ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Disc degeneration did not lead to an increased incidence of adjacent vertebral fractures in wedge-type OVCF patients.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStress concentration is a primary pathogenesis of adjacent vertebral fracture (AVF) following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Disc degeneration (DD) is highly prevalent in the elderly, including OVCF patients. As a key biomechanical function of the intervertebral disc (IVD) is to ensure uniform load distribution, the progression of DD may impair this capacity, leading to localized stress concentrations. This study aims to investigate the impact of DD on AVF risk and elucidate its underlying biomechanical mechanisms.
methodsClinical data from 65 patients were retrospectively reviewed. The cohort was stratified by the presence or absence of cranial AVF. The cranial IVDs adjacent to the fractured vertebrae were classified based on their degeneration phenotype, specifically the presence of disc fibrosis or collapse. We compared the incidence of these phenotypes between the AVF and non-AVF groups. Furthermore, regression analysis was employed to identify potential risk factors for AVF. In parallel, PVP simulations were conducted using biomechanical models that simulated disc fibrosis and collapse. Stress distributions within the cranial vertebral body and the motion range of the corresponding segment were computed and compared across the different models.
resultsClinically, neither the incidence of disc fibrosis (P = 0.549) nor collapse (P = 0.586) differed significantly between cohorts with and without AVF, nor did they serve as independent risk factors (OR: 1.428 and 1.385, respectively). Biomechanical simulations aligned with clinical findings, demonstrating that neither disc fibrosis nor collapse altered stress distributions in the cranial vertebral body. Conversely, DD models exhibited a reduced motion-quantified by the overall model displacement-across all loading conditions when compared to the non-degenerated model.
conclusionOur clinical and biomechanical analysis did not demonstrate an increased incidence of AVF in DD patients with wedge-type OVCF following PVP. This phenomenon may be attributed to a reduction in segmental motion, which subsequently lowers the stress values within the degenerative segment.
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