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Sun K, Liu J, Zhu H, Wang J, Wan H, Huang B, Zhang Q, Chen G. Lower psoas mass indicates worse prognosis in percutaneous vertebroplasty-treated osteoporotic vertebral compression fracture. Sci Rep 2024; 14:13880. [PMID: 38880790 PMCID: PMC11180649 DOI: 10.1038/s41598-024-64626-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/11/2024] [Indexed: 06/18/2024] Open
Abstract
The correlation between lower psoas mass and the prognosis of osteoporotic vertebral compression fractures (OVCF) is still unclear. This study aims to investigate the impact of lower psoas mass on the prognosis of patients undergoing percutaneous vertebroplasty (PVP). One hundred and sixty-three elderly patients who underwent single-segment PVP from January 2018 to December 2021 were included. The psoas to L4 vertebral index (PLVI) via MRI were measured to assess psoas mass. Patients were divided into high PLVI (> 0.79) and low PLVI (≤ 0.79) groups based on the median PLVI in the cohort. The basic information (age, gender, body mass index (BMI) and bone mineral density (BMD)), surgical intervention-related elements (duration of operation, latency to ambulation, period of hospital stay, and surgical site), postoperative clinical outcomes (Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) scores, Japanese Orthopaedic Association (JOA) scores), and incidence of secondary fractures) were compared. Patients showed no statistically significant differences in terms of age, gender, surgical sute, BMI, BMD and preoperative VAS, ODI, JOA scores (P > 0.05) between the two groups. However, there were significant differences in terms of latency to ambulation, period of hospital stay (P < 0.05). VAS, ODI, and JOA scores at 1, 6, and 12 months after surgery showed that the high PLVI group had significantly better outcomes than the low PLVI group (P < 0.05). Additionally, the low PLVI group had a significantly higher incidence of recurrent fracture (P < 0.05). Lower psoas mass can reduce the clinical effect of PVP in patients with osteoporotic vertebral compression fractures, and is a risk factor for recurrent vertebral fracture.
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Affiliation(s)
- Kai Sun
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China
- Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Jinan University (Heyuan Shenhe People's Hospital), Heyuan, 517000, China
| | - Jianjun Liu
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China
| | - Haoran Zhu
- Department of Orthopedic Surgery, The Fifth Affiliated Hospital of Jinan University (Heyuan Shenhe People's Hospital), Heyuan, 517000, China
| | - Jiajia Wang
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China
| | - Haiwu Wan
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China
| | - Bo Huang
- Department of Orthopedic Surgery, Jiujiang University Affiliated Hospital, Jiujiang, 332006, China.
| | - Qinglin Zhang
- Department of Orthopedic Surgery, Dongguan Qiaotou Hospital, Dongguan, 523539, China.
| | - Guoliang Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, 510632, China.
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Xu Y, Huang S, Li Z, Dai L, Wu H, Wang P, Yao X, Luo W, Liu Y, Yang W, Feng Y, Miao H, Xu J, Ye D. Single-cell RNA landscape of osteoimmune microenvironment in osteoporotic vertebral compression fracture and Kümmell's disease. Front Cell Dev Biol 2023; 11:1276098. [PMID: 38161331 PMCID: PMC10755405 DOI: 10.3389/fcell.2023.1276098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Background: Single-cell RNA sequencing (scRNA-seq) enables specific analysis of cell populations at single-cell resolution; however, there is still a lack of single-cell-level studies to characterize the dynamic and complex interactions between osteoporotic vertebral compression fractures (OVCFs) and Kümmell's disease (KD) in the osteoimmune microenvironment. In this study, we used scRNA-seq analysis to investigate the osteoimmune microenvironment and cellular composition in OVCFs and KD. Methods: ScRNA-seq was used to perform analysis of fractured vertebral bone tissues from one OVCF and one KD patients, and a total of 8,741 single cells were captured for single-cell transcriptomic analysis. The cellularity of human vertebral bone tissue was further analyzed using uniform manifold approximation and projection. Pseudo-time analysis and gene enrichment analysis revealed the biological function of cell fate and its counterparts. CellphoneDB was used to identify the interactions between bone cells and immune cells in the osteoimmune microenvironment of human vertebral bone tissue and their potential functions. Results: A cellular profile of the osteoimmune microenvironment of human vertebral bone tissue was established, including mesenchymal stem cells (MSCs), pericytes, myofibroblasts, fibroblasts, chondrocytes, endothelial cells (ECs), granulocytes, monocytes, T cells, B cells, plasma cells, mast cells, and early erythrocytes. MSCs play an immunoregulatory function and mediate osteogenic differentiation and cell proliferation. The differentiation trajectory of osteoclasts in human vertebral bone tissue was also revealed. In addition, ECs actively participate in inflammatory infiltration and coupling with bone cells. T and B cells actively participate in regulating bone homeostasis. Finally, by identifying the interaction of ligand-receptor pairs, we found that immune cells and osteoclasts have bidirectional regulatory characteristics, have the effects of regulating bone resorption by osteoclasts and promoting bone formation, and are essential for bone homeostasis. It is also highlighted that CD8-TEM cells and osteoclasts might crosstalk via CD160-TNFRSF14 ligand-receptor interaction. Conclusion: Our analysis reveals a differential landscape of molecular pathways, population composition, and cell-cell interactions during OVCF development into KD. OVCFs exhibit a higher osteogenic differentiation capacity, owing to abundant immune cells. Conversely, KD results in greater bone resorption than bone formation due to depletion of MSCs and a relatively suppressed immune system, and this immune imbalance eventually leads to vertebral avascular necrosis. The site of action between immune cells and osteoclasts is expected to be a new therapeutic target, and these results may accelerate mechanistic and functional studies of osteoimmune cell types and specific gene action in vertebral avascular necrosis and pathological bone loss diseases, paving the way for drug discovery.
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Affiliation(s)
- Yude Xu
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Suixiang Huang
- Department of Pain Medicine, Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Zhencong Li
- Department of Spinal Degeneration and Deformity Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Libing Dai
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Hao Wu
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Peigeng Wang
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Xiguan Yao
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Wei Luo
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Yiming Liu
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Weichao Yang
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Yi Feng
- The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China
| | - Haixiong Miao
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Dongping Ye
- Guangzhou Red Cross Hospital, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China
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An Y, Li L, Lin X, Zhang Z, Zheng Z, Wang C. Risk assessment for sandwich vertebral fractures in the treatment of osteoporosis vertebral compression fractures using two methods of bone cement reinforcement. J Orthop Surg Res 2023; 18:524. [PMID: 37481567 PMCID: PMC10363326 DOI: 10.1186/s13018-023-04006-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/13/2023] [Indexed: 07/24/2023] Open
Abstract
PURPOSE Bone cement augmentation surgery includes percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). In this study, we aimed to investigate the risk of sandwich vertebral fractures in the treatment of osteoporotic vertebral compression fractures via PVP and PKP. METHODS We performed a retrospective analytical study and included 61 patients with osteoporotic vertebral compression fractures who underwent PVP and PKP at the Spinal Surgery Department of The Second Hospital of Liaocheng Affiliated with Shandong First Medical University from January 2019 to January 2022. These patients were divided into the following two groups by simple random sampling: group A (N = 30) underwent PVP treatment and group B (N = 31) underwent PKP treatment. The surgical time, fluoroscopy frequency, visual analog scale (VAS) score, amount of bone cement, the leakage rate of bone cement in intervertebral space, Cobb angle, and the incidence of fractures in both groups of sandwich vertebral were recorded after 1 year of follow-up. RESULTS No statistically significant difference was found in terms of surgical time, fluoroscopy frequency, and VAS score between the two groups (P > 0.05). However, a statistically significant difference was found in terms of the amount of bone cement, the leakage rate of bone cement intervertebral space, Cobb angle, and the incidence of vertebral body fractures in both groups (P < 0.05). The amount of bone cement, the leakage rate of bone cement in intervertebral space, Cobb angle, and sandwich vertebral fractures were higher in Group A than in Group B. CONCLUSIONS When PVP and PKP were performed to treat osteoporotic vertebral compression fractures, the sandwich vertebral exhibited a risk of fracture. PVP exhibited a greater relative risk than PKP, which may be due to the relatively larger amount of bone cement, higher rate of bone cement leakage in the intervertebral space, and larger Cobb angle.
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Affiliation(s)
- Youzhi An
- Spine Surgery, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, No. 306, Jiankang Street, Linqing City, Shandong, China.
| | - Lili Li
- Medical Oncology, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, No. 306, Jiankang Street, Linqing City, Shandong, China
| | - Xuelin Lin
- Spine Surgery, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, No. 306, Jiankang Street, Linqing City, Shandong, China
| | - Zhen Zhang
- Spine Surgery, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, No. 306, Jiankang Street, Linqing City, Shandong, China
| | - Zhaoyun Zheng
- Spine Surgery, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, No. 306, Jiankang Street, Linqing City, Shandong, China
| | - Chengjiang Wang
- Spine Surgery, The Second Hospital of Liaocheng Affiliated to Shandong First Medical University, No. 306, Jiankang Street, Linqing City, Shandong, China
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Ge C, Chen Z, Cao P. Efficacy of percutaneous kyphoplasty on vertebral compression fractures with different bone mineral densities: a retrospective study. BMC Musculoskelet Disord 2023; 24:276. [PMID: 37038169 PMCID: PMC10088266 DOI: 10.1186/s12891-023-06341-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/20/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND This study was performed to investigate the clinical efficacy of percutaneous kyphoplasty (PKP) for vertebral compression fractures with different bone mineral densities (BMD). METHODS We performed a retrospective analysis of 232 patients with single-segment vertebral compression fractures who underwent PKP. Patients were divided into the normal BMD, osteopenia, and osteoporosis groups according to their average lumbar BMD before surgery. The visual analog scale (VAS) was used to compare differences in pain relief before and after surgery in each group. Corrections of the wedge angle and kyphotic angle before and after surgery were observed using anteroposterior and lateral radiographs and compared among the groups, as was the incidence of bone cement leakage. RESULTS Patients were followed up for 6-12 months, with an average follow-up time of 9.12 ± 1.68 months. The VAS score, wedge angle, and kyphotic angle of the three groups of patients decreased significantly at the end of the follow-up (P < 0.05). The changes in VAS score and wedge angle correction in the osteoporosis group were significantly larger than those in the normal BMD and osteopenia groups (P < 0.05). There were no significant differences among the three groups in terms of kyphotic angle correction or bone cement leakage rates (P > 0.05). CONCLUSIONS PKP has a positive effect on vertebral compression fractures with different BMD, and is especially suitable for osteoporotic vertebral compression fractures.
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Affiliation(s)
- Chen Ge
- Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 999, Xiwang road, Jiading district, Shanghai, 201801, China.
| | - Zhe Chen
- Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 999, Xiwang road, Jiading district, Shanghai, 201801, China
| | - Peng Cao
- Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 999, Xiwang road, Jiading district, Shanghai, 201801, China
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Zhang T, Deng Y. A design of a targeted puncture trajectory applied to unilateral extrapedicular percutaneous vertebroplasty. BMC Musculoskelet Disord 2023; 24:268. [PMID: 37020264 PMCID: PMC10074873 DOI: 10.1186/s12891-023-06387-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVE In this study, we introduced a design of a targeted puncture trajectory applied to unilateral extrapedicular percutaneous vertebroplasty. METHODS 62 individuals with osteoporotic vertebral compression fractures (OVCF) were included in this research at the Tongling People's Hospital, from January 2019 to December 2020. Percutaneous Vertebroplasty (PVP) was performed on all patients using a targeted unilateral extrapedicular puncture technique guided by G-arm fluoroscopy. The operating time, volume and dispersion of bone cement, and cement leak were all evaluated. The oswestry disability index(ODI) and the visual analog scale (VAS) were used to assess pain relief and quality of life (QOL). RESULTS The targeted puncture trajectory for unilateral extrapedicular PVP was used to successfully treat a total of 62 fractured vertebrae without any apparent clinical issues. In comparison to their equivalent preoperative values, the VAS and ODI values after surgery were considerably lower (P < 0.01). The bone cement not only could be across the midline of the targeted vertebrae but also appeared in both the bilateral pedicle and the center projection region on the anteroposterior X-ray film, according to radiologic results in all injured vertebrae. There were 3 cases of leakage at the anterior border of the vertebral body and 2 cases of leakage into the intervertebral region without significant clinical manifestations. Furthermore, no bone cement leaked into the vessels or spinal canal. CONCLUSION The design of the targeted puncture trajectory used in unilateral extrapedicular PVP not only ensures that the bone cement injector transcends the midline of the vertebral body, but it also improves the accuracy of the injector arriving at the contralateral pedicle projection area. As a result, this approach can increase well-distributed bone cement diffusion while preventing cement leakage into the spinal canal.
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Affiliation(s)
- Tao Zhang
- Department of Spine Surgery, Tongling People's Hospital, Tongling, 244000, Anhui, China
| | - Yinghu Deng
- Department of Spine Surgery, Tongling People's Hospital, Tongling, 244000, Anhui, China.
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Li Y, Tian J, Ge M, Ji L, Kang Y, Xia C, Zhang J, Huang Y, Feng F, Zhao T, Shao H. A Worldwide Bibliometric Analysis of Published Literature on Osteoporosis Vertebral Compression Fracture. J Pain Res 2022; 15:2373-2392. [PMID: 36003290 PMCID: PMC9395216 DOI: 10.2147/jpr.s375119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/05/2022] [Indexed: 01/02/2023] Open
Abstract
Background With the aging population growth in the world, the prevalence of osteoporotic vertebral compression fracture (OVCF) is rapidly increasing and receiving widespread attention. Although there are numerous articles on the topic, the research status and hotspot analysis are unclear. Objective The goal of this study is to identify trends in the OVCF field and to analyze the most highly cited original articles published in the Web of Science Index on OVCF using bibliometric analysis. Methods All OVCF data were obtained from the Web of Science Core Collection, and the number of citations, institutions, journals, countries, and years of publication in this field were visually analyzed using VOSviewer, the bibliometrics online analysis platform, and Excel software. Simultaneously, the top 100 most cited articles were extracted and analyzed. Results A total of 756 publications were related to OVCF were included from 1900 to 2022. In recent years, the number of articles on OVCF significantly increased. They are mainly from 41 countries/regions and 202 journals, led by China and the United States. Among all countries, China had the most significant contribution on OVCF (n = 363), and it also was cited most often (n = 3337). The institution with the most articles was Soochow University (n = 40). Osteoporosis International was the journal with most studies and has published 50 on this field. The journal of Spine was cited most often (n = 1968). The most productive periods were from 2016 to 2020, which received 294 articles and 4868 citations. After the analysis, the “vertebroplasty” and “kyphoplasty” of OVCF have been the most common research hotspots. Conclusion This study represents an updated bibliometric analysis of OVCF. The aim is to identify current research hotspots and future trends to guide clinicians and researchers in this field.
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Affiliation(s)
- Yanlei Li
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China.,Bengbu Medical College, Bengbu, People's Republic of China
| | - Jinlong Tian
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China.,Bengbu Medical College, Bengbu, People's Republic of China
| | - Meng Ge
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China.,Bengbu Medical College, Bengbu, People's Republic of China
| | - Lichen Ji
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China.,Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yao Kang
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China
| | - Chen Xia
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China
| | - Jun Zhang
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China.,Bengbu Medical College, Bengbu, People's Republic of China
| | - Yazeng Huang
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China.,Bengbu Medical College, Bengbu, People's Republic of China
| | - Fabo Feng
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China
| | - Tingxiao Zhao
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China.,Bengbu Medical College, Bengbu, People's Republic of China
| | - Haiyu Shao
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, People's Republic of China
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Wang Q, Sun C, Zhang L, Wang L, Ji Q, Min N, Yin Z. High- versus low-viscosity cement vertebroplasty and kyphoplasty for osteoporotic vertebral compression fracture: a meta-analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:1122-1130. [PMID: 35249143 DOI: 10.1007/s00586-022-07150-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND To compare high- versus low-viscosity bone cement on the clinical outcomes and complications in patients with Osteoporotic vertebral compression fractures (OVCFs) who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). METHODS PubMed, Embase, and the Cochrane Library were searched for papers published from inception up to February 2021 for potentially eligible studies comparing high- versus low-viscosity cement for PVP/PKP. The outcomes were the leakage rate, visual analog scale (VAS), and Oswestry Disability Index (ODI). RESULTS Eight studies (558 patients; 279 in each group) were included. The meta-analysis showed that the leakage rate was lower with high-viscosity cement than with low-viscosity cement (OR = 0.23, 95%CI 0.14-0.39, P < 0.001; I2 = 43.5%, Pheterogeneity = 0.088); similar results were observed specifically for the disk space, paravertebral space, and peripheral vein, but there were no differences regarding the epidural space and intraspinal space. The VAS was decreased more significantly with high-viscosity cement than with low-viscosity cement (WMD = - 0.21, 95%CI - 0.38, - 0.04, P = 0.015; I2 = 0.0%, Pheterogeneity = 0.565). Regarding the ODI, there was no difference between high- and low-viscosity cement (WMD = - 0.88, 95%CI - 3.06, 1.29, P = 0.426; I2 = 78.3%, Pheterogeneity < 0.001). CONCLUSIONS There were lower cement leakage rates in PVP/PKP with high-viscosity bone cement than low-viscosity bone cement. The two groups have similar results in ODI, but the VAS scores favor high-viscosity bone cement. Therefore, the administration of high-viscosity bone cement in PVP/ PKP could be a potential option for improving the complications of leakage in OVCFs, while the clinical efficacy of relieving pain is not certain.
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Affiliation(s)
- Qiang Wang
- Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China.
| | - Changtai Sun
- Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China
| | - Liang Zhang
- Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China
| | - Lin Wang
- Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China
| | - Quan Ji
- Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China
| | - Nan Min
- Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China
| | - Zilong Yin
- Department of Orthopaedics, Orthopaedics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dongdan DaHua Road, Beijing, 100730, China
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8
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Li Q, Long X, Wang Y, Guan T, Fang X, Guo D, Lv J, Hu X, Jiang X, Cai L. Clinical observation of two bone cement distribution modes after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. BMC Musculoskelet Disord 2021; 22:577. [PMID: 34167517 PMCID: PMC8223328 DOI: 10.1186/s12891-021-04480-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/14/2021] [Indexed: 02/08/2023] Open
Abstract
Background Current findings suggest that percutaneous vertebroplasty(PVP) is a suitable therapeutic approach for osteoporotic vertebral compression fractures (OVCFs). The present retrospective study aimed to investigate the differences in clinical efficacy and related complications between the two bone cement distribution modes. Methods We retrospectively reviewed the medical records of the patients with single-segment OVCFs who underwent bilateral percutaneous vertebroplasty. Patients were divided into blocky and spongy group according to the type of postoperative bone cement distribution. Clinical efficacy and related complications was compared between the two bone cement distribution modes on 24 h after the operation and last follow-up. Results A total of 329 patients with an average follow up time of 17.54 months were included. The blocky group included 131 patients, 109 females(83.2 %) and 22 males(16.8 %) with a median age of 72.69 ± 7.76 years, while the Spongy group was made up of 198 patients, 38 females(19.2 %) and 160 males(80.8 %) with a median age of 71.11 ± 7.36 years. The VAS and ODI after operation improved significantly in both two groups. The VAS and ODI in the spongy group was significantly lower than that in the blocky group, 24 h postoperatively, and at the last follow-up. There were 42 cases (12.8 %) of adjacent vertebral fractures, 26 cases (19.8 %) in the blocky group and 16 cases (8.1 %) in the spongy group. There were 57 cases (17.3 %) of bone cement leakage, 18 cases (13.7 %) in blocky group and 39 cases (19.7 %) in the spongy group. At 24 h postoperatively and at the last follow-up, local kyphosis and anterior vertebral height were significantly corrected in both groups, but gradually decreased over time, and the degree of correction was significantly higher in the spongy group than in the block group. The change of local kyphosis and loss of vertebral body height were also less severe in the spongy group at the last follow-up. Conclusions Compared with blocky group, spongy group can better maintain the height of the vertebral body, correct local kyphosis, reduce the risk of the vertebral body recompression, long-term pain and restore functions.
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Affiliation(s)
- Qiujiang Li
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China.,Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Xingxia Long
- West China Hospital, Sichuan University, Sichuan, China
| | - Yinbin Wang
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Tao Guan
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Xiaomin Fang
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Donggeng Guo
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China.,Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Jinhan Lv
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China.,Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Xuehua Hu
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Xiaocheng Jiang
- Graduate School of Ningxia Medical University, Yinchuan, Ningxia, China.,Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China
| | - Lijun Cai
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Lijun Cai, No. 56, Zhengyuan Street, Ningxia, 750002, Yinchuan, China.
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Unilateral percutaneous vertebroplasty for osteoporotic lumbar compression fractures: a comparative study between transverse process root-pedicle approach and conventional transpedicular approach. J Orthop Surg Res 2021; 16:73. [PMID: 33478545 PMCID: PMC7818944 DOI: 10.1186/s13018-021-02219-6] [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: 10/30/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose Percutaneous vertebroplasty (PVP) is a routine operation for the treatment of osteoporotic lumbar compression fractures (OLCFs). As is well known, unilateral puncture is a common method. However, with the conventional transpedicular approach (CTPA), the cement may be asymmetrically dispersed, so some surgeons use the transverse process root-pedicle approach (TPRPA). The objective of this study was to compare the clinical results and bone cement distribution of PVP for OLCF with unilateral TPRPA and CTPA to identify the advantages and disadvantages of the two surgical options. Patients and methods From January 2016 to June 2019, seventy-two elderly patients who underwent unilateral PVP for single-level OLCF were retrospectively reviewed. Operation time, injection amount and type of bone cement distribution, and bone cement leakage and surgical complications were recorded. The visual analog scale (VAS) scores and Oswestry disability index (ODI) scores were used to evaluate the clinical results. All patients were followed up for more than 12 months, and the assessment was based primarily on clinical and radiological outcomes. Results There were significant differences in the surgical time and the volume and the type of bone cement distribution and the lost of operative vertebra height between the two groups. However, there was no significant difference in bone cement leakage. Moreover, there were no significant differences in VAS and ODI between the two groups at 2 days and 12 months after the operation. Conclusions Unilateral TPRPA and CTPA are practical and feasible methods in PVP for the treatment of OLCF, and they have similar clinical effects. However, TPRPA has the advantages of a better distribution of bone cement and a shorter operation time and a better maintenance effect of injured vertebra height, without increasing the rate of bone cement leakage.
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Advances in Vertebral Augmentation Systems for Osteoporotic Vertebral Compression Fractures. Pain Res Manag 2020; 2020:3947368. [PMID: 33376566 PMCID: PMC7738798 DOI: 10.1155/2020/3947368] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/15/2020] [Accepted: 11/24/2020] [Indexed: 12/15/2022]
Abstract
Osteoporotic vertebral compression fracture (OVCF) is a common cause of pain and disability and is steadily increasing due to the growth of the elderly population. To date, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are almost universally accepted as appropriate vertebral augmentation procedures for OVCFs. There are many advantages of vertebral augmentation, such as short surgical time, performance under local anaesthesia, and rapid pain relief. However, there are certain issues regarding the utilization of these vertebral augmentations, such as loss of vertebral height, cement leakage, and adjacent vertebral refracture. Hence, the treatment for OVCF has changed in recent years. Satisfactory clinical results have been obtained worldwide after application of the OsseoFix System, the SpineJack System, radiofrequency kyphoplasty of the vertebral body, and the Kiva VCF treatment system. The following review discusses the development of the current techniques used for vertebral augmentation.
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Li Y, Cui W, Zhou P, Li C, Wen Y, Xiao W. Comparison of a flexible versus rigid bone cement injection system in unilateral percutaneous vertebroplasty. Eur J Med Res 2020; 25:36. [PMID: 32843077 PMCID: PMC7449043 DOI: 10.1186/s40001-020-00436-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/17/2020] [Indexed: 01/23/2023] Open
Abstract
Background Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector. Methods We undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture percutaneous vertebroplasty from our institution from June 2013 to July 2015. Operation time, radiation exposure, bone cement injection amount, and the incidence of bone cement leakage were recorded on presentation, the cement leakage was measured by X-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes. Results There was no significant difference in the operation time, radiation exposure time and incidence of bone cement leakage between the two groups. There was significant difference in the amount of bone cement injection and the difference between the two groups. There were no significant differences in VAS and the relative height of the vertebral body and local Cobb angle and QUALEFFO between the two groups at 1 week after PVP, significant difference was observed only 12 months after operation. Conclusions Application of flexible cement injector is safe and feasible, compared with the application of straight bone cement injector, without prolonging the operative time, radiation exposure time and the incidence of bone cement leakage; it has the advantages of good long-term effect and low incidence of vertebral fracture recurrence.
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Affiliation(s)
- Yuwei Li
- Department of Spinal Surgery, Luohe Central Hospital, Luohe Medical College, 56# Renmin Ave, Luohe, 462000, People's Republic of China.
| | - Wei Cui
- Department of Spinal Surgery, Luohe Central Hospital, Luohe Medical College, 56# Renmin Ave, Luohe, 462000, People's Republic of China.
| | - Peng Zhou
- Department of Spinal Surgery, Luohe Central Hospital, Luohe Medical College, 56# Renmin Ave, Luohe, 462000, People's Republic of China
| | - Cheng Li
- Department of Spinal Surgery, Luohe Central Hospital, Luohe Medical College, 56# Renmin Ave, Luohe, 462000, People's Republic of China
| | - Yan Wen
- Department of Spinal Surgery, Luohe Central Hospital, Luohe Medical College, 56# Renmin Ave, Luohe, 462000, People's Republic of China
| | - Wei Xiao
- Department of Spinal Surgery, Luohe Central Hospital, Luohe Medical College, 56# Renmin Ave, Luohe, 462000, People's Republic of China
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Tan L, Wen B, Guo Z, Chen Z. The effect of bone cement distribution on the outcome of percutaneous Vertebroplasty: a case cohort study. BMC Musculoskelet Disord 2020; 21:541. [PMID: 32791975 PMCID: PMC7427078 DOI: 10.1186/s12891-020-03568-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/04/2020] [Indexed: 01/11/2023] Open
Abstract
Background To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods One hundred thirty seven patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 h post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results 24 h post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6–24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. Analysis in subgroup B revealed no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.
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Affiliation(s)
- Lei Tan
- Department of Orthopaedics, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhong Guancun, Changping District, Beijing, 102206, China
| | - Bingtao Wen
- Department of Orthopaedics, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhong Guancun, Changping District, Beijing, 102206, China.
| | - Zhaoqing Guo
- Department of Orthopaedics, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhong Guancun, Changping District, Beijing, 102206, China.,Department of Orthopaedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Zhongqiang Chen
- Department of Orthopaedics, Peking University International Hospital, Life Park Road No.1 Life Science Park of Zhong Guancun, Changping District, Beijing, 102206, China.,Department of Orthopaedics, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
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Xu J, Lin J, Li J, Yang Y, Fei Q. "Targeted Percutaneous Vertebroplasty" Versus Traditional Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fracture. Surg Innov 2019; 26:551-559. [PMID: 31167616 DOI: 10.1177/1553350619853134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. In this randomized, nonblinded, controlled study, the feasibility and precision of "targeted percutaneous vertebroplasty" ("targeted PVP") for osteoporotic vertebral compression fracture (OVCF) was evaluated. Methods. A total of 42 patients, aged 50 to 87 years, with OVCF were randomly divided into 2 groups: A and B. Group A underwent "targeted PVP," and group B underwent traditional PVP with the guidance of C-arm fluoroscopy. Fluoroscopy times for skin puncture points (FTSPP), total radiation doses (TRD), total fluoroscopy times (TFT), and operation time were set as the main evaluation indicators. Results. FTSPP (1.52 ± 0.51 in group A vs 6.62 ± 2.58 in group B, U < .001), TRD (6.26 ± 1.51 in group A vs 11.32 ± 4.21 in group B, P < .001), TFT (16.57 ± 2.79 in group A vs 26.05 ± 6.18 in group B, P < .001), and operation time (20.05 ± 3.38 in group A vs 25.43 ±5.11 in group B, U < .001) were statistically different in the 2 groups. The incidence of cement leakage that occurred in group A (1/21, 4.76%) was significantly less than that in group B (9/21, 42.9%, P < 0.05). Conclusions. "Targeted PVP" may achieve (1) less skin positioning fluoroscopy times, less total fluoroscopy times and dose, shorter operation time, which is more precise than traditional PVP; (2) less incidence of cement leakage; and (3) visualization of the fractured vertebra, which is probably more valuable for the treatment of complicated OVCF patients.
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Affiliation(s)
- JunChuan Xu
- 1 Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - JiSheng Lin
- 1 Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jian Li
- 1 Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yong Yang
- 1 Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qi Fei
- 1 Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
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