Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures

Abstract Introduction New vertebral compression fractures (NVCFs) are adverse events after vertebral augmentation of osteoporotic vertebral compression fractures (OVCFs). Predicting the risk of vertebral compression fractures (VCFs) accurately after surgery is still a significant challenge for spinal surgeons. The aim of our study was to identify risk factors of NCVFs after vertebral augmentation of OVCFs and develop a nomogram. Methods We retrospectively reviewed the medical records of patients with OVCFs who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). Patients were divided into the NVCFs group and control group, base on the patients with or without NVCFs within 2 years follow-up period after surgery. A training cohort of 403 patients diagnosed in our hospital from June 2014 to December 2016 was used for model development. The independent predictive factors of postoperative VCFs were determined by least absolute shrinkage and selection operator (LASSO) logistic regression, univariate analysis and multivariate logistic regression analysis. We provided a nomogram for predicting the risk of NVCFs based on independent predictive factors and used the receiver operating characteristic curve (ROC), calibration curve, and decision curve analyses (DCA) to evaluated the prognostic performance. After internal validation, the nomogram was further evaluated in a validation cohort of 159 patients included between January 2017 and June 2018. Results Of the 403 patients in the training cohort, 49(12.16%) were NVCFs at an average of 16.7 (1 to 23) months within the 2 years follow-up period. Of the 159 patients in the validation cohort, 17(10.69%) were NVCFs at an average of 8.7 (1 to 15) months within the 2 years follow-up period. In the training cohort, the proportions of elderly patients older than 80 years were 32.65 and 13.56% in the NVCFs and control group, respectively (p = 0.003). The percentages of patients with previous fracture history were 26.53 and 12.71% in the NVCFs and control group, respectively (p = 0.010). The volume of bone cement were 4.43 ± 0.88 mL and 4.02 ± 1.13 mL in the NVCFs and Control group, respectively (p = 0.014). The differences have statistical significance in the bone cement leakage, bone cement dispersion, contact with endplate, anti-osteoporotic treatment, post-op Cobb angle and Cobb angle restoration characteristics between the two groups. The model was established by multivariate logistic regression analysis to obtain independent predictors. In the training and validation cohort, the AUC of the nomogram were 0.882 (95% confidence interval (CI), 0.824-0.940) and 0.869 (95% CI: 0.811-0.927), respectively. The C index of the nomogram was 0.886 in the training cohort and 0.893 in the validation cohort, demonstrating good discrimination. In the training and validation cohort, the optimal calibration curves demonstrated the coincidence between prediction and actual status, and the decision curve analysis demonstrated that the full model had the highest clinical net benefit across the entire range of threshold probabilities. Conclusion A nomogram for predicting NVCFs after vertebral augmentation was established and validated. For patients evaluated by this model with predictive high risk of developing postoperative VCFs, postoperative management strategies such as enhance osteoporosis-related health education and management should be considered.

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Development and Validation of a Nomogram for Predicting the Probability of Adjacent Segmental Fractures After Vertebral Augmentation of Osteoporotic Vertebral Compression Fractures

10.21203/rs.3.rs-263376/v1 ◽

2021 ◽

Author(s):

Qiujiang Li ◽

Xingxia Long ◽

Yinbin Wang ◽

Xiaomin Fang ◽

Donggeng Guo ◽

...

Keyword(s):

Confidence Interval ◽

Bone Cement ◽

Validation Cohort ◽

Curve Analysis ◽

Vertebral Compression Fractures ◽

Vertebral Augmentation ◽

Osteoporotic Vertebral Compression Fractures ◽

Decision Curve Analysis ◽

Compression Fractures ◽

Segmental Fractures

Abstract Background Adjacent segmental fractures are adverse events after vertebral augmentation of osteoporotic vertebral compression fractures(OVCFs). Predicting the risk of adjacent segmental fractures accurately after surgery is still a significant challenge for spinal surgeons. The aim of our study was to identify predictive factors of the risk of adjacent segmental fractures after vertebral augmentation of OVCFs and develop a nomogram. Methods A nomogram was compiled based on the training cohort of 403 patients, who were hospitalized for OVCFs and performed vertebral augmentation, in the People's Hospital of Ningxia Hui Autonomous Region from June 2014 to December 2016. The independent predictive factors of postoperative adjacent segmental fractures were determined by LASSO, univariate analysis and multivariate logistic regression analysis. Then, establish a nomogram based on these independent predictors. We assessed nomograme using variety methods, including area under the curve (AUC), calibration curve and decision curve analysis (DCA).The above results were verified by the validation cohort of 159 patients, who were hospitalized for OVCFs and performed vertebral augmentation between January 2017 and June 2018. Results The establishment of the nomogram was based on six independent predictors， were determined by multivariate analysis，including age, bone cement injection, bone cement leakage, contact between bone cement and vertebral endplates, bone cement dispersion, and anti-osteoporosis treatment. In the training and validation cohort, the AUC of the nomogram were 0.882 (95% confidence interval, 0.824–0.940) and 0.869 (95% confidence interval: 0.811–0.927),respectively.In the training and validation cohort, the optimal calibration curves demonstrated the coincidence between prediction and actual status, and the decision curve analysis demonstrated that the full model had the highest clinical net benefit across the entire range of threshold probabilities. Conclusion The risk prediction model shows a satisfactory prediction effect and could quantify the probability of adjacent segmental fractures after vertebral augmentation of OVCFs.

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Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02480-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zhongcheng An ◽

Chen Chen ◽

Junjie Wang ◽

Yuchen Zhu ◽

Liqiang Dong ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Bone Cement ◽

Vertebral Compression Fracture ◽

Univariate Analysis ◽

Compression Fracture ◽

Osteoporotic Vertebral Compression Fracture ◽

Vertebral Augmentation ◽

Surgical Methods

Abstract Objective To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF) and analyze the correlation between these factors and augmented vertebra recompression after PVA. Methods A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to the inclusion criteria. All cases meeting the inclusion and exclusion criteria were divided into two groups: 82 patients in the recompression group and 175 patients in the non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density (BMD) during follow-up, intravertebral cleft (IVC) before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery, and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA. Results A total of 257 patients from 353 patients were included in this study. The follow-up time was 12–24 months, with an average of 13.5 ± 0.9 months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P < 0.05). Among them, multiple factors logistic regression elucidated that more injected cement (P < 0.001, OR = 0.558) and high BMD (P = 0.028, OR = 0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B < 0). Preoperative IVC (P < 0.001, OR = 3.252) and bone cement not in contact with upper or lower endplates (P = 0.006, OR = 2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P = 0.007, OR = 0.337). Conclusions The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.

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ANVCFV Score System: Assessment for Probability of New Vertebral Compression Fractures after Percutaneous Vertebroplasty in Patients with Vertebral Compression Fractures

January 2018 - Pain Physician ◽

10.36076/ppj.2015/18/e1047 ◽

2015 ◽

Vol 6;18 (6;11) ◽

pp. E1047-E1057

Author(s):

Gao-Jun Teng

Keyword(s):

Risk Factors ◽

Cox Regression ◽

Validation Cohort ◽

Percutaneous Vertebroplasty ◽

Vertebral Compression Fractures ◽

Score System ◽

Training Cohort ◽

Compression Fractures ◽

Independent Risk Factors ◽

Risk Score System

Background: Percutaneous vertebroplasty (PVP) is widely used for the treatment of painful vertebral compression fractures (VCFs). However, new VCFs occur frequently after PVP. Objectives: We aim to establish an objective risk score system to assess the possibility of new vertebral fractures in patients with VCFs undergoing PVP. Study Design: This study was a retrospective study, and it was approved by the Institutional Review Board of our 2 institutions. Setting: This study consists of patients from 2 large academic centers. Methods: Patients with VCFs who underwent their first PVP and met the inclusion criteria between January 2007 and December 2013 at Hospital A (training cohort) and Hospital B (validation cohort) were included. In the training cohort, the independent risk factors for new VCFs after PVP were identified by multivariate stepwise backward Cox regression analysis from the risk factors selected by univariate analysis and Harrell’s C-statistics and used to develop the score system (assessment for new VCFs after PVP [ANVCFV]) to predict the probability of new VCFs. Results: In total, 397 patients (training cohort: n = 241; validation cohort: n = 156) were included in this study. In the training cohort, the ANVCFV score was developed based on 5 independent risk factors for the new VCFs after PVP, including lower computed tomography (CT) values, pre-existing old VCFs, intradiscal cement leakage, more than one vertebra treated, and superior or inferior marginal cement distribution in the vertebra. The patients were divided into 2 groups by the ANVCFV score of -1.5 to 8.5 vs. > 8.5 points in the probability of new VCFs (median fracture-free time: 1846 vs. 732 days; P < 0.001) in the training cohort. The accuracy of this score system was 77.4% for the training cohort and 85.3% for the validation cohort. Limitations: The main limitations of this study are that it is a retrospective study and that there is a significant difference of the treated vertebrae of PVP per session between the 2 cohorts. Conclusion: Patients who underwent their first PVP with an ANVCFV score > 8.5 points may exhibit an increased chance of suffering from new VCFs. Key words: Vertebral compression fracture, percutaneous vertebroplasty, newly developed, risk factors, risk score system, Cox regression model, accuracy, validation

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Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

10.21203/rs.3.rs-390833/v1 ◽

2021 ◽

Author(s):

Zhongcheng An ◽

Chen Chen ◽

Junjie Wang ◽

Yuchen Zhu ◽

Liqiang Dong ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Bone Cement ◽

Vertebral Compression Fracture ◽

Univariate Analysis ◽

Compression Fracture ◽

Osteoporotic Vertebral Compression Fracture ◽

Vertebral Augmentation ◽

Surgical Methods

Abstract Objective: To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF), and analyze the correlation between these factors and augmented vertebra recompression after PVA.Methods: A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to inclusion criteria. All cases meeting inclusion and exclusion criteria were divided into two groups: 82 patients in recompression group and 175 patients in non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density(BMD) during follow-up, intravertebral cleft（IVC）before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA. Results: A total of 257 patients from 353 patients were included in this study. The follow-up time was 12-24 months, with an average of (13.5±0.9) months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P<0.05). Among them, multiple factors logistic regressioin elucidated that more injected cement (P<0.001,OR=0.558) and high BMD (P=0.028, OR=0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B<0). Preoperative IVC (P<0.001, OR=3.252) and bone cement not in contact with upper or lower endplates (P=0.006, OR=2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P=0.007, OR=0.337).Conclusions: The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.

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Vertebral Augmentation for Compression Fractures Caused by Malignant Disease

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2010.0078 ◽

2010 ◽

Vol 8 (9) ◽

pp. 1095-1102 ◽

Cited By ~ 9

Author(s):

Rahul Rastogi ◽

Trusharth Patel ◽

Robert A. Swarm

Keyword(s):

Pain Relief ◽

Bone Cement ◽

Vertebral Body ◽

Malignant Disease ◽

Body Height ◽

Vertebral Compression Fractures ◽

Intractable Pain ◽

Vertebral Augmentation ◽

Vertebral Body Height ◽

Compression Fractures

Vertebral compression fractures are common in malignant disease and frequently cause severe back pain. However, management of that pain with conventional medical, radiotherapy, or surgical modalities is often inadequate. Vertebral augmentation techniques, such as vertebroplasty and kyphoplasty, are minimally invasive techniques in which methylmethacrylate bone cement is percutaneously injected into compressed vertebral bodies. Vertebral augmentation often improves mechanical stability of compressed vertebrae, provides pain relief, and may prevent progression of vertebral collapse. Kyphoplasty may provide increased chance for vertebral body height restoration, but the clinical importance of slight change in vertebral body height is unclear. Vertebral augmentation can be used in conjunction with other treatment modalities, and associated pain relief may improve patient tolerance of needed antitumor therapies, such as radiation therapy. Vertebral augmentation is generally very well tolerated, and complications associated with bone cement extravasation beyond the vertebral body have rarely been reported. Because it often provides good to excellent relief of otherwise intractable pain and is generally well tolerated, vertebral augmentation is becoming a first-line agent for management of painful vertebral compression fractures, especially in the setting of malignant disease.

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Percutaneous kyphoplasty for osteoporotic vertebral compression fractures via unilateral versus bilateral approach

10.21203/rs.3.rs-18059/v1 ◽

2020 ◽

Author(s):

Wenye Yao ◽

Bin Zhang ◽

Qi Lai ◽

Song Gao ◽

Runsheng Guo

Keyword(s):

Bone Cement ◽

Operative Time ◽

Cement Leakage ◽

Leakage Rate ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Bilateral Approach ◽

Unilateral Group

Abstract Objective To evaluate the efficacy of percutaneous kyphoplasty (PKP) for thoracolumbar osteoporotic vertebral compression fractures (OVCFs) via unilateral versus bilateral approach. Methods All patients who underwent PKP surgery for OVCFs in our hospital between June 2016 and December 2018 were included in this study. The pedicles were divided into two groups according to the manner of vertebral body puncture, which were as follows: unilateral pedicle puncture group (unilateral group, n=47) and bilateral pedicle puncture group (bilateral group, n=39).The operative time, amount of cement perfusion, correction angle of kyphosis, pain score before and after surgery, and leakage rate of bone cement were evaluated in all patients. The average follow-up was 19 months (range 13-34 months). Results The average age of patients who met the inclusion criteria, but not the exclusion criteria, was 76 years, and a total of 121 vertebral bodies were studied. There were 7 cases of postoperative bone cement leakage (unilateral group, 14.9%) and 6 cases of postoperative bone cement leakage (bilateral groups, 15.4%). There were differences in operative time and amount of cement perfusion between the two groups were statistically significant (P<0.05). There was no significant increase in age, body mass index, pain index during follow-up, treatment outcome, correction angle of kyphosis, and cement leakage rate between the two groups (P>0.05). Moreover, there was no significant difference in sex and bone cement leakage rate between the two groups by Pearson x 2 test (P>0.05). Conclusion Patients with OVCFs could obtain similar satisfactory clinical results via both unilateral and bilateral PKP approaches. However, the unilateral PKP approach is more advantageous as it has a shorter operative time, requires lesser cement volume, causes minimal trauma, is less costly, and results in lesser complications than the bilateral approach.

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Comparison of Percutaneous Vertebroplasty and Percutaneous Curved Vertebroplasty for Osteoporotic Vertebral Compression Fractures: Distribution of Bone Cement and Complication

10.21203/rs.3.rs-136112/v1 ◽

2020 ◽

Author(s):

Li Fan Jie ◽

Li Yang ◽

Wang Yan Jie ◽

Du YiBin

Keyword(s):

Bone Cement ◽

Vertebral Fractures ◽

Percutaneous Vertebroplasty ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Anterior Edge ◽

Significant Difference ◽

Medical University

Abstract Purpose: To evaluate the clinical efficacy and complications of percutaneous curved vertebroplasty in treatment of osteoporotic vertebral compression fractures.Methods: Patients with single vertebral osteoporotic vertebral compression fractures were selected. The patients were divided into Percutaneous curved vertebroplasty group and Percutaneous vertebroplasty group.Distribution and leakage of bone cement and recovery of the height of the anterior edge of the injured vertebra were observed. VAS and ODI were assessed preoperatively 1 day and 1 year postoperatively. Postoperative follow-up was conducted for 1 year to observe the occurrence of adjacent vertebral fractures. The trial was approved by the Ethics Committee of the Third Affiliated Hospital of Anhui Medical University. Results: Compared with the percutaneous vertebroplasty group, distribution of bone cement was more uniform and satisfactory, the leakage rate of bone cement was lower in the percutaneous curved vertebroplasty group. Both the visual analogue scale score and Oswestry disability index of the two groups at 1 day and I year after surgery were significantly improved compared with those before surgery (P < 0.05). There was no significant difference in VAS and ODI. The height of the anterior edge of the injured vertebral body of the two groups improved significantly(P < 0.05), and there was no significant difference between the two groups . There was no significant difference in the incidence of adjacent vertebral fractures between the two groups..Conclusion: The results show that PCVP has beneficial to the uniform distribution of bone cement in the fracture vertebrae and reduce the leakage of bone cement.

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Vertebroplasty Using Calcium Triglyceride Bone Cement (Kryptonite™) for Vertebral Compression Fractures

Interventional Neuroradiology ◽

10.15274/inr-2014-10060 ◽

2014 ◽

Vol 20 (5) ◽

pp. 576-582 ◽

Cited By ~ 4

Author(s):

Gianluigi Guarnieri ◽

Mario Tecame ◽

Roberto Izzo ◽

Pasquale Vassallo ◽

Angela Sardaro ◽

...

Keyword(s):

Bone Cement ◽

Pain Syndrome ◽

Successful Outcome ◽

Vertebral Compression Fractures ◽

Compression Fractures ◽

Radiographic Outcomes ◽

One Year ◽

The One ◽

Venous Leakage

This study assessed the one-year clinical and radiographic outcomes, in terms of pain-relief, vertebral re-fracture and complications, after vertebroplasty (VP) using a new osteoconductive cement (calcium triglyceride bone cement - Kryptonite™ bone cement, Doctors Research Group Inc., Southbury, CT, USA) to treat osteoporotic vertebral compression fractures. Sixteen consecutive osteoporotic patients (12 women and four men, mean age 68+/-10.5) were treated with VP using Kryptonite™ bone cement for a total of 20 vertebral fractures. All the patients complained of a pain syndrome resistant to medical therapy and all procedures were performed under fluoroscopy control with neuroleptoanalgesia using a monopedicular approach in 12 patients and bipedicular approach in four patients. All patients were studied by MR and MDCT and were evaluated with the visual analogue scale (VAS) and the Oswestry disability index (ODI) before treatment and at one and 12 months after the procedure. A successful outcome was observed in 80% of patients, with a complete resolution of pain. Differences in pre and post treatment VAS and ODI at one-year follow-up were significant (P<0.0001). We observed a disk and venous leakage in 66% of patients but only in one case did an asymptomatic pulmonary embolism occur during cement injection. Two cases of vertebral re-fractures at distant metamers were observed during follow-up. VP using Kryptonite bone cement is a helpful procedure that allows complete and long-lasting resolution of painful vertebral symptoms. The cost of the material is very high and the rate of disk and venous leakage is too high compared to standard cement.

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Clinical observation of two bone cement distribution modes after percutaneous vertebroplasty for osteoporotic vertebral compression fractures

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04480-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Qiujiang Li ◽

Xingxia Long ◽

Yinbin Wang ◽

Tao Guan ◽

Xiaomin Fang ◽

...

Keyword(s):

Bone Cement ◽

Clinical Efficacy ◽

Vertebral Body ◽

Percutaneous Vertebroplasty ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Cement Distribution ◽

Local Kyphosis

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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Clinical Observation of Two Bone Cement Distribution Modes After Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures

10.21203/rs.3.rs-468772/v1 ◽

2021 ◽

Author(s):

Qiujiang Li ◽

Xingxia Long ◽

Yinbin Wang ◽

Tao Guan ◽

Xiaomin Fang ◽

...

Keyword(s):

Bone Cement ◽

Clinical Efficacy ◽

Vertebral Body ◽

Percutaneous Vertebroplasty ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Cement Distribution ◽

Local Kyphosis

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 24h after the operation and last follow-up.RESULTS: The mean follow-up time was 17.54 months. 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, 24h 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 hour 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. Loss 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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