scholarly journals Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shou-qian Dai ◽  
Rong-qing Qin ◽  
Xiu Shi ◽  
Hui-lin Yang
Keyword(s):  
Blood Loss ◽  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
Significant Difference ◽  
Neurologically Intact ◽  
Operation Cost

Abstract Background Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD. Methods The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference. Conclusion PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, while PVP has the advantages of shorter operation time, less radiation volume and operation cost.

scholarly journals Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

2020 ◽  
Author(s):  
Shouqian Dai ◽  
Rongqing qin ◽  
xiu shi ◽  
Hui-lin Yang
Keyword(s):  
Blood Loss ◽  
Bone Cement ◽  
Clinical Efficacy ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
Significant Difference ◽  
Neurologically Intact

Abstract Background: Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD.Methods: The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results: All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference.Conclusion: PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, and can be recommended as a preferred treatment options for KD.

scholarly journals Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

2020 ◽  
Author(s):  
Jian-Zhong Chang ◽  
Ming-Jian Bei ◽  
Dong-Ping Shu ◽  
Cheng-Jun Sun ◽  
Ji-Bin Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Cement Leakage ◽  
Significant Difference ◽  
Kummell’S Disease ◽  
Adjacent Vertebra ◽  
Kümmell’S Disease ◽  
Time Point

Abstract Background Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease. Methods The clinical data that 56 cases of OVCF treated with either PVP (28 cases) or PKP (28 cases) and met the selection criteria from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, BMD, VAS, ODI, imaging measurement indexes before surgery between the two groups showed no significant difference (all P>0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy. Results The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebra between the two groups (all P > 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 d, 1 year and 2 years after surgery than before surgery (all P <0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P> 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P <0.05, respectively) and decreased significantly with time (all P <0.05), But there was not significant difference between the two groups at any time point (all P> 0.05). Conclusion Both PVP and PKP can achieve similar effects in the treatment of Kümmell's disease. Because the cost, operation time, blood loss, radiation exposure and surgical procedure of PVP are less than those of PKP, PVP has more clinical priority value.

scholarly journals Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

2020 ◽  
Author(s):  
Jian-Zhong Chang ◽  
Ming-Jian Bei ◽  
Dong-Ping Shu ◽  
Cheng-Jun Sun ◽  
Ji-Bin Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Bone Cement ◽  
Clinical Efficacy ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Cement Leakage ◽  
Significant Difference ◽  
Kummell’S Disease ◽  
Kümmell’S Disease ◽  
Time Point

Abstract Background Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease. Methods The clinical data that 56 cases of Kümmell's disease treated with either PVP (28 cases) or PKP (28 cases) from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, bone mineral density (BMD), visual analogue scale (VAS), Oswestry disability index (ODI), imaging measurement indexes before surgery between the two groups showed no significant difference (all P>0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy. Results The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebrae between the two groups (all P> 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 day, 1 year and 2 years after surgery than before surgery (all P <0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P> 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P <0.05, respectively) and decreased significantly with time (all P <0.05), But there was not significant difference between the two groups at any time point (all P> 0.05). Conclusion Both PVP and PKP can achieve similar effects in the treatment of Kümmell's disease. Because the cost, operation time, blood loss, radiation exposure and surgical procedure of PVP are less than those of PKP, PVP has more clinical priority value.

scholarly journals Efficacy and radiographic analysis of oblique lumbar interbody fusion for degenerative lumbar spondylolisthesis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Menghui Wu ◽  
Jia Li ◽  
Mengxin Zhang ◽  
Xufeng Ding ◽  
Dongxu Qi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Radiographic Analysis ◽  
Lumbar Interbody Fusion ◽  
Intraoperative Blood Loss ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Oblique Lumbar Interbody Fusion ◽  
Lumbar Spondylolisthesis

Abstract Background To compare the clinical efficacy and radiographic analysis of oblique lumbar interbody fusion (OLIF) and traditional posterior lumbar interbody fusion (PLIF) in treating degenerative lumbar spondylolisthesis (DLS). Methods Grade I DLS patients admitted to the Third Hospital of Hebei Medical University were retrospectively reviewed. In sum, 78 patients that underwent OLIF (n = 31) and PLIF (n = 47) treatment of DLS were recruited. Clinical data including clinical and radiological evaluations were collected pre-operatively and at each follow-up. Japanese Orthopaedic Association (JOA) scores, Oswestry Disability Index (ODI), lumbar lordosis (LL), disc height (DH), and fusion rates were compared between the OLIF and PLIF groups. Results The operation time for both groups was 131.3 ± 14.6 min in the OLIF group and 156.9 ± 37.4 min in the PLIF group (P < 0.001). The intraoperative blood loss was 163.6 ± 63.9 ml in the OLIF group and 496.8 ± 122.6 ml in the PLIF group (P < 0.001). The length of the surgical incision was 4.63 ± 0.57 cm in the OLIF group and 11.83 ± 1.37 cm in the PLIF group (P < 0.001). The number of intraoperative and post-operative complications for both groups was 10 in the OLIF group and 20 in the PLIF group. Significant clinical improvement (P < 0.05) was observed in JOA scores and ODI when comparing pre-operative evaluation and final follow-up. After statistical analysis, there was no significant difference in the preoperative JOA scores between the two groups. There was no significant difference when comparing pre-operative LL and DH for either group. Post-operative reexamination was improved as compared to pre-operative exams. And the improvement of DH was better in the OLIF group as compared to the PLIF group. Conclusions For DLS patients, both OLIF and PLIF can achieve good results. Furthermore, OLIF displays marked advantages including smaller surgical incisions, shorter anesthesia times, decreased intraoperative blood loss, and post-operative pain better relieved.

Total Shoulder Arthroplasty After Previous Arthroscopic Surgery for Glenohumeral Osteoarthritis: A Case-Control Matched Cohort Study

2021 ◽  
pp. 036354652110064
Author(s):  
Philip-C. Nolte ◽  
Bryant P. Elrick ◽  
Justin W. Arner ◽  
T.J. Ridley ◽  
Thomas E. Woolson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Patient Satisfaction ◽  
Blood Loss ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Revision Arthroplasty ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
Glenohumeral Osteoarthritis

Background: When comprehensive arthroscopic management (CAM) for glenohumeral osteoarthritis fails, total shoulder arthroplasty (TSA) may be needed, and it remains unknown whether previous CAM adversely affects outcomes after subsequent TSA. Purpose: To compare the outcomes of patients with glenohumeral osteoarthritis who underwent TSA as a primary procedure with those who underwent TSA after CAM (CAM-TSA). Study Design: Cohort study; Level of evidence, 3. Methods: Patients younger than 70 years who underwent primary TSA or CAM-TSA and were at least 2 years postoperative were included. A total of 21 patients who underwent CAM-TSA were matched to 42 patients who underwent primary TSA by age, sex, and grade of osteoarthritis. Intraoperative blood loss and surgical time were assessed. Patient-reported outcome (PRO) scores were collected preoperatively and at final follow-up including the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), shortened version of Disabilities of the Arm, Shoulder and Hand (QuickDASH), 12-Item Short Form Health Survey Physical Component Summary (SF-12 PCS), visual analog scale, and patient satisfaction. Revision arthroplasty was defined as failure. Results: Of 63 patients, 56 of them (19 CAM-TSA and 37 primary TSA; 88.9%) were available for follow-up. There were 16 female (28.6%) and 40 male (71.4%) patients with a mean age of 57.8 years (range, 38.8-66.7 years). There were no significant differences in intraoperative blood loss ( P > .999) or surgical time ( P = .127) between the groups. There were 4 patients (7.1%) who had failure, and failure rates did not differ significantly between the CAM-TSA (5.3%; n = 1) and primary TSA (8.1%; n = 3) groups ( P > .999). Additionally, 2 patients underwent revision arthroplasty because of trauma. A total of 50 patients who did not experience failure (17 CAM-TSA and 33 primary TSA) completed PRO measures at a mean follow-up of 4.8 years (range, 2.0-11.5 years), with no significant difference between the CAM-TSA (4.4 years [range, 2.1-10.5 years]) and primary TSA (5.0 years [range, 2.0-11.5 years]) groups ( P = .164). Both groups improved significantly from preoperatively to postoperatively in all PRO scores ( P < .05). No significant differences in any median PRO scores between the CAM-TSA and primary TSA groups, respectively, were seen at final follow-up: ASES: 89.9 (interquartile range [IQR], 74.9-96.6) versus 94.1 (IQR, 74.9-98.3) ( P = .545); SANE: 84.0 (IQR, 74.0-94.0) versus 91.5 (IQR, 75.3-99.0) ( P = .246); QuickDASH: 9.0 (IQR, 3.4-27.3) versus 9.0 (IQR, 5.1-18.1) ( P = .921); SF-12 PCS: 53.8 (IQR, 50.1-57.1) versus 49.3 (IQR, 41.2-56.5) ( P = .065); and patient satisfaction: 9.5 (IQR, 7.3-10.0) versus 9.0 (IQR, 5.3-10.0) ( P = .308). Conclusion: Patients with severe glenohumeral osteoarthritis who failed previous CAM benefited similarly from TSA compared with patients who opted directly for TSA.

scholarly journals Clinical Efficacy of Different Bone Cement Distribution Patterns in Percutaneous Kyphoplasty: A Retrospective Study

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. E409-E416
Author(s):  
Tianming Zou
Keyword(s):  
Bone Cement ◽  
Clinical Outcomes ◽  
Distribution Patterns ◽  
Cement Leakage ◽  
Percutaneous Kyphoplasty ◽  
Significant Difference ◽  
Cement Distribution ◽  
Group A ◽  
The Mean

Background: Bone cement distribution patterns in percutaneous kyphoplasty (PKP) is the key factor in keeping the vertebral stabilization and curative effect. However, the same cement volume can result in different bone cement distribution patterns and can thereby lead to different clinical outcomes. Therefore we investigated associations between cement distribution patterns and the occurrence rates of recompression in cemented vertebrae after PKP for patients with osteoporotic vertebral compression fractures (OVCFs). Objectives: The study focuses attention on the influence of compact and dispersive cement distribution patterns in PKP for patients with OVCFs. Study Design: A retrospective cohort study. Setting: An affiliated people’s hospital of a university. Methods: According to different cement distribution patterns, patients were assigned to 4 groups. The demographic data, radiographic data, and clinical outcomes were compared between the 4 groups. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were evaluated before and 2 days after PKP. Moreover, the relationships between bone cement and clinical outcomes were analyzed. The epidemiologic data, clinical outcomes, and complications of the 4 groups were assessed. Comparisons of the radiologic and clinical results of the 4 groups were made pre- and postoperatively. Anterior height of fractured vertebrae (AH), the kyphotic Cobb angle, and the volumetric cubage index of the fractured vertebrae were measured. Results: A total of 104 subjects were retrospectively analyzed and followed up (median age, 75.01 ± 8.42 years; age range, 56–94 years). The mean procedure duration was 61.26 ± 23.05 minutes (range, 30–140 minutes). The mean follow-up was 12.1 ± 2.2 months (range, 2–15 months). Statistically, there was no significant difference in terms of gender, age, body mass index, and bone mineral density (P > 0.05). The incidence of cement leakage was significantly lower in group A than those in the other groups. The total amount of bone cement injected into 104 cases (104 vertebral bodies in total) was 848.5 mL, and the amount of bone cement injected into a single vertebral body was 7.94 ± 1.38 mL. The amount of bone cement injection in each group was the lowest (6.80 ± 1.66 mL) in group D, followed by (7.94 ± 1.38 mL) group B, and the highest (8.96 ± 1.68 mL) in group A, with a statistically significant difference between the 4 groups (P < 0.05). No serious complications were observed during the follow-up periods. The AH and Cobb angle improved significantly for the 4 groups (P < 0.05). The VAS score decreased from 3.55 ± 0.54, 3.53 ± 0.65, 3.40 ± 0.58, and 3.40 ± 0.66 preoperatively to 0.18 ± 0.39, 0.23 ± 0.41, 0.20 ± 0.40, and 0.15 ± 0.36 at 48 hours postoperatively. The ODI score dropped from 35.65 ± 4.54, 36.45 ± 4.72, 34.12 ± 4.86, and 35.65 ± 4.34 preoperatively to 15.47 ± 1.32, 15.32 ± 1.34, 15.23 ± 1.26, and 15.73 ± 1.17 at 48 hours postoperatively. Limitations: Our estimation of the vertebral body volume is imprecise. In addition, the number of subjects with OVCFs was small in this retrospective study. The volume of the fractured vertebra was not calculated accurately. Conclusions: Significant associations between cement distribution patterns and bone cement leakage affected the clinical outcome in patients after PKP. A higher incidence of bone cement leakage was observed in patients with treated vertebrae exhibiting a single-dispersive or single-compact pattern. Key words: Percutaneous kyphoplasty, osteoporotic vertebral compression fracture, bone cement distribution patterns

scholarly journals Treatment of Osteoporotic Vertebral Compression Fracture by Precise Injection and Staged Perfusion of Bone Cement Kyphoplasty: A Comparison Study

2021 ◽  
Author(s):  
Jian Huang ◽  
Jun Huang ◽  
Ming Chen ◽  
Zongbo Zhou ◽  
Zhifu Lu ◽  
...  
Keyword(s):  
Bone Cement ◽  
Vertebral Body ◽  
Compression Fracture ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Control Group ◽  
The Third ◽  
Significant Difference ◽  
Experimental Group

Abstract Study design: Retrospective cohort study.Objective: To explore the clinical effect of precise injection and staged perfusion of bone cement kyphoplasty in the treatment of osteoporotic vertebral compression fracture.Methods: 110 patients treated with kyphoplasty from January 2020 to June 2021 were selected and divided into experimental group (n = 55) and control group (n = 55) according to different surgical methods. The experimental group was treated with precise injection and staged perfusion of bone cement kyphoplasty, while the control group was treated with traditional kyphoplasty. The operation time,intraoperative blood loss and amount of bone cement injection were recorded. The pain improvement was evaluated by VAS score. The operation effect were evaluated by anterior height of injured vertebral body, middle height of injured vertebral body, wedge angle of injured vertebral body and distribution grade of bone cement. The incidence of surgical complications was evaluated by the number of bone cement leakage.Results: There were no significant difference in the operation time, intraoperative blood loss and the amount of bone cement injection in two groups. There were no significant difference in VAS scores at 2h, 4h and 48h after operation between the two groups (P > 0.05); There were no significant difference in the ratio of anterior height of injured vertebral body between the two groups on the third day after operation and the last follow-up (P > 0.05); There were no significant difference in the ratio of middle height of injured vertebral body between the two groups on the third day after operation and the last follow-up (P > 0.05); There were no significant difference in wedge angle of injured vertebral body between the two groups at the third day after operation and the last follow-up (P > 0.05). There was significant difference in the distribution grade of bone cement between the two groups (P < 0.01); There was significant difference in the number of bone cement leakage between the two groups (P < 0.01), In cases of bone cement leakage, there were 1 case of type C, 1 case of type S in the experimental group, 7 cases of type C and 2 cases of type S in the control group.Conclusion: Precise injection and staged perfusion of bone cement kyphoplasty in the treatment of osteoporotic vertebral compression fracture can effectively reduce surgical complications and improve surgical efficacy.

Comparison of percutaneous vertebroplasty with a side-hole push rod and conventional percutaneous vertebroplasty for the treatment of OVCFs

2020 ◽  
Author(s):  
Zhengshuai Jin ◽  
Hailong Zhou ◽  
Xuefei Yan ◽  
Chunming Wang ◽  
Yuanqing Mao ◽  
...  
Keyword(s):  
Bone Cement ◽  
Operative Time ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Postoperative Results ◽  
Injection Volume ◽  
Side Hole ◽  
Cement Injection

Abstract ObjectiveThe aim of this study was to compare the clinical efficacy of percutaneous vertebroplasty with a side-hole push rod (modified PVP) and conventional PVP in treating osteoporotic vertebral compression fractures (OVCFs).Materials and methodsThis study included 69 patients with 1-level OVCFs. Perioperative indicators, including the operative time, cement injection volume, cement leakage rate, and distribution of cement in the fractured area, were analysed. The visual analogue scale (VAS) and Oswestry disability index (ODI) were administered pre- and postoperatively.ResultsNo significant differences were observed in the operative time or cement injection volume between the two groups (p > 0.05). The total diffusion score of bone cement in the PVP group was significantly lower than that in the modified PVP group (p < 0.05). Compared with the conventional PVP group, the modified PVP group had a significantly lower VAS score at 3 days postoperatively (p < 0.05). There were no differences in the VAS or ODI scores between the two groups at the last follow-up (p > 0.05). Bone cement leakage was observed in 15 cases in the conventional PVP group (15/32) and in 9 cases in the modified PVP group (9/37).ConclusionThe modified version of PVP provides sufficient cement to fill the fractured area and is associated with a lower incidence of cement leakage and undesired postoperative results than is conventional PVP, indicating that modified PVP is a safe and effective new technique for the treatment of OVCFs.

scholarly journals Analysis of the effect of percutaneous vertebroplasty in the treatment of thoracolumbar Kümmell’s disease with or without bone cement leakage

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ya-Ping Xiao ◽  
Ming-Jian Bei ◽  
Cui-Qing Yan ◽  
Jian-Zhong Chang
Keyword(s):  
Visual Analogue Scale ◽  
Cobb Angle ◽  
Bone Cement ◽  
Analogue Scale ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Mineral Density ◽  
Kummell’S Disease ◽  
Kümmell’S Disease

Abstract Background Bone cement leakage is a major complication in the treatment of percutaneous vertebroplasty for Kümmell’s disease, and the focus of close attention during the surgery. The purpose of this article was to investigate the clinical outcomes of Kümmell’s disease treated by percutaneous vertebroplasty with or without bone cement leakage. Methods A total of 64 patients with Kümmell’s disease from December 2016 to February 2018 treated by percutaneous vertebroplasty were included in the study. After the treatment, 32 cases were respectively divided into two groups according to X-ray examination of bone cement leakage: leakage group and non-leakage group. Preoperative course, age, sex, bone mineral density, damaged segment, anterior vertebral height, vertebral compression rate, Cobb angle, visual analogue scale and Oswestry dysfunction index were compared between the two groups. After surgery, the amount of bone cement injected, operation time, adjacent vertebral refracture rate, visual analogue scale, Oswestry dysfunction index, the recovery value of vertebral anterior height and the improvement value of Cobb angle were compared between the two groups. Results The course, age and Cobb angle of the leakage group were significantly greater than those of the non-leakage group (P< 0.05, respectively). The height of anterior vertebral margin and bone mineral density in the leakage group were significantly lower than those in the non-leakage group (P< 0.05, respectively). The two groups were followed up for at least 24 months. The amount of bone cement injected was significantly greater in the leakage group than in the non-leakage group (P=0.000). Visual analogue scale and Oswestry dysfunction index of the two groups on the second day after surgery and at the last follow-up were significantly lower than these before surgery (P< 0.05, respectively), but there was no significant difference between the two groups. In the leakage group, the recovery value of the anterior edge height of the injured vertebra and the improvement value of the Cobb angle on the second day after surgery and at the last follow-up were significantly improved compared with the non-leakage group (P< 0.05, respectively). Conclusion Percutaneous vertebroplasty is an effective and minimally invasive treatment for Kümmell’s disease. The leakage group had longer course, older age, more serious kyphotic deformity, vertebral compression and osteoporosis, and higher amount of bone cement injected than these of the non-leakage group. However, there were not significant differences in the rate of adjacent vertebral refractures, visual analogue scale and Oswestry dysfunction index between the two groups. Therefore, the bone cement leakage does not affect the surgical effect.

scholarly journals Open vs. Percutaneous Pedicle Screw Insertion for Thoracolumbar Traumatic A3 and A4 AO Fractures - 18-Months Follow-Up

2017 ◽  
Vol 36 (04) ◽  
pp. 207-212
Author(s):  
Flávio Romero ◽  
Rodolfo Vieira ◽  
Bruno Ancheschi
Keyword(s):  
Blood Loss ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Statistical Significance ◽  
Column Height ◽  
Intraoperative Blood Loss ◽  
Percutaneous Screw Fixation ◽  
Significant Difference ◽  
The Mean

Purpose To compare the efficacy and safety of the percutaneous screw fixation (PSF) and the open pedicle screw fixation (OPSF) on thoracolumbar (TL) fracture. Methods Sixty-four adult patients with TL vertebral fractures who underwent open or percutaneous posterior short-segment transpedicular screw fixation between January of 2013 and September of 2015 were retrospectively reviewed. All patients underwent clinical, radiological and quality of life follow-up for at least 18 months. Results There was no significant difference in age, gender, time between injury and surgery, and preoperative percentage of anterior column height, preoperative sagittal regional Cobb angle, or kyphotic angle of fractured vertebra between these two groups (p > 0.05). There was significantly less intraoperative blood loss in the PSF (87.6 ± 24.6 mL) than in the OPSF group (271.4 ± 142.6 mL) (p < 0.05). The mean surgery time was 62 minutes (range 42–130 minutes) for open and 58 minutes (range 35 to 128 minutes) for percutaneous screw fixation. The surgery time was shorter in the PSF group, but with no statistical significance (p > 0.05). The mean Oswestry disability index (ODI) scores after 18-months were 23.12 ± 8.2 for the PSF and 24.12 ± 9.2 for the OPSF group, without any statistical significance (p > 0.05). Conclusion Both open and percutaneous screw fixations are safe and effective. The percutaneous techniques significantly reduced the intraoperative blood loss compared with the open techniques.

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