scholarly journals Impact of Multifidus Muscle Atrophy on the Occurrence of Secondary Symptomatic Adjacent Osteoporotic Vertebral Compression Fractures

2021 ◽  
Author(s):  
Georg Osterhoff ◽  
Garnik Asatryan ◽  
Ulrich J. A. Spiegl ◽  
Christian Pfeifle ◽  
Jan-Sven Jarvers ◽  
...  
Keyword(s):  
Muscle Atrophy ◽  
Fatty Infiltration ◽  
Fatty Degeneration ◽  
Vertebral Compression Fractures ◽  
Muscle Area ◽  
Multifidus Muscle ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Adjacent Vertebral Fracture ◽  
One Year

AbstractTo assess the potential influence of multifidus atrophy and fatty degeneration on the incidence of adjacent vertebral compression fractures within one year after the index fracture. In a retrospective cohort study, patients who underwent surgery for an OVCF were identified and baseline characteristics, fracture patterns and the occurrence of secondary adjacent fractures within one year were obtained by chart review. Multifidus muscle atrophy and fatty degeneration were determined on preoperative MRI or CT scans. In this analysis of 191 patients (mean age 77 years, SD 8, 116 female), OF type 3 was the most common type of OVCF (49.2%). Symptomatic adjacent OVCFs within one year after index fracture were observed in 23/191 patients (12%) at mean 12, SD 12 weeks (range 1–42 weeks) postoperatively. The mean multifidus muscle area was 264, SD 53 mm2 in patients with an adjacent vertebral fracture and 271, SD 92 mm2 in patients without a secondary fracture (p = 0.755). Mean multifidus fatty infiltration was graded Goutallier 2.2, SD 0.6 in patients with an adjacent fracture and Goutallier 2.2, SD 0.7 in patients without an adjacent fracture (p = 0.694). Pre-existing medication with corticosteroids was associated with the occurrence of an adjacent fracture (p = 0.006). Multifidus area and multifidus fatty infiltration had no significant effect on the occurrence of adjacent vertebral fractures within one year after the index fracture. Patients with a pre-existing medication with corticosteroids were more likely to sustain an adjacent fracture.

scholarly journals Risk Factors for Refracture following Primary Osteoporotic Vertebral Compression Fractures

2021 ◽  
pp. E335-E340
Author(s):  
Weihua Cai
Keyword(s):  
Risk Factors ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Hounsfield Units ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Fracture History ◽  
Primary Fracture

Background: In the aging population, osteoporosis and related complications have become a global public health problem. Osteoporotic vertebral compression fractures are among the most common type of osteoporotic fractures and patients are at risk of secondary vertebral compression fracture. Objectives: To identify risk factors for secondary vertebral compression fracture following primary osteoporotic vertebral compression fractures. Study Design: Retrospective study. Setting: Department of Orthopedic, an affiliated hospital of a medical university. Methods: This retrospective cohort study evaluated the risk factors for secondary vertebral compression fracture in 317 consecutive patients with systematic osteoporotic vertebral compression fractures who received percutaneous vertebroplasty and kyphoplasty or conservative treatment. Patients were divided into secondary vertebral compression fracture (n = 43) and non- secondary vertebral compression fracture (n = 274) groups. We retrospectively analyzed clinical characteristics and radiographic parameters, including gender, age, body mass index, number of primary fractures, primary treatment (percutaneous vertebroplasty and kyphoplasty or conservative treatment), nonspinal fracture history before primary fracture, primary fracture at the thoracolumbar junction, steroid use, bisphosphonate therapy, and Hounsfield units value of L1. Results: Comparison between the groups showed significant differences in age (P = 0.001), nonspinal fracture history (P < 0.001), and Hounsfield units value of L1 (P < 0.001). The receiver operating characteristic curves demonstrated that the optimal thresholds for age and Hounsfield units value of L1 were 75 (sensitivity: 55.8%; specificity: 67.5%) and 50 (sensitivity: 88.3%; specificity: 67.4%), respectively. In multivariate logistic regression analysis, nonspinal fracture history (OR = 6.639, 95% CI = 1.809 – 24.371, P = 0.004) and Hounsfield units value of L1 < 50 (OR = 15.260, 95% CI = 6.957 – 33.473, P < 0.001) were independent risk factors for secondary vertebral compression fracture. Limitations: The main limitation is the retrospective nature of this study. Conclusion: Patients with low Hounsfield units value of L1 or non-spinal fracture history are an important population to target for secondary fracture prevention. Key words: Risk factor, vertebral, secondary fracture, osteoporosis

Extrapedicular approach of percutaneous vertebroplasty in the treatment of upper and mid‐thoracic vertebral compression fracture

2005 ◽  
Vol 46 (3) ◽  
pp. 280-287 ◽  
Author(s):  
K.‐R. Han ◽  
C. Kim ◽  
J.‐S. Eun ◽  
Y.‐S. Chung
Keyword(s):  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Safe Procedure ◽  
Compression Fractures ◽  
Clinical Complications ◽  
Technical Procedure ◽  
One Year ◽  
Changes Over Time

Purpose: To evaluate the clinical outcome of the extrapedicular approach of percutaneous vertebroplasty (PVP) for upper and mid‐thoracic vertebral compression fractures in patients. Material and Methods: Extrapedicular vertebroplasty was performed in painful compression fractures at T4–T8 levels. The assessment criteria were changes over time in visual analog scale (VAS) and mobility score. We evaluated the volume of cement injected, the size of needle required, and complications. Results: Procedures were performed in 27 patients with a total of 34 affected vertebral bodies. Early (within a week) and one year later, clinical follow‐ups showed that pain intensity had decreased by 50% one day after operation and later by 70–80%. Mobility scores of all patients were improved immediately after the procedure. Average volume of polymethylmethacrylate (PMMA) per vertebral body was 3.8±1.2 ml. Leakage of PMMA occurred in one vertebral level (intradiskal space), but did not cause clinical complications. Conclusion: PVP of upper and mid‐thoracic spine with an extrapedicular approach is an efficient and safe procedure for treating painful thoracic vertebral compression fracture under a cautious patient selection and meticulous technical procedure.

scholarly journals Risk factors of the Secondary Fractures for Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebroplasty

2020 ◽  
Author(s):  
Xiao-kui Kang ◽  
Sheng-fu Guo ◽  
Hui-xin Liu ◽  
Li-li Huang ◽  
Qun-long Jiang
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Meta Analysis ◽  
Thoracolumbar Spine ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Secondary Fractures

Abstract Background Percutaneous vertebroplasty related postoperative secondary fractures risk factors were not consistent in patients with osteoporotic vertebral compression Fractures. The purpose was to identify the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty.Methods Potential academic articles were identified from Cochrane Library, Medline, PubMed, Embase, ScienceDirect and other databases. The time range we retrieved from was that from the inception of electronic databases to August 2019. Gray studies were identified from the references of included literature reports. STATA version 11.0 (Stata Corporation, College Station, Texas, USA) was used to analyze the pooled data.Results Fourteen studies involving 1910 patients, 395 of whom had secondary fracture following the surgery were included in this meta-analysis. The results of meta-analysis showed the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty was related to bone mineral density [WMD= -0.518, 95%CI(-0.784,-0.252), P=0.000], cement leakage [RR=0.596, 95%CI (0.444,0.798), P=0.001] and kyphosis after primary operation [WMD=4.510, 95%CI (3.061,6.004),P=0.000], but not to gender, age, body mass index (BMI), cement volume, thoracolumbar spine, and cement injection approaches.Conclusions BMD, cement leakage and kyphosis after primary operation are the risk factors closely correlative to the secondary fracture after percutaneous vertebroplasty. There has not been enough evidence to support the association between the secondary fracture and gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approach.

scholarly journals Role of percutaneous vertebroplasty with high-viscosity cement in the treatment of severe osteoporotic vertebral compression fractures

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kunpeng Li ◽  
Changbin Ji ◽  
Dawei Luo ◽  
Wen Zhang ◽  
Hongyong Feng ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Operative Time ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
High Viscosity ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Vertebral Height ◽  
Compression Fractures ◽  
One Year

AbstractSevere osteoporotic vertebral compression fractures (OVCFs) were considered as relative or even absolute contraindication for vertebroplasty and kyphoplasty and these relevant reports are very limited. This study aimed to evaluate and compare the efficacy of vertebroplasty with high-viscosity cement and conventional kyphoplasty in managing severe OVCFs. 37 patients of severe OVCFs experiencing vertebroplasty or kyphoplasty were reviewed and divided into two groups, according to the procedural technique, 18 in high-viscosity cement percutaneous vertebroplasty (hPVP) group and 19 in conventional percutaneous kyphoplasty (cPKP) group. The operative time, and injected bone cement volume were recorded. Anterior vertebral height (AVH), Cobb angle and cement leakage were also evaluated in the radiograph. The rate of cement leakage was lower in hPVP group, compared with cPKP group (16.7% vs 47.4%, P = 0.046). The patients in cPKP group achieved more improvement in AVH and Cobb angle than those in hPVP group postoperatively (37.2 ± 7.9% vs 43.0 ± 8.9% for AVH, P = 0.044; 15.5 ± 4.7 vs 12.7 ± 3.3, for Cobb angle, P = 0.042). At one year postoperatively, there was difference observed in AVH between two groups (34.1 ± 7.4 vs 40.5 ± 8.7 for hPVP and cPKP groups, P = 0.021), but no difference was found in Cobb angle (16.6 ± 5.0 vs 13.8 ± 3.8, P = 0.068). Similar cement volume was injected in two groups (2.9 ± 0.5 ml vs 2.8 ± 0.6 ml, P = 0.511). However, the operative time was 37.8 ± 6.8 min in the hPVP group, which was shorter than that in the cPKP group (43.8 ± 8.2 min, P = 0.021). In conclusion, conventional PKP achieved better in restoring anterior vertebral height and improving kyphotic angle, but PVP with high-viscosity cement had lower rate of cement leakage and shorter operative time with similar volume of injected cement.

scholarly journals Risk factors for secondary fractures to percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wei Mao ◽  
Fei Dong ◽  
Guowei Huang ◽  
Peiliang He ◽  
Huan Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Mineral Density ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Secondary Fractures ◽  
At Home

Abstract Background Osteoporotic vertebral compression fracture (OVCF) is one of the most common fragile fractures, and percutaneous vertebroplasty provides considerable long-term benefits. At the same time, there are many reports of postoperative complications, among which fracture after percutaneous vertebroplasty is one of the complications after vertebroplasty (PVP). Although there are many reports on the risk factors of secondary fracture after PVP at home and abroad, there is no systematic analysis on the related factors of secondary fracture after PVP. Methods The databases, such as CNKI, Wan Fang Database and PubMed, were searched for documents on secondary fractures after percutaneous vertebroplasty published at home and abroad from January 2011 to March 2021. After strictly evaluating the quality of the included studies and extracting data, a meta-analysis was conducted by using Revman 5.3 software. Results A total of 9 articles were included, involving a total of 1882 patients, 340 of them diagnosed as secondary fractures after percutaneous vertebroplasty. Conclusion The additional history of fracture, age, bone mineral density (BMD), bone cement leakage, intravertebral fracture clefts and Cobb Angle might be risk factors related to secondary fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. The height of vertebral anterior and body mass index (BMI) were not correlated.

scholarly journals The outcome of expandable titanium mesh implants for the treatment of multi-level vertebral compression fractures caused by multiple myeloma

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 28
Author(s):  
Surya Gandham ◽  
Abdurrahman Islim ◽  
Saud Alhamad ◽  
Sathya Thambiraj
Keyword(s):  
Multiple Myeloma ◽  
Average Length ◽  
Perioperative Complications ◽  
Clinical Excellence ◽  
Balloon Kyphoplasty ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Average Length Of Stay ◽  
Patient Reported ◽  
One Year

Background: Painful vertebral compression fractures (VCFs) in myeloma patients severely reduce quality of life. Currently, the International Myeloma Working Group (IMWG) and National Institute of Clinical Excellence NICE advocate the use of either balloon kyphoplasty or vertebroplasty in the management of these fractures. Methods: All patients with VCFs and myeloma who adhered to the IMWG indications for vertebral augmentation were treated with the Osseofix® implant. Visual analogue scores (VAS) and Oswestry disability index (ODI) were taken preoperatively and at least one year following surgery. Cobb angle and implant migration were measured on lateral standing radiographs. Results: Sixteen patients (average age 62, SD = 11.6) consisting of 82 levels (range 3–8) were stabilised with no perioperative complications or revisions at one year. There was an improvement in patient-reported outcomes with the median preoperative VAS of 8.6 (IQR 7.3–10.0) reducing to 3 (IQR 1.0–4.0) after one year (P < 0.001) whilst an average improvement of 31.4 (SD = 19.6) points in the ODI scores was reported (P < 0.001). There was no significant collapse or implant failure at one year with a greater improvement in the VAS/ODI score, when more implants were used (P = 0.049 and 0.008, respectively). The average length of stay was 2.2 days (SD = 1.7). Conclusion: The use of the Osseofix® implant in VCFs caused by multiple myeloma has shown a statistically significant improvement in both pain and outcome scores. There were no complications or significant radiological deterioration of spinal alignment over the course of a year.

scholarly journals Cascading Adjacent Level Vertebral Compression Fractures Necessitating a Series of Eleven Kyphoplasties

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Evan Curatolo ◽  
Matthew Reuter ◽  
Adil Samad ◽  
Daniel Flynn ◽  
Marc Menkowitz ◽  
...  
Keyword(s):  
Thoracic Kyphosis ◽  
Vertebral Compression Fractures ◽  
Adjacent Level ◽  
Compression Fractures ◽  
Randomized Controlled ◽  
Body Fracture ◽  
Related Quality ◽  
Previously Treated ◽  
One Year

Vertebral kyphoplasty is a procedure used for the treatment of compression fractures. While early randomized-controlled trials were equivocal regarding its benefits, more recent RCTs have shown favorable results for kyphoplasty with regard to pain relief, functional recovery, and health-care related quality of life compared to control patients. Risks of kyphoplasty include but are not limited to cement extrusion, infection, hematoma, and vertebral body fracture of adjacent levels. We describe a case of a 66-year-old male attorney who underwent eleven kyphoplasties in an approximately one-year period, the majority of which were for fractures of vertebrae adjacent to those previously treated with kyphoplasty. Information on treatment was gathered from the patient’s hospital chart and outpatient office notes. Following the last of the eleven kyphoplasties (two at T8, one each at all vertebrae from T9 to L5), the patient was able to function without pain and return to work. His physiologic thoracic kyphosis of 40 degrees prior to the first procedure was maintained, as were his lung and abdominal volumes. We conclude that kyphoplasty is an appropriate procedure for the treatment of vertebral compression fractures and can be used repeatedly to address fractures of levels adjacent to a previous kyphoplasty.

Sign in / Sign up

Export Citation Format

Share Document