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

BMC Surgery ◽  
2019 ◽  
Vol 19 (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.

scholarly journals Comparison Between Percutaneous Kyphoplasty And Percutaneous Vertebroplasty In Terms of The Efficacy For Osteoporotic Vertebral Compression Fractures: A Meta-Analysis

2021 ◽  
Author(s):  
Hai-Tao Zhu ◽  
De-Gang Ding ◽  
Shui Wang ◽  
Yu-Long Zhu
Keyword(s):  
Meta Analysis ◽  
Operation Time ◽  
The Elderly ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Beneficial Effects ◽  
Radiographic Outcomes ◽  
Vas Scores

Abstract Background & Aim: Osteoporotic vertebral compression fractures (OVCFs) are acknowledged as common occurred fractures among humans, especially for the elderly population. The minimally invasive percutaneous methods such as kyphoplasty as well as vertebroplasty have been valid and effective tools in terms of reducing clinical problems, which are associated with more beneficial effects as compared to traditional methods such as open surgery or conservative treatment. Hence, we conducted the current meta-analysis in order to gather updated evidence available for the systematical assessment of the clinical and radiographic outcomes of VP in comparison of KP.Methods: Publications on comparison kyphoplasty versus vertebroplasty in treatment of OVCFs were collected. After rigorous and thorough review of quality, we extracted the data on the basis of eligible trials, which analyzed the summary hazard ratios (HRs) of the endpoints of interested.Results: Totally, our inclusion criteria involved five studies. 561subjects involving 334 patients received VP and 227 patients received KP were included, of which patients receiving KP or VP failed to show any significant differences in the visual analog scale (VAS) scores (MD =-0.02, 95% CI -0.40 – 0.35; P = 0.91),and the risk of cement leakage (OR =1.60, 95% CI 0.82 – 3.12; P = 0.17). Nevertheless, the Oswestry Disability Index (ODI) scores (MD =-1.56, 95% CI -2.39 – -0.73; P = 0.0002), the injected cement volume (MD =-0.40, 95% CI -0.77 – -0.04; P = 0.03) and the operation time (MD =-9.67, 95% CI -11.55 – -7.80; P ＜0.00001) in VP group were linked to markedly lower trend in comparison of KP group with significant statistical difference.Conclusion: The present meta-analysis controls the acceptable level of the efficacy across the involved trials. The VP had ODI scores, the injected cement volume and the operation time exerted several advantages in this meta-analysis. Yet, VP failed to show benefits in terms of the VAS scores and cement leakage in comparison of KP therapy. Given the combined results of our study, the optimal treatment for patient harboring OVCFs should be determined by further high-quality and multi-center RCTs along with longer follow-ups as well as larger sample size.

scholarly journals Percutaneous curved vertebroplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures

2019 ◽  
Vol 47 (6) ◽  
pp. 2424-2433 ◽  
Author(s):  
Yonghong Cheng ◽  
Yiming Liu
Keyword(s):  
Bone Cement ◽  
Cement Leakage ◽  
Leakage Rate ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Injection Volume ◽  
X Ray ◽  
Compression Fractures ◽  
Cement Injection ◽  
Vas Scores

Objective To evaluate the clinical efficacy of percutaneous curved vertebroplasty (PCVP) in treating thoracic and lumbar osteoporotic vertebral compression fractures (OVCFs). Methods Patients with thoracolumbar OVCFs were recruited and randomly divided into three treatment groups: PCVP, unilateral percutaneous vertebroplasty (PVP) or bilateral PVP. Bone cement dispersion in the fractured vertebrae was observed. Surgery duration, X-ray frequency, bone cement injection volume, bone cement leakage rate and visual analogue scale (VAS) scores were recorded. Results Among 78 patients included, surgery duration and X-ray frequency were significantly lower in the PCVP and unilateral PVP groups versus bilateral PVP group. Bone cement injection volume was significantly higher in the bilateral PVP group (6.3 ± 1.4 ml) versus unilateral PVP (3.5 ± 1.1 ml) and PCVP groups (4.6 ± 1.2 ml). VAS scores at 24 h and 3 months post-surgery were significantly decreased versus baseline in all groups. The bone cement leakage rate was lowest in the PCVP group (8.8% [3/34 patients]). Conclusion PCVP is associated with reduced trauma, less complicated surgery with shorter duration, fewer X-rays, lower complication rate, and quicker postoperative recovery versus unilateral and bilateral PVP.

scholarly journals Analysis of two minimally invasive procedures for osteoporotic vertebral compression fractures with intravertebral cleft: a systematic review and meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hongyu Wei ◽  
Chunke Dong ◽  
Yuting Zhu ◽  
Haoning Ma
Keyword(s):  
Meta Analysis ◽  
Operation Time ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Controlled Trials ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Vertebral Height ◽  
Compression Fractures ◽  
Short And Long Term

Abstract Background A systematic review and meta-analysis to assess the pros and cons of percutaneous vertebroplasty (PVP) versus kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral cleft (IVC) including all available evidence from controlled trials. Methods Databases including Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched to identify relevant studies comparing PVP and PKP for OVCFs with IVC. The outcomes mainly included visual analog scale (VAS), Oswestry Disability Index (ODI), local kyphotic angle (LKA), rate of vertebral height (VH%), and adverse events. Results Nine studies enrolling 688 patients were eligible for meta-analysis. The results indicated no significant differences between the two groups in the short-and long-term VAS, ODI, LKA, or VH% (P > 0.05). Compared with PVP, PKP was associated with significantly longer operation time (P < 0.05), higher cost (P > 0.05), and more injected cement volume (P < 0.05). In terms of adverse events, PKP has a lower risk of cement leakage (P < 0.05), while with no significant difference in adjacent-level fracture rates (P > 0.05). Conclusion The two procedures have similar short- and long-term pain relief, functional recovery, local kyphosis correction, and vertebral height maintenance in OVCFs with IVC. PKP is superior to PVP for the injected cement volume, and lower cement leakage rate, however, with longer operation time, more fluoroscopy times, and higher cost. Further randomized controlled trials (RCTs) should be conducted to confirm these results.

scholarly journals Vesselplasty versus vertebroplasty in the treatment of osteoporotic vertebral compression fractures with posterior wall rupture

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110663
Author(s):  
Kai Xu ◽  
Ya-Ling Li ◽  
Song-Hua Xiao
Keyword(s):  
Pain Relief ◽  
Bone Cement ◽  
Spinal Canal ◽  
Operation Time ◽  
Posterior Wall ◽  
Cement Leakage ◽  
Leakage Rate ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Osteoporotic Compression Fractures

Objective This study was performed to compare the effectiveness and safety of vesselplasty versus vertebroplasty in the treatment of osteoporotic compression fractures with posterior wall rupture. Methods Patients who underwent treatment of a single osteoporotic vertebral compression fracture with posterior wall rupture from January 2016 to February 2020 were retrospectively reviewed. They were divided into a vesselplasty group (n = 17) and a vertebroplasty group (n = 43). Pain relief, radiographic outcomes, and bone cement leakage were compared between the two groups. Results There were no significant differences in the operation time, postoperative pain relief, vertebral compression recovery, or local Cobb angle improvement between the two groups. However, the overall bone cement leakage rate (29.4% vs. 67.4%) and spinal canal leakage rate (0.0% vs. 30.2%) were significantly lower in the vesselplasty group than vertebroplasty group. Conclusions Vesselplasty offers similar pain relief and vertebral compression recovery but lower spinal canal leakage compared with vertebroplasty. Vesselplasty is thus a better option than vertebroplasty for patients with osteoporotic compression fractures with posterior wall rupture.

scholarly journals A Tentative Study of Individual Puncture Path of PVP/ PKP in Treating OVCFs

2021 ◽  
Author(s):  
Sheng Guo ◽  
Changming Xiao ◽  
Chenglong Wang ◽  
Sen Li
Keyword(s):  
Operation Time ◽  
Clinical Work ◽  
The Elderly ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Surgical Methods ◽  
Significant Difference ◽  
Vas Scores ◽  
Better Than

Abstract Background: The prior objective of this study is to discuss individualized puncture path of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of the elderly with severe osteoporotic vertebral compression fractures (OVCFs).Previous studys have compared the clinical efficacy and safety of PVP and PKP. Based on their research results, we will make a further investigation about this two main operations in treating OVCFs and propose a set of original and feasible puncture plan in clinical work, which will improve efficiency and safety of PKP and PVP.Methods: We searched all the articles related to PVP and PKP in treating OVCFs on medicine database. Issues of the selected journals published from 1999 to 2020 were hand-searched by us, including experimental or review articles. Combining conclusions of these researches and clinical cases of our department, we are forged to find more common and preferred treatments for patients with OVCFs under different situations.Results: Most of thees studies revealed that there was no significant difference in relieving the back pain and improving the quality of patients’ life between PVP and PKP surgeries, which generally based on the VAS scores and Oswestry disability index(ODI) scores. However, PKP has a lower rate of bone cement leakage and incidence of adjacent vertebrae fracture than the PVP. Restoring the vertebral height and local kyphotic angle corrections of PKP are much better than that of PVP. On the other hand, more operation time, higher cost and rate of re-surgery of PKP should also be taken into consideration when we make better choice for patients. Therefore, we are forged to find individual methods for patients who are diagnosed as OVCFs.Conclusions: Both the two types of operation can significantly relieve the pain of the patients ,reduce the risk of occurring complication and mortality after OVCFs. There is no so-called best treatment for patients between PVP and PKP. We should take the comprehensive actual conditions into account when choosing surgical methods for patients with OVCFs, which is absolutely vital to us. However, individual puncture path is beneficial for us to make operations including both PKP and PVP.

scholarly journals Intravertebral Vacuum Cleft and Its Varied Locations within Osteoporotic Vertebral Compression Fractures: Effect on Therapeutic Efficacy

2017 ◽  
Vol 6 (20;6) ◽  
pp. E979-E986
Author(s):  
Xiaobing Jiang
Keyword(s):  
Therapeutic Efficacy ◽  
Body Height ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Number Of Patients ◽  
Significant Difference

Background: Previous studies have reported a high incidence of re-collapse of the augmented vertebrae after percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral vacuum cleft (IVC) during long-term followup. Previous IVC might be considered an important predisposing factor for re-collapse, but the prior studies could not find a significant correlation. Objective: To determine the incidence and distribution characteristics of IVCs and to further assess IVCs in their varied locations. To assess the long-term therapeutic efficacy of PVA for OVCFs with IVC. Study Design: A retrospective cohort study. Setting: Department of spinal surgery, an affiliated hospital of a medical university. Methods: A retrospective review was performed on 594 patients who underwent PVA to treat OVCFs from January 2010 to December 2013. Eighty-two patients with the IVC sign were enrolled in the study. The follow-up period was a minimum of 2 years. The difference between IVC and non-IVC patients was compared. Comparisons of the radiological and clinical findings at varied IVC locations were made pre-operatively and post-operatively (immediate, at one year, and at 2 years). Results: IVC incidence correlated with older patient age and severe demineralization. Other baseline parameters showed no significant differences. The rate of cement leakage and vertebral fracture was significantly lower in the IVC groups than in the non-IVC groups intraoperatively. There was no significant difference in the incidence of cement leakage or adjacent vertebral fractures between the 3 IVC groups. In the immediate postoperative period, all patients benefited from significant improvement in vertebral body height and kyphotic angle correction. However, significant re-collapse was observed at the 2-year post-operative followup for the IVC patients when compared to the non-IVC patients. Among the 3 IVC groups, the most severe re-collapse was observed with inferior endplate IVCs. Superior endplate IVCs and IVCs extending to both endplates demonstrated only mild re-collapse at the 2-year follow-up. Limitation: Due to the infrequency of this process, the number of patients with IVCs was small. Conclusion: PVA treatment was initially effective in all patients with OVCFs. However, significant re-collapse of the augmented vertebrae with IVCs, especially those with inferior endplate IVCs, was found with long-term follow-up.

scholarly journals Creation of a planned or central-clefted puncture combined with a second puncture during vertebroplasty to treat osteoporotic vertebral compression fractures with large clefts

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Chi Li ◽  
Yang Zhou ◽  
Min-yu Zhu ◽  
Yu Wang ◽  
Zheng-mao Zhang ◽  
...  
Keyword(s):  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Pain Scores ◽  
Significant Difference ◽  
Dispersion Patterns ◽  
Group A ◽  
Group B

Abstract Background Cemented vertebrae frequently re-fracture after vertebroplasty to treat osteoporotic vertebral compression fractures (OVCFs) with large clefts. We compared the efficacy of planned and central-clefted puncture, both followed by a second puncture, as treatments for OVCFs with large clefts. Methods We retrospectively studied 38 patients. 18 of whom underwent planned puncture (group A) and 20 central-clefted puncture (group B). A second puncture was performed when the initially injected cement was restricted to the cleft. We recorded a visual analog scale (VAS) pain scores, vertebral kyphotic angles (KAs), and compression ratios (CRs) preoperatively and at 2 days and 6 months postoperatively. We recorded the cement dispersion patterns and complications. Results Second punctures succeeded in 15/18 and 7/20 patients of groups A and B, respectively. At 2 days postoperatively, the VAS score, KA, and CR were significantly better than the preoperative values (P < 0.01); no significant difference was found between the two groups (P > 0.05). At the 6-month follow-up, all scores were poorer than at 2 days postoperatively (all P < 0.05), significantly more so in group B than group A (P < 0.05). Significant differences in terms of the cement dispersion patterns, and the cemented vertebral re-fracture and cement leakage rates, were observed between the two groups (all P < 0.05). Conclusion The two-puncture techniques were initially effective when treating large-clefted OVCFs. However, compared to the central-clefted puncture, the planned puncture improved the success rate of the second puncture, allowed better cement dispersion, and reduced the incidence of vertebral re-fracture during follow-up.

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

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.

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

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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