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Eur Spine J (2017) 26:15611563 DOI 10.1007/s00586-017-5027-5
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Answer to the Letter to the Editor of Ming Yang et al. concerning Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty by Ren HL et al. (2015) Eur Spine J;24(4):750758
Hai-long Ren1
Received: 27 February 2017 / Accepted: 1 March 2017 / Published online: 7 March 2017 Springer-Verlag Berlin Heidelberg 2017
Dear Editor,
We thank you for your interest in our article entitled Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty [1], and we agree with some of the readers points.
First, the purpose of our research was to explore the risk factors associated with new symptomatic vertebral compression fractures in osteoporotic patients who have undergone percutaneous vertebroplasty (PVP), and not the risk factors of adjacent vertebral compression fractures after PVP. We clearly show cases of new fractures in Table 2 and have included six patients with one adjacent vertebral fracture, nine patients with a remote vertebral fracture, ve patients with two remote vertebral fractures, and one patient with three remote vertebral fractures [1]. New vertebral compression fractures after PVP likely arise through a clinical course different from that of adjacent vertebral fractures, and, therefore, have different causes and characteristics. Thus, in terms of our research purpose and from a statistical point of view, we do not think that a subgroup analysis is a necessary or suitable choice. If our study is a multi-center and big sample study, it is a good idea.
Second, there are numerous complex factors related to the prevalence of new vertebral fractures after PVP. In addition to the factors mentioned by the reader in the letter, the list should also include the distribution of bone cement
in the vertebral body and the type or biomechanical properties of bone cement [24], among others. We believe that the presence of new vertebral fractures is not the result of a single factor, but rather multiple factors. The main or predominant factors that lead to new vertebral fractures remain the subject of intense investigation. Our study presents retrospective clinical research; it is neither a review nor is it an attempt to draw a conclusion...