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Chen J, Xu C, Yu J. Vesselplasty for the treatment of osteoporotic vertebral compression fractures with peripheral wall damage: a retrospective study. Br J Neurosurg 2024; 38:272-276. [PMID: 33319625 DOI: 10.1080/02688697.2020.1862054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
STUDY DESIGN A retrospective study. OBJECTIVE The clinical efficacy of vertebroplasty and kyphoplasty treating osteoporotic vertebral compression fractures (OVCF) has been widely recognized in recent years. However, there are also disadvantages of bone cement leakage (BCL), limited correction of kyphosis and recovery of vertebral height. Nowadays, in view of these shortcomings, vesselplasty has been widely used in clinical practice. The objective of this study is to assess its clinical effect and application value for the treatment of OVCF with peripheral wall damage. METHODS 62 patients (70 vertebrae) treated for OVCF with peripheral wall damage using vesselplasty retrospectively reviewed. The data collection included operation time, volume of bone cement, relevant surgical complications, visual analog scale (VAS), Oswestry disability index (ODI), vertebral body height and kyphosis Cobb angle. RESULTS The volume of bone cement was 3-8 (5.3 ± 1.3) ml. There were 3 vertebrae of BCL (4.3%). VAS and ODI at different time points after operation were decreased compared with before operation (all p < 0.05). There were no statistical differences between VAS or ODI at different postoperative time points (p > 0.05). Vertebral body height and Cobb angle at different time points after operation were improved compared with before operation (all p < 0.05). There were no statistical differences between vertebral body height or Cobb angle at different postoperative time points (all p > 0.05). CONCLUSIONS Vesselplasty may reduce the risk of BCL and better control the dispersion of bone cement in the treatment of OVCF. It relieves pain, restores vertebral body height and corrects kyphosis, especially in OVCF with peripheral wall damage. Therefore, vesselplasty is safe and worthy of clinical application.
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Affiliation(s)
- Jiguang Chen
- Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China
| | - Chongqing Xu
- Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiangming Yu
- Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, PR China
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Ma B, Smith A. Outpatient minimally invasive spine surgeries during the COVID-19 pandemic - A retrospective analysis of 164 consecutive cases. World Neurosurg X 2023; 20:100229. [PMID: 37456692 PMCID: PMC10344935 DOI: 10.1016/j.wnsx.2023.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/10/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To share our surgical experiences of minimally invasive cervical and lumbar procedures for patients who suffered from non-fatal motor vehicle accidents (MVAs) in the ambulatory surgery centers (ASCs) during the coronavirus disease 2019 (COVID-19) pandemic. Methods Anterior cervical discectomy and fusion (ACDF), anterior lumbar interbody fusion (ALIF), minimally invasive laminotomy and discectomy (MILD), percutaneous endoscopic laser-assisted discectomy (PELD) and percutaneous kyphoplasty (PK) were performed on carefully selected patients. Results From January 2020 to December 2021, our group performed 164 cases on 153 patients involving 249 intervertebral disc (IVD) levels. Of these, 116 cases (70.73%) on 114 patients (74.51%) were cervical, 48 cases (29.27%) were lumbar (including 8 PK cases). Eight patients had both cervical and lumbar procedures in a single anesthetic session (SAS) and were discharged on the same day. One hundred and six ACDF cases (92.17%) were at the C4-C5 and C5-C6 levels, which comprised of 146 (76.04%) IVDs. Of the 40 non-PK lumbar cases, 38 (95.0%) were at L4 to S1 lumbar levels. Six of these cases (15.0%) involved 2 lumbar levels. In contrast, 6 out of 8 kyphoplasties (75.0%) involved lower thoracic/higher lumbar vertebral columns (T11 to L2) and 2 were at the lower lumbar L4 level. Conclusions We successfully and safely performed various cervical and lumbar spine surgeries in the ASCs amid COVID-19 pandemic and all patients achieved the same-day discharge (SDD). In the non-fatal MVAs, mid-lower cervical (C4 to C6) and lower lumbar (L4 to S1) IVDs were the most affected levels.
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Li Y, Qian Y, Shen G, Tang C, Zhong X, He S. Percutaneous mesh-container-plasty versus percutaneous kyphoplasty for the treatment of Kümmell's disease: a retrospective cohort study. J Orthop Surg Res 2023; 18:260. [PMID: 36998039 PMCID: PMC10061694 DOI: 10.1186/s13018-023-03753-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Both percutaneous kyphoplasty (PKP) and percutaneous mesh-container-plasty (PMCP) were important procedures for the treatment of Kümmell's disease. This study aimed to compare the clinical and radiological results of PKP and PMCP for the treatment of Kümmell's disease. METHODS This study included patients with Kümmell's disease treated at our center between January 2016 and December 2019. A total of 256 patients were divided into two groups according to the surgical treatment they received. Clinical, radiological, epidemiological, and surgical data were compared between the two groups. Cement leakage, height restoration, deformity correction, and distribution were evaluated. The visual analog scale (VAS), Oswestry Disability Index (ODI), and short-form 36 health survey domains "role-physical" (SF-36 rp) and "bodily pain" (SF-36 bp) were calculated preoperatively, immediately after surgery, and 1-year postoperatively. RESULTS The VAS and ODI scores improved in the PKP [preoperative: 6 (6-7), 68.75 ± 6.64; postoperative: 2 (2-3), 23.25 ± 3.50, respectively] (p < 0.05) and the PMCP [preoperative: 6 (5-7), 67.70 ± 6.50; postoperative: 2 (2-2), 22.24 ± 3.55, respectively] groups (p < 0.05). There were significant differences between the two groups. The mean cost in the PKP group was lower than that in the PMCP group (3697 ± 461 vs. 5255 ± 262 USD, p < 0.05). The cement distribution in the PMCP group was significantly higher than that in the PKP group (41.81 ± 8.82% vs. 33.65 ± 9.24%, p < 0.001). Cement leakage was lower in the PMCP group (23/134) than in the PKP group (35/122) (p < 0.05). The anterior vertebral body height ratio (AVBHr) and Cobb's angle improved in the PKP (preoperative: 70.85 ± 16.62% and 17.29 ± 9.78°; postoperative: 80.28 ± 13.02% and 13.05 ± 8.40°, respectively) and PMCP (preoperative: 70.96 ± 18.01% and 17.01 ± 10.53°; postoperative: 84.81 ± 12.96% and 10.76 ± 9.23°, respectively) groups (p < 0.05). There were significant differences in vertebral body height recovery and segmental kyphosis improvement between the two groups. CONCLUSIONS PMCP had advantages over PKP in terms of pain relief and functional recovery for the treatment of Kümmell's disease. Moreover, PMCP is more effective than PKP in preventing cement leakage, increasing cement distribution, and improving vertebral height and segmental kyphosis, despite its higher cost.
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Affiliation(s)
- Yimin Li
- Department of Orthopaedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Yunfan Qian
- Department of Orthopaedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Guangjie Shen
- Department of Orthopaedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Chengxuan Tang
- Department of Orthopaedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Xiqiang Zhong
- Department of Orthopaedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Shaoqi He
- Department of Orthopaedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China.
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Li Y, Qian Y, Shen G, Tang C, Zhong X, He S, He S. Percutaneous mesh-container-plasty versus percutaneous kyphoplasty in the treatment of malignant thoracolumbar compression fractures: a retrospective cohort study. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2022; 56:395-401. [PMID: 36567543 PMCID: PMC9885624 DOI: 10.5152/j.aott.2022.22094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to compare the clinical and radiological results of percutaneous mesh-container-plasty versus percutaneous kyphoplasty in the treatment of malignant thoracolumbar compression fractures. METHODS Patients with malignant thoracolumbar compression fractures treated in a single tertiary care center between January 2011 and December 2020 were retrospectively reviewed and included in the study. Ninety-four patients who were diagnosed by pathological biopsy were divided into 2 groups according to the type of surgical treatment: the percutaneous kyphoplasty group (50 patients: 24 male, 26 female; mean age=73.02 ± 7.79 years) and the percutaneous mesh-container-plasty group (44 patients: 21 male, 23 female; mean age=74.68 ± 7.88 years). The epidemiological data, surgical outcomes, and clinical and radiological features were compared between the 2 groups. Cement leakage, height restoration, deformity correction, and cement distribution were calculated from the radiographs. The visual analog scale, Oswestry disability index, Karnofsky performance scale scores, and short-form 36 health survey domains role physi cal and bodily pain were calculated preoperatively, immediately, and 1 year postoperatively. RESULTS The visual analog scale score improved from 5 (range=4-6) preoperatively to 2 (range=2-3) immediately postoperatively in the percutaneous kyphoplasty group and from 5 (range=4-6) preoperatively to 2 (range=2-2) immediately postoperatively in the percutane ous mesh-container-plasty group; there was a significant difference between the 2 groups (P=.018). Although Oswestry disability index, Karnofsky performance scale, short-form 36 health survey domains bodily pain and role physical significantly improved in both groups after surgery compared to the preoperative period, there was no significant difference between the 2 groups (P > .05). The mean cost in the percutaneous kyphoplasty group was lower than that in the percutaneous mesh-container-plasty group (5563 ± 439 vs. 6569 ± 344 thousand dollars, P < .05). There was no difference between the cement volume in the 2 groups, and cement distribution in the percutaneous mesh-container-plasty group was higher than that in the percutaneous kyphoplasty group (44.30% ± 10.25% vs. 32.54% ± 11.76%, P < .05). Cement leakage was found to be lesser in the percutaneous mesh-container-plasty group (7/44) than in the percutane ous kyphoplasty group (18/50, P < .05). There were no statistically significant differences in the recovery of vertebral body height and improvement of segmental kyphosis between the 2 groups (P > .05). CONCLUSION Percutaneous kyphoplasty and percutaneous mesh-container-plasty both have significant abilities in functional recovery, height restoration, and segment kyphosis improvement in treating malignant thoracolumbar compression fractures. Percutaneous mesh container-plasty may be better able to relieve pain, inhibit cement leakage, and improve cement distribution than percutaneous kypho plasty. However, percutaneous mesh-container-plasty requires a relatively longer procedure and is more expensive than percutaneous kyphoplasty. LEVEL OF EVIDENCE Level III, Therapeutic Study.
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Ran Q, Li T, Kuang ZP, Guo XH. Percutaneous transforaminal endoscopic decompression combined with percutaneous vertebroplasty in treatment of lumbar vertebral body metastases: A case report. World J Clin Cases 2022; 10:7944-7949. [PMID: 36158475 PMCID: PMC9372846 DOI: 10.12998/wjcc.v10.i22.7944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 05/19/2022] [Accepted: 06/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Percutaneous endoscopic lumbar discectomy (PTED) is a procedure that is commonly used to treat lumbar disc herniation and spinal stenosis. Despite its less invasiveness, this surgery is rarely used to treat spinal metastases. Percutaneous vertebroplasty (PVP) has been utilized to treat lumbar vertebral body metastases but it has not proven useful in treating sciatic patients.
CASE SUMMARY A 68-year-old woman presented with low back pain and radicular symptoms. She couldn't straighten her legs because of severe pain. Computed tomography (CT) showed a mass lesion in the lung and bone destruction in the L4 vertebrae. The biopsy of the lung lesion revealed adenocarcinoma and the biopsy for L4 vertebrae revealed metastatic adenocarcinoma. PTED paired with PVP was performed on the patient due to the patient's poor overall physical state and short survival time. Transcatheter arterial embolization of vertebral tumors was performed before surgical resection to reduce excessive blood loss during the operation. The incision was scaled up with the TESSY technology. The pain was obviously relieved following the operation and no serious complications occurred. Postoperative CT showed that the decompression around the nerve root was successful, polymethyl methacrylate filling was satisfactory and the tumor tissue around the nerve root was obviously removed. During the 1-year follow-up period, the patient was in a stable condition.
CONCLUSION PTED in combination with PVP is an effective and safe treatment for Lumbar single-level Spinal Column metastases with radicular symptoms. Because of the small sample size and short follow-up time, the long-term clinical efficacy of this method needs to be further confirmed.
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Affiliation(s)
- Qiang Ran
- Department of Orthopaedics, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400010, China,
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, Sichuan Province, China
| | - Tong Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, Sichuan Province, China
| | - Zhi-Ping Kuang
- Department of Orthopaedics, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
| | - Xiao-Hong Guo
- Department of Pharmacy, Chongqing Hospital of Traditional Chinese Medicine, Chongqing 400000, China
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Combined Application of Grid Body Surface Locator and Preemptive Analgesia in Daytime Vertebroplasty. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2651062. [PMID: 35924112 PMCID: PMC9343197 DOI: 10.1155/2022/2651062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
Objective To explore the clinical advantages of grid body surface locator combined with preemptive analgesia in the treatment of osteoporotic lumbar fractures in daytime vertebroplasty. Methods A retrospective study was conducted on 120 patients who underwent lumbar vertebroplasty in the Department of Orthopedics of General Hospital of Northern Theater Command from January 2017 to January 2020. According to the preoperative planning and analgesic mode of treatment, they were divided into the daily operation experimental group and the traditional mode control group. Prone positioning of a patient under anesthetic is safe of ensuring optimum surgical access for many procedures, providing that the risks are fully understood. The general baseline data, intraoperative fluoroscopy times and operation time, bone cement injection volume, bone cement permeability, VAS score before operation, 1 day, and 3 months after operation, and the recovery of anterior vertebral height before and after operation were analyzed. Results There was no statistically significant difference in the preoperative general data between the two groups. One day after operation, the VAS score of the experimental group was lower than that of the control group, but there was no difference after 3 months. The permeability of bone cement in the experimental group was lower than that in the control group, the height of anterior edge of injured vertebra was better than that in the control group, and the operation time was less than that in the control group. Conclusion The daytime operation experimental group can significantly alleviate postoperative pain, increase the amount of bone cement injection, and reduce the permeability of bone cement through preoperative planning of puncture path and key puncture points, combined with advanced labor pain, but there is no significant difference in long-term pain relief.
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Yang Y, Tian Q, Wang T, Lu Y, Li W, Wu C. Vessel-Plasty Using Bone-Filling Mesh Container for Treatment of Malignant Severe Compression Fractures in Cervical Vertebrae. J Pain Res 2022; 15:1173-1182. [PMID: 35478996 PMCID: PMC9037846 DOI: 10.2147/jpr.s360195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To evaluate the feasibility, safety, and efficacy of vessel-plasty using bone-filling mesh container (BFMC) for malignant severe compression fractures of cervical vertebra. Methods This study prospectively recruited fifteen consecutive patients (eight men, seven women; mean age, 57.4 years) with severe malignant compression fractures of cervical vertebrae for vessel-plasty. Procedure duration, incidence of cement leakage and other complications, pain relief and improvement of neck function were analyzed. Pain was assessed using a visual analog scale (VAS) and function by the neck disability index (NDI), with scores recorded before the procedure and at 3 days and 1, 3, 6 and 12 months after the procedure. Results A total of 16 vertebrae were treated. All vertebrae had destruction of bone in more than one place as well as broken bone walls. Mean procedure duration was 42.9±13.6 minutes. Bone cement leakage occurred in two vertebrae without any symptoms. No procedure-related complications occurred. Mean VAS and NDI declined from 7.1 ± 1.4 and 63.6 ± 16.3, respectively, before the procedure to 3.5 ± 1.1 and 37.4 ± 11.0, respectively, at three days after the procedure (P < 0.01). CT images at three months after the procedure confirmed that there were no cases of refractures at the treated or adjacent levels, recurrence of vertebral collapse and mobilization of bone cement block. Conclusion Vessel-plasty using BFMC appears to be effective and safe for malignant severe compression fractures in cervical vertebrae. It is effective in stabilizing vertebral body, relieving pain.
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Affiliation(s)
- Yue Yang
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China
| | - Qinghua Tian
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China
| | - Tao Wang
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China
| | - Yingying Lu
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China
| | - Wenbin Li
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China
| | - Chungen Wu
- Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China
- Correspondence: Chungen Wu; Wenbin Li, Department of Diagnostic and Interventional Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yi Shan Road, Shanghai, People’s Republic of China, Tel +8618930177559; +8618930177524, Email ;
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Kuo YR, Cheng TA, Chou PH, Liu YF, Chang CJ, Chuang CF, Su PF, Lin RM, Lin CL. Healing of Vertebral Compression Fractures in the Elderly after Percutaneous Vertebroplasty-An Analysis of New Bone Formation and Sagittal Alignment in a 3-Year Follow-Up. J Clin Med 2022; 11:jcm11030708. [PMID: 35160158 PMCID: PMC8836520 DOI: 10.3390/jcm11030708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Vertebral compression fractures, resulting in significant pain and disability, commonly occur in elderly osteoporotic patients. However, the current literature lacks long-term follow-up information related to image parameters and bone formation following vertebroplasty. PURPOSE To evaluate new bone formation after vertebroplasty and the long-term effect of vertebroplasty. METHODS A total of 157 patients with new osteoporotic compression fractures who underwent vertebroplasty were retrospectively analyzed. The image parameters, including wedge angles, compression ratios, global alignment, and new bone formation, were recorded before and after vertebroplasty up to three years postoperatively. RESULTS The wedge angle improved and was maintained for 12 months. The compression ratios also improved but gradually deteriorated during the follow-up period. New bone formation was found in 40% of the patients at 36 months, and the multivariate analysis showed that this might have been related to the correction of the anterior compression ratio. CONCLUSIONS Vertebroplasty significantly restored the wedge angles and compression ratios up to one year postoperatively, and new bone formation was noted on plain radiographs, which increased over time. Last, the restoration of vertebral parameters may contribute to new bone formation.
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Affiliation(s)
- Yuh-Ruey Kuo
- Department of Orthopedic Surgery, National Cheng Kung University Hospital, Tainan City 704, Taiwan; (Y.-R.K.); (T.-A.C.); (C.-J.C.)
| | - Ting-An Cheng
- Department of Orthopedic Surgery, National Cheng Kung University Hospital, Tainan City 704, Taiwan; (Y.-R.K.); (T.-A.C.); (C.-J.C.)
| | - Po-Hsin Chou
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
- Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Yuan-Fu Liu
- Department of Orthopedic Surgery, National Cheng Kung University Hospital Douliu Branch, Douliu City 640, Taiwan;
| | - Chao-Jui Chang
- Department of Orthopedic Surgery, National Cheng Kung University Hospital, Tainan City 704, Taiwan; (Y.-R.K.); (T.-A.C.); (C.-J.C.)
| | - Cheng-Feng Chuang
- Department of Statistics, National Cheng Kung University, Tainan City 701, Taiwan; (C.-F.C.); (P.-F.S.)
| | - Pei-Fang Su
- Department of Statistics, National Cheng Kung University, Tainan City 701, Taiwan; (C.-F.C.); (P.-F.S.)
| | - Ruey-Mo Lin
- Department of Orthopedic Surgery, An-Nan Hospital, China Medical University, Tainan City 709, Taiwan;
| | - Cheng-Li Lin
- Department of Orthopedic Surgery, National Cheng Kung University Hospital, Tainan City 704, Taiwan; (Y.-R.K.); (T.-A.C.); (C.-J.C.)
- Department of Orthopedics, College of Medicine, National Cheng Kung University, Tainan City 701, Taiwan
- Musculoskeletal Research Center, Innovation Headquarter, National Cheng Kung University, Tainan City 701, Taiwan
- Medical Device Innovation Center (MDIC), National Cheng Kung University, Tainan City 701, Taiwan
- Correspondence:
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Li Y, Qian Y, Shen G, Tang C, Zhong X, He S. Safety and efficacy studies of kyphoplasty, mesh-container-plasty, and pedicle screw fixation plus vertebroplasty for thoracolumbar osteoporotic vertebral burst fractures. J Orthop Surg Res 2021; 16:434. [PMID: 34229695 PMCID: PMC8258959 DOI: 10.1186/s13018-021-02591-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Percutaneous kyphoplasty (PKP), percutaneous mesh-container-plasty (PMCP), and pedicle screw fixation plus vertebroplasty (PSFV) were three methods for osteoporotic vertebral burst fractures (OVBF). The purpose of the current study was to evaluate the clinical safety and efficacy of PKP, PMCP, and PSFV for OVBFs. Methods This retrospective study included 338 consecutive patients with thoracolumbar OVBFs who underwent PKP (n = 111), PMCP (n = 109), or PSFV (n = 118) and compared their epidemiological data, surgical outcomes, and clinical and radiological features. Clinical evaluations of VAS and ODI and radiological evaluations of height restoration, deformity correction, cement leakage, and canal compromise were calculated preoperatively, postoperatively, and 2 years postoperatively. Results Cement leakage (31/111 vs. 13/109 and 16/118, P < 0.05) was significantly higher in group PKP than in groups PSFV and PMCP. VAS and ODI scores improved postoperatively from 7.04 ± 1.15 and 67.11 ± 13.49 to 2.27 ± 1.04 and 22.00 ± 11.20, respectively, in group PKP (P < 0.05); from 7.04 ± 1.29 and 67.26 ± 12.79 to 2.17 ± 0.98 and 21.01 ± 7.90, respectively, in group PMCP (P < 0.05); and from 7.10 ± 1.37 and 67.36 ± 13.11 to 3.19 ± 1.06 and 33.81 ± 8.81, respectively, in the PSFV group (P < 0.05). Moreover, postoperative VAS and ODI scores were significantly higher in group PSFV than in groups PKP and PMCP (P < 0.05). However, VAS scores were not significantly different in the three groups 2 years postoperatively (P > 0.05). Postoperative anterior (81.04 ± 10.18% and 87.51 ± 8.94% vs. 93.46 ± 6.42%, P < 0.05) and middle vertebral body height ratio (83.01 ± 10.16% and 87.79 ± 11.62% vs. 92.38 ± 6.00%, P < 0.05) were significantly higher in group PSFV than in groups PMCP and PKP. Postoperatively, Cobb angle (10.04 ± 4.26° and 8.16 ± 5.76° vs. 4.97 ± 4.60°, P < 0.05) and canal compromise (20.76 ± 6.32 and 19.85 ± 6.18 vs. 10.18 ± 6.99, P < 0.05) were significantly lower in group PSFV than in groups PMCP and PKP. Conclusion Despite relatively worse radiological results, PMCP is a safe and minimally invasive surgical method that can obtain better short-term clinical results than PKP and PSFV for OVBFs.
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Affiliation(s)
- Yimin Li
- Department of Orthopaedic Surgery, Third affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Yunfan Qian
- Department of Orthopaedic Surgery, Third affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Guangjie Shen
- Department of Orthopaedic Surgery, Third affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Chengxuan Tang
- Department of Orthopaedic Surgery, Third affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Xiqiang Zhong
- Department of Orthopaedic Surgery, Third affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China
| | - Shaoqi He
- Department of Orthopaedic Surgery, Third affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China.
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Tang C, Tang X, Zhang W, Dai M, Peng M, He S. Percutaneous mesh-container-plasty for osteoporotic thoracolumbar burst fractures: A prospective, nonrandomized comparative study. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2021; 55:22-27. [PMID: 33650506 DOI: 10.5152/j.aott.2021.20045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE This study aimed to compare the clinical and radiological results of percutaneous mesh-container-plasty (PMCP) versus percutaneous kyphoplasty (PKP) in the treatment of osteoporotic thoracolumbar burst fractures. METHODS A prospective study of 122 patients with osteoporotic thoracolumbar burst fractures was conducted. The patients were nonrandomly assigned to receive PKP (62; 16 men, 46 women) and PMCP (60; 14 men, 46 women). The epidemiological data, surgical outcomes, and clinical and radiological features were compared between the 2 groups. Cement leakage, height restoration, deformity correction, canal compromise, and cement distribution were calculated from the radiographs. Visual pain analog scale (VAS), the Oswestry disability index (ODI), and short-form 36 health survey domains role physical (SF-36 rp) and bodily pain (SF-36 bp) were calculated before surgery and immediately and 2 years after surgery. RESULTS Although VAS, ODI, SF-36 bp, and SF-36 rp scores improved from 7 (6-9), 71.28±16.38, 22 (0-32), and 25 (0-50) preoperatively to 2 (1-3), 20.02±8.97, 84 (84-84), and 75 (75-100) immediately postoperatively in the PMCP group (p<0.05) and from 7 (6-8), 71.40±13.52, 22 (10.5-31.75), and 25 (0-50) preoperatively to 2 (1-3), 21.78±11.21, 84 (84-84), and 75 (75-100) immediately postoperatively in the PKP group (p<0.05), there was no difference between the 2 groups. The mean cost in the PKP group was less than that in the PMCP group ($5109±231 vs. $6699±201, p<0.05). Anterior, middle, and posterior vertebral body height ratios in the PMCP group were greater than those in the PKP group postoperatively (88.44%±3.76% vs. 81.10%±11.78%, 86.15%±3.50% vs. 82.30%±11.02%, and 93.91%±3.01% vs. 91.43%±6.71%, respectively, p<0.05). The Cobb angle in the PMCP group was lower than that in the PKP group postoperatively (6.67°±4.39° vs. 8.99°±4.06°, p<0.05). Cement distribution in the PMCP group was higher than that in the PKP group (30.48%±5.62% vs. 27.18%±4.87%, p<0.05). Cement leakage was observed to be lesser in the PMCP group (2/60) than in the PKP group (10 vs. 62, p<0.05). CONCLUSION Both PKP and PMCP treatments seem to have significant ability in pain relief and functional recovery. Despite its higher cost, PMCP treatment may have a better inhibition ability of cement leakage, cement distribution, height restoration, and improvement in segmental kyphosis than PKP treatment for osteoporotic thoracolumbar burst fractures. LEVEL OF EVIDENCE Level II, Therapeutic Study.
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Affiliation(s)
- Chengxuan Tang
- Department of Orthopedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaojun Tang
- Department of Orthopedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weihao Zhang
- Department of Orthopedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Minghai Dai
- Department of Orthopedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Maoxiu Peng
- Department of Orthopedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shaoqi He
- Department of Orthopedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Zhang L, Wang B, Cao P, Zhang Q, Liu X, Li M. Combination therapy with percutaneous osteoplasty and transcatheter arterial chemoembolization for the treatment of pelvic bone metastases: preliminary report. Support Care Cancer 2020; 29:2529-2536. [PMID: 32945958 DOI: 10.1007/s00520-020-05783-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 09/14/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the clinical efficacies of percutaneous osteoplasty (POP) and combination therapy with percutaneous osteoplasty and transcatheter arterial chemoembolization (POPTACE) for the treatment of pelvic bone metastases. METHODS A retrospective study of 100 patients with pelvic bone metastases who had been treated by POP (n = 50) and POPTACE (n = 50) was conducted in this work. The clinical efficacies of these two treatments were evaluated by comparing their pain and functional abilities and bone metastases ability at the pre- and post-operative time points. RESULTS POPTACE and POP treatments had no significant differences (P > 0.05) in VAS scores and KPS scores. Concerning tumor response, a partial response in 37 of 50 (74%) patients at 1 month for the POPTACE group and a partial response in 26 of 50 (52%) patients at 1 month for the POPC group were observed (P = 0.04). Although POPTACE and POP treatments had significant and similar ability in pain relief and functional recovery ability for the treatment of pelvic bone metastases, POPTACE treatment had a significantly better tumor response ability (partial response and stable response) compared with POP treatment. CONCLUSION Both POP and POPTACE were effective methods for the treatment of pelvic bone metastases. Moreover, these initial outcomes suggest POPTACE treatment may be better than POP treatment. POPTACE treatment has great value and is worth promoting vigorously in orthopedics clinics.
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Affiliation(s)
- Lu Zhang
- Department of Orthopedic Surgery, The Peony People's Hospital of Heze City (The Central Hospital of Heze City), No. 2111, Kangzhuang Road, Heze, 274000, Shandong Province, People's Republic of China
| | - Benyun Wang
- Department of Obstetrics and Gynecology, The Peony People's Hospital of Heze City (The Central Hospital of Heze City), No. 2111, Kangzhuang Road, Heze, 274000, Shandong Province, People's Republic of China
| | - Pijian Cao
- Department of Orthopedic Surgery, The Peony People's Hospital of Heze City (The Central Hospital of Heze City), No. 2111, Kangzhuang Road, Heze, 274000, Shandong Province, People's Republic of China
| | - Qinglin Zhang
- Department of Orthopedic Surgery, The Peony People's Hospital of Heze City (The Central Hospital of Heze City), No. 2111, Kangzhuang Road, Heze, 274000, Shandong Province, People's Republic of China
| | - Xunwei Liu
- Department of Nuclear Medicine, 960 Hospital of PLA (The General Hospital of Jinan Command), No. 25, Shifan Road, Jinan, 250031, Shandong Province, People's Republic of China
| | - Min Li
- Department of Nuclear Medicine, 960 Hospital of PLA (The General Hospital of Jinan Command), No. 25, Shifan Road, Jinan, 250031, Shandong Province, People's Republic of China.
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Yin H, He X, Yi H, Luo Z, Chen J. Analysis of the Causes on Poor Clinical Efficacy of Kyphoplasty Performed in Unilateral Transpedicular Puncture for the Treatment of Senile Osteoporotic Vertebral Compression Fractures. Sci Rep 2019; 9:1498. [PMID: 30728397 PMCID: PMC6365570 DOI: 10.1038/s41598-018-37727-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/13/2018] [Indexed: 12/15/2022] Open
Abstract
This study intends to analyze the causes on poor clinical efficacy of kyphoplasty performed in unilateral transpedicular puncture for the treatment of senile osteoporotic vertebral compression fractures. A retrospective study was conducted on a consecutive series of 70 patients who had underwent kyphoplasty performed in unilateral transpedicular puncture for the treatment of senile osteoporotic vertebral compression fractures between March 2016 to March 2017. These patients were compared for clinical data to investigate the causes on poor clinical efficacy of kyphoplasty performed in unilateral transpedicular puncture for the treatment of senile osteoporotic vertebral compression fractures. Comparison result of the indices between these patients showed that the differences in body weight, fracture type and bone cement dispersion were statistically significant. Logistic multivariate regression analysis showed body weight (OR = 0.892, p = 0.042), fracture type 2 (OR = 0.089, p = 0.020) and bone cement dispersion (OR = 4.773, p = 0.025) are risk factors for poor clinical efficacy. The results of corresponding analysis on VAS (Visual Analogue Scale), vertebral height and Cobb angle in patients with poor clinical efficacy showed that there is a correlation between them. We believe that patients' weight, dispersion degree of bone cement and fracture type of injured vertebra are the risk factors of kyphoplasty with poor clinical efficacy.
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Affiliation(s)
- Hao Yin
- Department of Orthopaedic Surgery, Hunan Provincial People's Hospital, Changsha, People's Republic of China
| | - Xuejun He
- Department of Orthopaedic Surgery, Hunan Provincial People's Hospital, Changsha, People's Republic of China.
| | - Huijun Yi
- Department of Orthopaedic Surgery, Hunan Provincial People's Hospital, Changsha, People's Republic of China
| | - Zhiguo Luo
- Department of Orthopaedic Surgery, Hunan Provincial People's Hospital, Changsha, People's Republic of China
| | - Jianmin Chen
- Department of Orthopaedic Surgery, Hunan Provincial People's Hospital, Changsha, People's Republic of China
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Qin J, Li J, Liu Y, Zhao B, Dong H, Dong B, Zhang R, Ning N, Zhang X, Cui F, Li H, He X, Wang D. Clinical comparison between a percutaneous hydraulic pressure delivery system and balloon tamp system using high-viscosity cement for the treatment of osteoporotic vertebral compression fractures. Clinics (Sao Paulo) 2019; 74:e741. [PMID: 31166471 PMCID: PMC6530436 DOI: 10.6061/clinics/2019/e741] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 12/21/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Osteoporotic vertebral compression fractures (OVCFs) affect the elderly population, especially postmenopausal women. Percutaneous kyphoplasty is designed to treat painful vertebral compression fractures for which conservative therapy has been unsuccessful. High-viscosity cement can be injected by either a hydraulic pressure delivery system (HPDS) or a balloon tamp system (BTS). Therefore, the purpose of this study was to compare the safety and clinical outcomes of these two systems. METHODS A random, multicenter, prospective study was performed. Clinical and radiological assessments were carried out, including assessments of general surgery information, visual analog scale, quality of life, cement leakage, and height and angle restoration. RESULTS Using either the HPDS or BTS to inject high-viscosity cement effectively relieved pain and improved the patients' quality of life immediately, and these effects lasted at least two years. The HPDS using high-viscosity cement reduced cost, surgery time, and radiation exposure and showed similar clinical results to those of the BTS. In addition, the leakage rate and the incidence of adjacent vertebral fractures after the HPDS treatment were reduced compared with those after treatment using the classic vertebroplasty devices. However, the BTS had better height and angle restoration abilities. CONCLUSIONS The percutaneous HPDS with high-viscosity cement has similar clinical outcomes to those of traditional procedures in the treatment of vertebral fractures in the elderly. The HPDS with high-viscosity cement is better than the BTS in the treatment of mild and moderate OVCFs and could be an alternative method for the treatment of severe OVCFs.
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Affiliation(s)
- Jie Qin
- The Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
- Corresponding authors. E-mail: /
| | - Jianjun Li
- The Key Laboratory of Biomedical Information Engineering of the Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
- Corresponding authors. E-mail: /
| | - Ying Liu
- The Department of Education, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
| | - Bo Zhao
- The Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
| | - Hui Dong
- The Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
| | - Bo Dong
- The Department of Orthopedics, the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xi'an, Shaanxi Province, P. R. of China
| | - Rui Zhang
- The Department of Orthopedics, Tangdu Hospital, Xi'an, Shaanxi Province, P. R. of China
| | - Ning Ning
- Xi'an Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
| | - Xin Zhang
- Foreign Language School, Northwest University, Xi'an, Shaanxi Province, P. R. of China
| | - Feng Cui
- The Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
| | - Haopeng Li
- The Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
| | - Xijing He
- The Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
- Corresponding authors. E-mail: /
| | - Dong Wang
- The Department of Orthopedics, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P. R. of China
- Corresponding authors. E-mail: /
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Zhang P, Zhong ZH, Yu HT, Zhou W, Li J. Therapeutic effects of new-type hydraulic delivery vertebroplasty, balloon kyphoplasty and conventional pusher-type vertebroplasty on single segmental osteoporotic vertebral compression fracture. Exp Ther Med 2018; 16:3553-3561. [PMID: 30233708 PMCID: PMC6143827 DOI: 10.3892/etm.2018.6624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/31/2018] [Indexed: 12/28/2022] Open
Abstract
This study aims to evaluate safety and practicality in clinical application for better guidance of single segmental osteoporotic vertebral compression fractures treatment. From May 2012 to September 2013, a total of 188 cases of patients with fractures, who received different treatment, were incorporated in the study and then divided into: group A (n=59), conventional pusher-type vertebroplasty; group B (n=54), balloon kyphoplasty; group C (n=60), new-type hydraulic delivery vertebroplasty treatment. The overall follow-up rate was 92.02%. Postoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores were significantly improved more than those of the preoperative scores in the three groups. Bone cement injection volumes in group A were significantly lower than those in group B and group C. Vertebral height recovery rates among groups were obviously different, showing statistical significance. After a year of follow-up, the vertebral height recovery outcome in group A was obviously poorer than that in group B and group C. A poorer outcome in group B was also found when compared with group C. In addition, the vertebral height restoration had a certain degree of loss, with the loss rate of 20.5, 14.0 and 7.5% in the three groups, respectively. Three operation methods have equivalent effects in the improvement of symptoms and functional recovery. Therefore, the new-type hydraulic delivery vertebroplasty provides a relatively more concise operation and shorter operation time, displaying more outstanding performance of clinical efficacy in spinal reconstruction and reduction of complications risks by evaluating the diffusion of the bone cement, vertebral height restoration rate and postoperative complications.
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Affiliation(s)
- Ping Zhang
- Department of Orthopaedic, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Zhi-Hong Zhong
- Department of Orthopaedic, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Hao-Tao Yu
- Department of Orthopaedic, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Wei Zhou
- Department of Orthopaedic, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
| | - Jian Li
- Department of Orthopaedic, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
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Li D, Wu Y, Huang Y, Augustine B, Yue J. Risk factors of recompression of cemented vertebrae after kyphoplasty for osteoporotic vertebral compression fractures. INTERNATIONAL ORTHOPAEDICS 2016; 40:1285-90. [PMID: 27118375 DOI: 10.1007/s00264-016-3203-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/15/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE To evaluate the risk factors correlated with loss of cemented vertebral body height after kyphoplasty in patients with osteoporotic vertebral compression fractures. METHODS Thirty-four consecutive patients with single-level osteoporotic vertebral compression fractures who underwent kyphoplasty in the Affiliated Hospital of Jiangsu University between January 2012 and August 2014 were retrospectively analysed. Eight independent variables (age, gender, body mass index, pre-operative T-score in bone mineral density, the volume of polymethylmethacrylate injected, pre-operatively vertebral body height, the restoration of body height and the distance between polymethylmethacrylate and endplate) were assessed. The recompression of body height was the dependent variable. Multivariate linear regression analyses were used to determine the factors associated with recompression of body height. RESULTS Multiple linear regression analyses indicated that the recompression of cemented vertebral body height was correlated with the distance between polymethylmethacrylate and endplate (P = 0.008, b' = 0.489). The final multiple linear regression model, which included only the distance between polymethylmethacrylate and endplate, resulted in a formula that accounted for 41.02 % of the recompression of body height. CONCLUSIONS The distance between polymethylmethacrylate and endplate is an important risk factor of recompression of cemented vertebrae after kyphoplasty for patients with osteoporotic vertebral compression fractures.
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Affiliation(s)
- Dapeng Li
- Department of Orthopaedics, Affiliated Hospital of Jiangsu University, No. 438 Jiefang Road, Zhenjiang City, 212001, Jiangsu Province, China.
| | - Yan Wu
- Department of Orthopaedics, Affiliated Hospital of Jiangsu University, No. 438 Jiefang Road, Zhenjiang City, 212001, Jiangsu Province, China
| | - Yonghui Huang
- Department of Orthopaedics, Affiliated Hospital of Jiangsu University, No. 438 Jiefang Road, Zhenjiang City, 212001, Jiangsu Province, China
| | - Balaara Augustine
- Department of Radiology, Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, Jiangsu, China
| | - Jiawei Yue
- Department of Orthopaedics, Affiliated Hospital of Jiangsu University, No. 438 Jiefang Road, Zhenjiang City, 212001, Jiangsu Province, China
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