scholarly journals Robot-Assisted Versus Fluoroscopy-Assisted Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fracture: A Retrospective Study

2020 ◽  
pp. 219256822097822
Author(s):  
Wei Yuan ◽  
Xiaotong Meng ◽  
Wenhai Cao ◽  
Yue Zhu
Keyword(s):  
Retrospective Study ◽  
Exposure Time ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Operation Time ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Robot Assisted ◽  
Intraoperative Radiation ◽  
Fluoroscopy Exposure

Study design: A retrospective study. Objectives: To compare the clinical and radiological outcomes of robot assisted (RA) and fluoroscopy assisted (FA) percutaneous kyphoplasty (PKP) in treating single/double segment osteoporotic vertebral compression fracture (OVCF). Methods: Patients with single/double segment OVCF receiving either RA or FA PKP were evaluated retrospectively at our spine center from April 2018 to October 2019. The operation time, fluoroscopy frequency, fluoroscopy exposure time, total radiation dose, visual analogue scale (VAS), local kyphosis angle (LKA), height of fractured vertebra (HFV) and complications were compared between the single/double RA group and the FA group. Results: A total of 96 cases were included in this study, with 59 cases of single segment OVCF and 37 cases of double segment OVCF. For single/double segment OVCF, both RA and FA PKP could relieve pain and reduce fracture. The RA group showed lower fluoroscopy frequency, shorter fluoroscopy exposure time during operation for surgeons, better correction in LKA and HFV, lower rate of cement leakage, but more fluoroscopy frequency, fluoroscopy exposure time and radiation dose for patients compared with the FA group (P < 0.05), while the single RA group showed longer operation time compared with the FA group (P < 0.05). Conclusions: For single/double segment OVCF, RA has more advantages in correcting vertebra fracture, reducing intraoperative radiation exposure for surgeons, and reducing the cement leakage rate, but it increases intraoperative radiation for patients compared with FA PKP. And FA has shorter operation time in treating single segment OVCF than RA PKP.

“Targeted Percutaneous Vertebroplasty” Versus Traditional Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fracture

2019 ◽  
Vol 26 (5) ◽  
pp. 551-559
Author(s):  
JunChuan Xu ◽  
JiSheng Lin ◽  
Jian Li ◽  
Yong Yang ◽  
Qi Fei
Keyword(s):  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Operation Time ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Controlled Study ◽  
Radiation Doses ◽  
Group A ◽  
Group B

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.

scholarly journals Radiological and clinical outcomes of balloon kyphoplasty for osteoporotic vertebral compression fracture in patients with rheumatoid arthritis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ji Guo ◽  
Weifeng Zhai ◽  
Licheng Wei ◽  
Jianpo Zhang ◽  
Lang Jin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vertebral Fractures ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Balloon Kyphoplasty ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Control Group ◽  
Compression Rate ◽  
Kyphotic Angle

Abstract Background This study was conducted to investigate the outcomes and complications of balloon kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in patients with rheumatoid arthritis (RA) and compare its radiological and clinical effects with OVCF patients without RA. Methods Ninety-eight patients in the RA group with 158 fractured vertebrae and 114 patients in the control group with 150 vertebrae were involved in this study. Changes in compression rate, local kyphotic angle, visual analog scale (VAS) and Oswestry disability index (ODI) scores, conditions of bone cement leakage, refracture of the operated vertebrae, and new adjacent vertebral fractures were examined after KP. In addition, patients in the RA group were divided into different groups according to the value of erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and whether they were glucocorticoid users or not to evaluate their influence on the outcomes of KP. Results KP procedure significantly improved the compression rate, local kyphotic angle, and VAS and ODI scores in both RA and control groups (p<0.05). Changes in compression rate and local kyphotic angle in the RA group were significantly larger than that in the control group (p<0.05), and patients with RA suffered more new adjacent vertebral fractures after KP. The outcomes and complications of KP from different ESR or CRP groups did not show significant differences. The incidence of cement leakage in RA patients with glucocorticoid use was significantly higher than those who did not take glucocorticoids. In addition, RA patients with glucocorticoid use suffered more intradiscal leakage and new adjacent vertebral fractures. Conclusions OVCF patients with RA obtained more improvement in compression rate and local kyphotic angle after KP when compared to those without RA, but they suffered more new adjacent vertebral fractures. Intradiscal leakage and new adjacent vertebral fractures occurred more in RA patients with glucocorticoid use. Trial registration Retrospectively registered.

scholarly journals Radiological and clinical effect of balloon kyphoplasty for the management of rheumatoid arthritis patients with osteoporotic vertebral compression fracture

2020 ◽  
Author(s):  
Ji Guo ◽  
Weifeng Zhai ◽  
Licheng Wei ◽  
Jianpo Zhang ◽  
Lang Jin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Balloon Kyphoplasty ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Control Group ◽  
Compression Rate ◽  
Kyphotic Angle ◽  
Vertebral Bodies

Abstract Objective: This study was conducted to investigate the outcome of percutaneous balloon kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture(OVCF) in patients with rheumatoid arthritis (RA) and analyze the influence of erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), injected cement volume and duration of taking glucocorticoid on the outcome of KP procedure. Methods: A total of 39 RA patients (63 vertebral bodies) and 38 patients (50 vertebral bodies) without RA received KP management for OVCF. Changes in vertebral compression rate, local kyphotic angle, conditions of bone cement leakage, visual analogue scale (VAS) and Oswestry disability index (ODI) scores were evaluated for radiological and clinical outcomes of KP procedure. In addition, 39 OVCF patients with RA were divided into different groups according to the value of ESR, CRP, injected cement volume and duration of taking glucocorticoid to evaluate their influence on the outcomes of KP procedure.Results: The KP procedure significantly improved the compression rate, local kyphotic angle, VAS and ODI scores in both RA group and control group. The compression rate increased 11.56±3.8% in RA group which is significantly larger than the control group(p<0.05). The change of local kyphotic angle in RA group was 3.77±1.9, which is also larger than that in control group(p<0.05). Whereas, the changes of VAS and ODI scores were not significantly different between the two groups. Besides, radiological and clinical outcomes were not significantly different among the groups of different ESR, CRP, injected cement volume and duration of taking glucocorticoid no matter before or 1 year after the KP procedure, but 44% RA patients who take glucocorticoid for over 10 years had cement leakage after the KP procedure which is significantly higher than the group of RA patients with less than 10 years glucocorticoid use(p<0.05). In addition, 7 intradiscal cement leakage occurred in patients take glucocorticoid over 10 years where as no intradiscal leakage showed up in its control group(p<0.01).Conclusion: KP procedure was effective for OVCF patients with or without RA, for restoring vertebral body height, reducing local kyphotic angle, relieving pain and recovering spinal function. Compared to the control group, RA patients received more improvement in compression rate and local kyphotic angle after the operation. Intradiscal leakage occurred more in patients who take glucocorticoid for over 10 years.

scholarly journals Risk factors of postoperative bone cement leakage on osteoporotic vertebral compression fracture: a retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kui Zhang ◽  
Jiang She ◽  
Yandong Zhu ◽  
Wenji Wang ◽  
Erliang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Cement ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Posterior Wall ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Type B ◽  
Logistic Analysis ◽  
Type C

Abstract Purpose To investigate risk factors of bone cement leakage in percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture (OVCF). Methods A total of 236 patients (344 vertebrae) who underwent PVP between November 2016 and June 2020 were enrolled in the study. Clinical and radiological characteristics, including age, gender, course of disease, trauma, type of vertebral fracture, cortical continuity of vertebral body, intervertebral vacuum cleft (IVC), fracture severity, fracture level, basivertebral foramen, bone cement dispersion types, the cement injection volume, the type of cement leakage, puncture approach, and intrusion of the posterior wall, were considered as potential risk factors. Three types of leakage (type-B, type-C, and type-S) were defined and risk factors for each type were analyzed. Logistic analysis was used to study the relationship between each factor and the type of cement leakage. Results The incidences of the three types of leakage were 28.5%, 24.4%, and 34.3%. The multinomial logistic analysis revealed that the factors of type-B leakage were the shape of cement and basivertebral foramen. One significant factor related to type-C leakage was cortical disruption, and the factors of type-S leakage were bone cement dispersion types, basivertebral foramen, cleft, fracture severity, an intrusion of the posterior wall, and gender. Conclusion Different types of cement leakage have their own risk factors, and the analysis of risk factors of these might be helpful in reducing the rate of cement leakage.

scholarly journals Percutaneous Kyphoplasty in Treating Osteoporotic Vertebral Compression Fracture With Kyphotic Deformity: A Compared Study

2020 ◽  
Author(s):  
Wenye Yao ◽  
Runsheng Guo ◽  
Qi Lai ◽  
Bin Zhang
Keyword(s):  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Operation Time ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Kyphotic Deformity ◽  
Percutaneous Kyphoplasty ◽  
Bilateral Group ◽  
Significant Difference ◽  
Unilateral Group

Abstract Objective: To evaluate the efficacy and safety of percutaneous kyphoplasty (PKP) for thoracolumbar osteoporotic vertebral compression fracture (OVCF) with kyphosis via unilateral versus bilateral approach.Methods: All patients suffered OVCF with kyphosis were retrospectively reviewed. Of those, performed unilateral PKP or underwent bilateral PKP with random. The clinical and radiological data such as the correction of deformity, sagittal profle and record of the perioperative morbidity of the patients were analyzed.Results: All patients (76±3.6 years) were enrolled in this investigation, including 47 in the unilateral and 39 in the bilateral group. No significant difference in general data was detected between the two groups (p >0.05). Howere, the operation time and cement amount 28.2±3.4 min, 3.8±0.6 ml in the unilateral group, while 50.1±4.6 min, 5.4±0.5 ml in the bilateral group, respectively (P <0.05).In addition,The preoperative visual analog scale(VAS) and Vertebral local kyphosis angle were 8.8±0.65 and 16.3 ± 6.5°compared to last follow-up 3.15±0.78 and 14.26± 2.16°in unilateral group, while 8.5±0.78 and 16.5 ± 7.1°compared to last follow-up 2.66±0.86 and 13.81±2.38°in bilateral group, respectively (P < 0.05). Furthermore, Oswestry Disablility Index (ODI) and prevertebral height ratio in both groups were significantly different before and after surgery, but no significant difference between the two groups (p >0.05).Conclusion: Both bilateral and unilateral PKP are relatively safe and provide effective treatment for patients with painful thoracolumbar osteoporotic vertebral compression fracture with mild kyphotic deformity. However, unilateral PKP need less operation time and volume of cement.

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