Association of early vertebroplasty with risk of hip replacement: a nationwide population-based cohort study

Abstract Background Studies show that vertebral fractures could predict the risk of hip fractures. We aimed to evaluate the potential benefits of whether the timing of vertebroplasty (VP) for vertebral fracture associated with the risk of hip fracture for hip replacement. Methods We identified 142,782 patients from the Taiwan National Health Insurance Database with thoracolumbar vertebral fracture (TLCF) (ICD-9-CM: 805.2-805.9) who were followed up from 2000 to 2013. These patients were divided into those who underwent VP (VP group) (ICD-9-CM: 78.49) within 3 months and those who did not (non-VP group). After adjusting for the confounding factors, the Cox proportional hazards analysis was used to estimate the effect of early VP on reducing the risk of hip fracture. Results In the 14-year follow-up, the cumulative incidence rate of hip replacement in the VP group was lower than that in the non-VP group (0.362% and 0.533%, respectively, long-rank p<0.001). There was a significant difference between the two groups since the first-year follow-up. Conclusion Our study showed that early VP performed to avoid progression of the kyphotic changes following TLCF may reduce the risk of hip fracture. These results, obtained from retrospective data, indicate that a prospective study is warranted.