fracture Patterns and Efficacy of Prophylactic Vertebroplasty in Osteoporotic Vertebral Compression Fractures: A Retrospective Single-Center Study

Background: The concept of prophylactic vertebroplasty (PrVP) has been proposed to prevent recurrent fractures after vertebroplasty (VP); however, its efficacy remains controversial. The purpose of this study was to analyze fracture patterns and evaluate the effectiveness of PrVP in reducing refracture rates. Methods: A retrospective analysis was conducted from January 2015 to December 2023 involving consecutive patients who underwent VP for osteoporotic vertebral compression fractures (OVCFs). Fractures were classified according to the German Society for Orthopedics and Trauma (DGOU) Classification of Osteoporotic Fractures, and further divided into subgroups. Patients were categorized into PrVP or non-PrVP groups. The follow-up assessments included radiographic evaluations, pain scores, and disability indices between the two groups. Results: A total of 121 patients were included. PrVP was associated with reduced occurrence of subsequent vertebral compression fractures (VCFs) and adjacent vertebral fractures (AVFs) in the biendplate-involvement subgroup (7.7% versus 28.6%, P=0.031; 2.6% versus 23.8%, P=0.009). The postoperative disability scores at 3 months (12.1 ± 2.1 versus 12.9 ± 2.1, P=0.034) and at 6 months (11.7 ± 2.6 versus 12.8 ± 2.5, P=0.014) differed significantly between the groups. No significant differences were observed in AVF occurrence among the other fracture subgroups. Postoperative pain relief was significant in both groups, but the difference was not statistically significant. Conclusions: Our study highlights the potential benefits of PrVP in reducing AVF occurrence in patients with biendplate-involved. Postoperative disability scores improved significantly with PrVP, especially in patients receiving postoperative osteoporosis medication. Trial registration: This study was approved by the Research Ethics Committee of China Medical University Hospital (Approval number: CMUBH2019-001).