Analysis on the Effect of Different Surgical Methods on the Treatment of Senile Osteoporotic Spinal Compression Fractures and the Influencing Factors of Complications

Osteoporotic fractures are a common type of fractures in the elderly, among which spinal compression fractures are more common. After the occurrence of fractures, due to the compression and burst of the vertebral body, this will lead to local kyphosis deformity and even affect the balance of the sagittal spine. In the past, conservative treatments were used for osteoporotic spinal compression fractures. Although it can relieve pain symptoms, it can easily lead to complications such as aggravation of osteoporosis and deep vein thrombosis of the lower extremities. At present, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are the main clinical surgical treatments, both of which are minimally invasive surgery, short operation time, effective pain relief, and rapid postoperative recovery. Although both of them are effective, there is still controversy over the efficacy of both in the treatment of osteoporotic spinal compression fractures. The purpose of this study was to investigate the efficacy of PVP and PKP in the treatment of elderly osteoporotic spinal compression fractures and to analyze the related factors that affect the occurrence of postoperative complications. The results show that both PVP and PKP can effectively improve the pain and dysfunction of elderly patients with osteoporotic spinal compression fracture, restoration of vertebral height, and correct kyphosis, but PKP has better effect and higher safety and is worth promoting. Postoperative complications of patients are related to their age, bone mineral density, use of hormones, and antiosteoporosis treatment.

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Unilateral curved versus bipedicular vertebroplasty in the treatment of osteoporotic vertebral compression fractures

BMC Surgery ◽

10.1186/s12893-019-0653-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Rui Zhong ◽

Jianheng Liu ◽

Runsheng Wang ◽

Yihao Liu ◽

Binbin Chen ◽

...

Keyword(s):

Compression Fracture ◽

Operation Time ◽

Cement Leakage ◽

Leakage Rate ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Significant Difference ◽

Vas Scores ◽

Postoperative Improvement

Abstract Background Vertebral compression fracture is one of the most common complications of osteoporosis. In this study an unilateral curved vertebroplasty device was developed, and the safety, effectiveness, and surgical parameters of curved vertebroplasty (CVP) in the treatment of painful osteoporotic vertebral compression fractures was investigated and compared with traditional bipedicular vertebroplasty (BVP). Methods We investigated 104 vertebral augmentation procedures performed over 36 months. CVP and BVP procedures were compared for baseline clinical variables, pain relief (Visual Analog Scale, VAS), disability improvement (Oswestry Disability Index, ODI), operation time, number of fluoroscopic images, volume of cement per level, and cement leakage rate for each level treated. Complications and refracture incidence were also recorded in the two groups. Results The VAS and ODI in both group had no significant difference preoperative (P > 0.05), and a significant postoperative improvement in the VAS scores and ODI was found in both group (P < 0.001). However, the CVP group had significantly lower operation time, number of fluoroscopic images, and cement leakage rate per level than the BVP group (P < 0.05); however, the volumes of cement per level were similar in the two groups (P > 0.05). Neither group had any serious complications. Five and two patients in the BVP group developed refractures at non-adjacent and adjacent levels, respectively, with one patient developing refractures twice; however, none of the patients in the CVP group developed refractures at any level. Conclusions Our findings revealed that both CVP and BVP were safe and effective treatments for osteoporotic vertebral compression fractures, and CVP entails a shorter operation time, less exposure to fluoroscopy, and lower rate of cement leakage.

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Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults - a prospective observational study

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-1241-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Liyuan Fu ◽

Yuanyuan Zhang ◽

Bohan Shao ◽

Xiangjing Liu ◽

Bo Yuan ◽

...

Keyword(s):

Logistic Regression ◽

Cardiac Surgery ◽

Postoperative Complications ◽

Grip Strength ◽

Heart Surgery ◽

Characteristic Curve ◽

Postoperative Recovery ◽

Cutoff Point ◽

Middle Aged ◽

Related Factors

Abstract Background Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods A total of 212 patients with mean age 63.8 ± 6.3 who underwent cardiac surgery participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the association between grip strength grouping and complications. Results We found that 36 patients had 30-day complications. EuroSCORE were 2.15 ± 1.52 and 2.42 ± 1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p < 0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After regrouped characteristic information by grip recovery cutoff point, we found that percentage of the estimated 6 min walk distance (41.5 vs 48.3, p = 0.028) and hospitalization time (7.2 vs 6.1, p = 0.042) had worse trends in lower recovery group. Conclusions Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups. Trial registration Our research was registered on Research Registry website, the registry number was ChiCTR1800018465. Date: 2018/9/20. Status: Successful.

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MRI PATTERN OF VERTEBRAL FRACTURES DUE TO OSTEOPOROSIS, INFECTION, AND MALIGNANT TUMORS

Journal of Musculoskeletal Research ◽

10.1142/s0218957710002491 ◽

2010 ◽

Vol 13 (02) ◽

pp. 57-63

Author(s):

Mohamed El-Sayed Abdel-Wanis ◽

Mohamed Tharwat Mahmoud Solyman ◽

Nahla Mohamed Ali Hasan

Keyword(s):

Vertebral Body ◽

Vertebral Fractures ◽

Malignant Tumors ◽

Compression Fracture ◽

Osteoporotic Fractures ◽

Spinal Infection ◽

Vertebral Compression Fractures ◽

Vertebral Collapse ◽

Compression Fractures ◽

Vertebral Wedging

No previous studies discussed the significance of the MRI pattern of vertebral collapse in differentiation between vertebral compression fractures due to malignancy, osteoporosis, and infections. MRI was used in the evaluation of 152 atraumatic vertebral compression fractures in 80 patients: 85 malignant, 34 osteoporotic, and 33 infective. Central collapse of the fractured vertebral body was the commonest pattern in malignant fractures (57 vertebrae, 67%), followed by uniform collapse (21 vertebrae, 24.7%), then anterior wedging (5 vertebrae, 5.9%), and finally posterior wedging (2 vertebrae, 2.4%). In osteoporotic fractures, anterior wedging was the commonest pattern (18 vertebrae, 53%), followed by central collapse (11 vertebrae, 32.3%), then uniform collapse (4 vertebrae, 11.8%), and finally posterior wedging (1 vertebra, 2.9%). In vertebral compression fractures due to spinal infection, anterior wedging was the commonest pattern (20 vertebrae, 60.6%), followed by uniform collapse (12 vertebrae, 36.4%), while only one vertebra (3%) was centrally collapsed. Central collapse of the vertebral body is highly suggestive of malignant compression fracture while anterior vertebral wedging is highly suggestive of a benign compression fracture.

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Bone mineral density and fracture risk in patients with rheumatic diseases

Medical Council ◽

10.21518/2079-701x-2020-8-120-127 ◽

2020 ◽

pp. 120-127

Author(s):

O. V. Dobrovolskaya ◽

A. O. Efremova ◽

N. V. Demin ◽

N. V. Toroptsova

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Rheumatic Diseases ◽

Low Energy ◽

Mineral Density ◽

X Ray ◽

Compression Fractures ◽

Spinal Compression ◽

Autoimmune Processes ◽

Post Menopause

Introduction: Decrease in bone mineral density (BMD) and risk of fractures in rheumatic diseases (RD) is caused by the pathogenetic mechanisms underlying RD and the effects of drugs used to treat them on bone.Aim of the study: to assess the condition of BMD, frequency and risk of fractures in postmenopausal women with different RD.Material and methods: The study enrolled 260 women in postmenopause (median age 61 years) (54; 68 year) with systemic scleroderma (SS), rheumatoid arthritis (RA) and osteoarthritis (OA). Patients were sanitized and examined using dual energy X-ray absorptiometry; a 10-year risk of fractures was calculated using the FRAX® algorithm.Results: A reduced BMD was observed in 210 (81%) women with RD, while osteoporosis (OP) was found in 43% of women with SS, 31% of women with RA and 17% of women with OA. In all RD, osteoporosis was more common in the lumbar spine than in the proximal femur. The frequency of low-energy fractures in the anamnesis was 35, 29 and 20 percent for those with SS, RA and OA, respectively. The most frequent fractures among women with SS and RA were vertebral fractures, and in patients with OA - forearm fractures. The 10-year risk of new fractures according to FRAX® and the need for antiosteoporotic treatment in women with OA was less than in patients with SS and RA (p < 0.0001). Of all patients examined, 44% needed pathogenetic antiosteoporotic therapy, and in actual practice 25% of women received it. Patients with RA were most often treated with zoledronic acid, alendronate and parenteral form of ibandronate.Conclusions: The frequency of OPs and the 10-year risk of fractures in autoimmune RD was significantly higher than in OA. The structure of low-energy fractures in RD is different: in autoimmune processes and glucocorticoids (GC) intake, spinal compression fractures were significantly more common. Pathogenetic treatment for OP in women in post-menopause with RD is not performed frequently enough, which may cause repeated low-energy fractures.

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Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study

10.21203/rs.2.12567/v4 ◽

2019 ◽

Author(s):

Liyuan Fu ◽

Yuanyuan Zhang ◽

Bohan Shao ◽

Xiangjing Liu ◽

Bo Yuan ◽

...

Keyword(s):

Logistic Regression ◽

Cardiac Surgery ◽

Postoperative Complications ◽

Grip Strength ◽

Heart Surgery ◽

Characteristic Curve ◽

Postoperative Recovery ◽

Cutoff Point ◽

Middle Aged ◽

Related Factors

Abstract Background: Although perioperative care during heart surgery has improved considerably, the rate of postoperative complications has remained stable. It has not been concluded how to better apply grip strength to clinical, postoperative complications. So our study aimed at researching the best way for using grip value for predicting early postoperative complications. Methods: A total of 212 patients with mean age 63.8±6.3 who underwent cardiac surgery participated in our study. We analyzed the ROC curve of grip strength, grip/weight and grip recovery with complications, found the best cutoff point. Logistic regression confirmed the association between grip strength grouping and complications. Results: We found that 36 patients had 30-day complications. EuroSCORE were 2.15±1.52 and 2.42±1.58 between normal and complication groups, respectively. The area under the receiver-operating characteristic curve (AUC) of grip recovery take the most area (0.837, p<0.001), and the cutoff point was 83.92%. In logistic regression, lower grip recovery has higher risk impact on 30-day complications for 25.68 times than normal group, after adjusted surgery-related factors. After regrouped characteristic information by grip recovery cutoff point , we found that percentage of the estimated 6 minute walk distance (41.5 vs 48.3, p=0.028) and hospitalization time (7.2 vs 6.1, p=0.042) had worse trends in lower recovery group. Conclusions: Poor grip recovery may be related to higher risk of postoperative complications within 30 days after discharge in middle-aged and older people independent of surgical risk. The results of this study provide a reference for the development of rehabilitation programs in the early postoperative recovery, and may also be a prognostic indicator for postoperative high-risk groups.

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Abstract 318: Heart Failure and Osteoporosis- an Evidence Based Approach

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.318 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Anmol Kapoor ◽

Amanpreet Singh ◽

Armandeep Singh

Keyword(s):

Heart Failure ◽

Heart Disease ◽

Case Series ◽

Compression Fracture ◽

Osteoporotic Fractures ◽

Mineral Density ◽

Multiple Fractures ◽

Community Based ◽

Patients With Heart Failure ◽

Shared Risk

Background: Heart disease occurs when there is reduced blood flow to the heart. It refers to a range of conditions that affect the heart. These conditions include ischemic heart disease (which can lead to acute myocardial infarction), angina, arrhythmia, atrial fibrillation, and heart failure, among others. Currently, there are 600,000 Canadians living with heart failure (HF) with 50,000 Canadians being diagnosed every year with HF. Community-based heart failure clinics have been proven to reduce hospitalizations, but Alberta has only one. The CHARM (Community Heart Failure Assessment, Rehabilitation and Management) clinic at Advanced Cardiology, Calgary, Alberta is a community based, charity funded clinic providing outpatient care, which is physician-directed but RN managed. We intended to investigate whether there was any relationship between patients with heart failure and their pre-disposition to osteoporosis and vice versa. Methods: We performed an observational case series with a retrospective chart review of 600 CHARM clinic patients who have been diagnosed with Heart Failure till June 2019. The primary endpoint was to look at CHARM clinic's prevalence of HF, patients who ever had Bone Mineral Density (BMD) done and if there was an intertwining relationship by comparing co-existence of heart failure with osteoporosis. Results: •Total # of pts above 65 years of age from a pool of 356 clinic pts = 169•Total # of pts above 65 years of age who had BMD done before June 2019 = 60•Total # of pts above 65 years of age who have Not had BMD done before June 2019 =108•Percentage of patients above 65 years of age who had BMD done before June 2019 = 35%•Percentage of patients above 65 years of age who have not had BMD done before June 2019 = 65%We also compared our finding with studies from Raymond b. Et al and Ezekowitz and it was found that out of 623 patients with Heart failure, 12% had moderate to severe vertebral compression fracture, 55% of those people have multiple fractures. It was seen that CHF patients with osteoporosis were the features that they were mostly female, Caucasian, smoker, obese, hypertensive, COPD, and patients with prevalence of diabetes. Conclusion: It was noticed from our clinic data that 65% of the patients with CHF did not have a BMD done (till June2019) and there by the presence of osteoporosis could have gone undiagnosed. What complicates CHF and osteoporosis is the age factor (mostly elderly), shared risk factors(factors include advanced age, hypovitaminosis D, renal disease and diabetes mellitus), medication use like (loop diuretics) and common pathogenic mechanisms(activation of the renin-angiotensin-aldosterone system) affect both HF and osteoporosis. It is to be noted that CHF is a major risk factor for mortality following fracture as the patient becomes immobile and it is important to carefully assess osteoporosis and take measures to reduce the risk of osteoporotic fractures.

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Perioperative poor grip strength recovery is associated with 30-day complication rate after cardiac surgery discharge in middle-aged and older adults- a prospective observational study

10.21203/rs.2.12567/v5 ◽

2019 ◽

Author(s):

Liyuan Fu ◽

Yuanyuan Zhang ◽

Bohan Shao ◽

Xiangjing Liu ◽

Bo Yuan ◽

...

Keyword(s):

Logistic Regression ◽

Cardiac Surgery ◽

Postoperative Complications ◽

Grip Strength ◽

Heart Surgery ◽

Characteristic Curve ◽

Postoperative Recovery ◽

Cutoff Point ◽

Middle Aged ◽

Related Factors

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Comparison between percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of posterior wall rupture and osteoporotic vertebral compression fractures-Case - based retrospective study

10.21203/rs.3.rs-19906/v1 ◽

2020 ◽

Author(s):

Yong-sheng Gou ◽

Yue Hu ◽

Hai-bo Li ◽

Bo-lin fu ◽

Zheng Che

Keyword(s):

Retrospective Study ◽

Clinical Efficacy ◽

Percutaneous Vertebroplasty ◽

Compression Fracture ◽

Operation Time ◽

Posterior Wall ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Percutaneous Kyphoplasty

Abstract Background: Percutaneous kyphoplasty (PKP) or percutaneous vertebral plasty (PVP) has been widely applied in the treatment of osteoporotic vertebral compression fractures (osteoporotic vertebral compression will fracture, OVCF) because of its minimally invasive and effective. To compare the clinical efficacy and safety of percutaneous vertebroplasty versus percutaneous kyphoplasty for osteoporotic vertebral compression fractures with posterior wall broken. Methods: 82 patients with osteoporotic vertebral compression fracture with posterior wall broken were divided into PVP group(group A) and PKP group(group B)．The operation time, perspective times, bone cement volume injected. cement leakage, hospitalization expenses, preoperative visual analog score(VAS) and Oswestry disability index(ODI), restoration height of vertebral, the vertebrae height loss and new fracture of adjacent vertebra were evaluated during the follow-up. Results: The PVP group incurred significantly shorter operation time(40.37 ±8.26 min) and less perspective times (22.23 ±3.79 times)than the PKP group(46.74 ±9.58 min and 27.96 ±5.71 times respectively)( P<0.05). The PVP group incurred significantly less expenses than the PKP group(P<0.05). The VAS scores and ODI at 1 day and 6 months post-operation were significantly lower than pre-operation in both groups(P<0.05). Conclusion: Both PVP and PKP Can obtain satisfactory clinical efficacy for the treatment of osteoporotic vertebral compression fractures with posterior wall broken,but the former may have advantages of less expenses,shorter operation time. Trial registration: This retrospective study was approved by the ethics committee of the first people's hospital of shuangliu district, Chengdu, Moreover, this study was also registered in the Chinese clinical trial registry with the registration number of ChiCTR1900028176.

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

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02722-w ◽

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.

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Risk Factors of New Vertebral Compression Fracture After Percutaneous Kyphoplasty or Vertebroplasty: A Retrospective Study of 752 Patients

10.21203/rs.3.rs-1057960/v1 ◽

2021 ◽

Author(s):

Bo-bo Zhang ◽

Zhong-wei Song ◽

Ying Wang ◽

Zhi-wei Ren ◽

Wei-zhou Yang ◽

...

Keyword(s):

Risk Factors ◽

Univariate Analysis ◽

Compression Fracture ◽

Osteoporosis Treatment ◽

Vertebral Compression Fractures ◽

Height Loss ◽

Mineral Density ◽

Compression Fractures ◽

Factors Associated ◽

Significant Difference

Abstract Summary Irregularly postoperative anti-osteoporosis treatment (AOT), number of treated vertebrae (NTV) ≥ 2, bone mineral density (BMD) ≤－3.0 SDs, body mass index (BMI) <18.5kg/m2 or BMI ≥ 24kg/m2, vertebral height loss ratio (VHLR)＞20% were strong risk factors associated with new vertebral compression fractures (NVCF) after percutaneous vertebroplasty or kyphoplasty (PVP/PKP) in patients with osteoporotic vertebral compression fractures (OVCF). There was no difference between NVCF occurred adjacent or remote after PKP/PVP intervention.Introduction NVCF have been connected to PVP/PKP surgery for patients with VCF. There are some debates about whether new vertebral body fractures are simply a result of the natural progression of osteoporosis or whether they should be regarded as a consequence of augmentation. We tried to investigate and identify the risk factors which may be relevant to NVCF after PVP/PKP surgery in OVCF patients.Methods The authors retrospectively analyzed the occurrence of NVCF in 752 patients treated with PVP or PKP for OVCF. Possible risk factors, such as age, gender, refracture time (RT), AOT, NTV, BMD, BMI, and VHLR, were assessed.All methods are carried out in accordance with relevant guidelines and regulations.Results Significant differences (P<0.05) were found between the NVCF and control groups with regard to AOT, number of treated vertebrae, BMD, BMI, and VHLR by univariate analysis. And irregularly AOT, NTV ≥ 2, BMD ≤－3.0 SDs, BMI < 18.5 kg/m2 or BMI ≥ 24kg/m2, VHLR＞20% were found to be the significant factors in multivariate analysis. To evaluate a direct and more precise effect of the procedures on untreated vertebrae, the NVCF group was subdivided into adjacent and remote fracture groups. All of factors have no significant difference between two subgroups.Conclusion In the current study, the incidence of NVCF after PVP/PKP is 9.58%. Irregularly AOT, NTV ≥ 2, BMD ≤－3.0 SDs, BMI <18.5kg/m2 or BMI ≥ 24kg/m2, VHLR＞20% were strong risk factors associated with NVCF after PVP/PKP in patients with OVCF. There was no difference between NVCF occurred adjacent or remote after PKP/PVP intervention and that might be the result of the osteoporosis itself. All of those should be addressed during preoperative communication and postoperative management.

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