Spinal radiosurgery ups vertebral fracture risk

Army service increases lumbar fracture risk
Army service increases lumbar fracture risk

HealthDay News -- Vertebral compression fracture (VCF) is a common adverse effect in patients receiving spine stereotactic body radiotherapy (SBRT),study finding suggest.

In an effort to assess the risk and predictive factors associated with VCF, Arjun Sahgal, MD, of the University of Toronto, and colleagues analyzed data from 410 spinal segments treated with SBRT in 252 patients.

A total of 57 VCFs occurred in 10 spinal segments (14%), which included new fractures (47%) and fracture progression (53%), the researchers reported in the Journal of Clinical Oncology.

About 65% of the fractures occurred within the first four months, and the median time to fracture was 2.46 months (range, 0.03 to 43.01 months). Risk of VCF increased with increasing dose per fraction, with the highest risk for ≥24 Gy versus 20 to 23 Gy versus ≤19 Gy.

Three of the six criteria in the Spinal Instability Neoplastic Scoring System -- baseline VCF, lytic tumor and spinal deformity -- were significant VCF predictors.

"Caution must be observed when treating with ≥20 Gy/fraction, in particular, for patients with lytic tumor, spinal misalignment and a baseline VCF," the researchers wrote. "Frequent short-term follow-up is required, as nearly two-thirds of all VCF occurred within the first four months."

References

  1. Sahjal A et al. J Clin Oncol. 2013; doi: 10.1200/JCO.2013.50.1411.
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