Brain & Spine · Nov 2026
Long-term survival, refracture and reoperation following vertebral augmentation for osteoporotic vertebral fractures: up to an 11-year single-centre cohort
By Bommireddy L, Haider K, Cherukuri S et al.
Introduction Osteoporotic vertebral fractures (OVF) are common fragility fractures associated with morbidity and increased mortality. Benefits of vertebral cement augmentation in the short term have been well studied. However, long-term outcomes are less known. This study evaluated long-term survival, refracture, reoperation and predictors of outcome following cement augmentation for OVF. Methods A retrospective single-centre cohort study was performed. Patients who underwent cement augmentation for OVF between August 2015-August 2019 were identified from a local database. Demographics, fracture characteristics, operative details, cement leak, patient-reported outcome measures, refracture, reoperation, and mortality were recorded. Long-term survival and refracture-free survival were assessed using statistical methods. Results 106 patients were included. Median age was 73 years and 74.5% were female. Kyphoplasty was performed in 71.7%, vertebroplasty in 24.5%, and combined augmentation in 3.8%. Patient-reported outcomes improved significantly. Over the study period of up to 11 years, 45 patients died (42.5%), with Kaplan-Meier estimated survival of 53.4% at 10 years. Refracture occurred in 30 patients (28.3%), most commonly being adjacent to treated level. Adjacent fractures occurred earlier than non-adjacent fractures. There were 21 patients (19.8%) that underwent reoperation for refracture. Increasing age, higher Charlson Comorbidity Index (CCI), worse baseline Oswestry Disability Index and EuroQol-5Dimensional index were associated with increased mortality, while no factors significantly predicted refracture. Conclusion Cement augmentation for OVF was associated with significant early improvement in pain, disability, and health-related quality of life. Age, CCI, preoperative ODI and EQ-5D index were predictive of mortality. Larger prospective studies are needed to validate these long-term findings.