{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:56:34Z","timestamp":1772103394217,"version":"3.50.1"},"reference-count":32,"publisher":"BMJ","issue":"11","funder":[{"name":"project of the Health Commission of Sichuan Province","award":["20PJ194"],"award-info":[{"award-number":["20PJ194"]}]},{"name":"the Science and Technology Support Program of Sichuan Province","award":["JH2018055"],"award-info":[{"award-number":["JH2018055"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2020,12,4]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>It is unclear whether the sandwich vertebra, is at higher risk of new symptomatic fractures (NSFs), and whether prophylactic augmentation might benefit patients with sandwich vertebrae.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare fracture-free probabilities of sandwich, ordinary-adjacent, and non-adjacent vertebrae, and identify predictors of NSFs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were retrospectively analyzed for patients who had undergone vertebral augmentation resulting in sandwich vertebrae. NSF rates were determined and predictors were identified using Cox proportional hazard models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The analysis included 1408 untreated vertebrae (147 sandwich, 307 ordinary-adjacent, 954 non-adjacent vertebrae) in 125 patients. NSFs involved 19 sandwich, 19 ordinary-adjacent, and 16 non-adjacent vertebrae. The NSF rate was significantly higher in the patients with sandwich vertebrae (27.2%) than among all patients (14.8%). At the vertebra-specific level, the NSFs rate was 12.9% for sandwich vertebrae, significantly higher than 6.2% for ordinary-adjacent and 1.7% for non-adjacent vertebrae. The corresponding fracture-free probabilities of sandwich, ordinary-adjacent, and non-adjacent vertebrae were 0.89, 0.95, and 0.99 at 1\u2009year, and 0.85, 0.92, and 0.98 at 5 years (p&lt;0.05). Cox modeling identified the following as predictors for occurrence of an NSF in a given vertebra: vertebra location, type of vertebrae, number of augmented vertebrae, and puncture method.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Sandwich vertebrae are at higher risk of NSFs than ordinary-adjacent and non-adjacent vertebrae, and several NSF risk factors were identified. Since 85% of sandwich vertebrae are fracture-free for 5 years and NSF risk increases with the number of augmented vertebrae, prophylactic augmentation of every sandwich vertebra may be unnecessary.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2020-016985","type":"journal-article","created":{"date-parts":[[2021,1,19]],"date-time":"2021-01-19T17:11:11Z","timestamp":1611076271000},"page":"1058-1062","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Fracture-free probability and predictors of new symptomatic fractures in sandwich, ordinary-adjacent, and non-adjacent vertebrae: a vertebra-specific survival analysis"],"prefix":"10.1136","volume":"13","author":[{"given":"Jin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Sichuan University West China Hospital, Chengdu, Sichuan, China"},{"name":"Department of Orthopaedics, Chengdu First People\u2019s Hospital, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuchao","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Chengdu First People\u2019s Hospital, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Chengdu First People\u2019s Hospital, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shenghui","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Chengdu First People\u2019s Hospital, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6194-4345","authenticated-orcid":false,"given":"Hao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Sichuan University West China Hospital, Chengdu, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,1,19]]},"reference":[{"key":"2025092910450628000_13.11.1058.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.50"},{"key":"2025092910450628000_13.11.1058.2","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1038\/s41574-019-0220-8","article-title":"Fracture prediction, imaging and screening in osteoporosis","volume":"15","author":"Fuggle","year":"2019","journal-title":"Nat Rev Endocrinol"},{"key":"2025092910450628000_13.11.1058.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31341-1"},{"key":"2025092910450628000_13.11.1058.4","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-015026"},{"key":"2025092910450628000_13.11.1058.5","doi-asserted-by":"publisher","DOI":"10.3171\/2010.12.SPINE10286"},{"key":"2025092910450628000_13.11.1058.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60954-3"},{"key":"2025092910450628000_13.11.1058.7","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s00198-018-4804-2","article-title":"Which is the best treatment of osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty, or non-surgical treatment? 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