Efficacy analysis of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with kyphosis

Abstract BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) have a high incidence, which have attracted wide attention from society. However, few scholars have conducted researches on osteopenic vertebral compression fractures (osteopenic VCFs). Our research has compared the clinical and imaging effects of percutaneous kyphoplasty (PKP) and percutaneous pedicle screw fixation (PPSF) in the treatment of Osteopenic thoracolumbar vertebral compression fractures (Osteopenic VCFs).METHODS: From December 2018 to September 2020, 70 patients with osteopenic VCFs who had undergone PKP and PPSF surgeries at our medical center were reviewed retrospectively. All patients were divided into PKP group (n=38) and PPSF group (n=32). Clinical data including clinical and radiological evaluation results were performed pre- and postoperatively.RESULTS: The operation time, bleeding volume, postoperative bedtime, and hospitalization period in PKP group were lower than those in PPSF group (P<0.05). The visual analogue scale (VAS) and Oswestry Disability Index (ODI) of two groups in the last follow-up were lower than those before the operation (P<0.05). On the 3rd day after the operation, VAS and ODI in PPSF group were higher than those in PKP group (P<0.05). The anterior height of injured vertebrae (AH) of two groups was recovered compared with that before the operation. Compared with two groups in each period, there was no obvious difference in AH or the height restoration of injured vertebrae (HR) (P>0.05). The anterior height ratio of injured vertebrae (AHR) of PPSF group was higher than that of PKP group after the operation (P<0.05). The kyphosis angle (KA) in PPSF group was smaller than PKP group after the operation (P<0.05). All patients in PPSF group have achieved bony healing at the last follow-up.CONCLUTIONS: Both PPSF and PKP can achieve satisfactory clinical results in the treatment of Osteopenic VCFs. The short-term clinical effect of PKP is better than that of PPSF, but the latter has better long-term results, including the correction and maintenance of vertebral height and the acquisition of osseous fusion.

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One Approach Anterior Decompression and Fixation with Posterior Unilateral Pedicle Screw Fixation for Thoracolumbar Osteoporotic Vertebral Compression Fractures

Orthopaedic Surgery ◽

10.1111/os.12947 ◽

2021 ◽

Author(s):

Hui‐wang Wang ◽

Yong‐cheng Hu ◽

Zhan‐yong Wu ◽

Hua‐rong Wu ◽

Jian‐qing Ma ◽

...

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Anterior Decompression ◽

Compression Fractures ◽

Unilateral Pedicle Screw Fixation ◽

Unilateral Pedicle Screw

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Percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of thoracic and lumbar metastatic tumor

10.21203/rs.3.rs-624695/v1 ◽

2021 ◽

Author(s):

Xiaowei Ma ◽

Yi Zhao ◽

Jiazheng Zhao ◽

Hongzeng Wu ◽

Helin Feng

Keyword(s):

Pedicle Screw ◽

Percutaneous Vertebroplasty ◽

Screw Fixation ◽

Metastatic Tumor ◽

Pedicle Screw Fixation ◽

En Bloc ◽

Percutaneous Pedicle Screw ◽

Percutaneous Pedicle Screw Fixation ◽

En Bloc Corpectomy ◽

Pedicle Screw Loosening

Abstract Background Evaluation of the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) in the treatment of thoracic and lumbar metastatic tumor.Methods 20 patients with thoracic and lumbar metastatic tumor were treated with PPSF combined with PVP and followed up 6–25 months. Using the visual analog scale (VAS) and the Barthel Index of Activities of Daily Living (BIADL) to evaluate pain intensity and quality of life before surgery and at 7 days, 3 months, 6 months after treatment.Results In this study, a total of 20 patients were followed up for 6–25 months (mean time was 14.10 months). The VAS scores of all patients were significantly decreased, while the BIADL scores were significantly increased. No patients suffered from complications such as infection, pedicle screw loosening or PMMA oozing. Spine stability was observed in all the surviving patients during the follow-up.Conclusions PPSF combined with PVP is a potentially viable treatment for thoracolumbar metastases in patients with poor systemic condition or patients who refuse to undergo a conventional open procedure such as en bloc corpectomy, and in the presence of vertebral instability or pathological fracture without significant spinal compression.

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Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell’s Osteonecrosis

BioMed Research International ◽

10.1155/2016/3878063 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Hyeun-Sung Kim ◽

Dong-Hwa Heo

Keyword(s):

Pedicle Screw ◽

Compression Ratio ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Vertebral Height ◽

Kyphotic Angle ◽

Short Segment ◽

Compression Fractures ◽

Percutaneous Pedicle Screw ◽

Percutaneous Pedicle Screw Fixation

Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis.Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group.Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P<0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P<0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P<0.05).Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell’s osteonecrosis.

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Vertebroplasty and vertebroplasty in combination with intermediate bilateral pedicle screw fixation for OF4 in osteoporotic vertebral compression fractures: a retrospective single-Centre cohort study

BMC Surgery ◽

10.1186/s12893-019-0646-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Weiyang Zhong ◽

Xinjie Liang ◽

Xiaoji Luo ◽

Zhengxue Quan

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Group A ◽

Group B ◽

Bilateral Pedicle Screw

Abstract Background Although various studies have described the outcomes and complications of each treatment for OF 4 in osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen. This study aimed to investigate the clinical effect of OF 4 in patients with OVCFs treated with percutaneous vertebroplasty (PV) compared with PV in combination with intermediate bilateral pedicle screw fixation (IBPSF). Methods A total of 110 patients with OF 4 in OVCFs from January 2011 to December 2013 were reviewed retrospectively and divided into two groups (group A: PV, group B: PV + IBPSF). According to the guidelines of the German Society for Orthopaedics and Trauma (DGOU), OF 4 consists of 3 fracture types. The clinical and radiographic assessments were observed preoperatively, postoperatively, and during follow-up. Results The patients were followed for an average of 60.50 ± 15.20 months (group A) and 58.20 ± 17.60 months (group B) without significant differences. No significant differences were found in BMD, BMI and cement volume between the two groups, but differences were found for operation time, blood loss, and hospitalization time. The VAS and ODI scores improved better significantly at the final follow-up in group B but not in group A. Compared with the preoperative values, the postoperative kyphosis angle and loss of fractured segment height significantly improved, but the difference between the groups was significant after 3 months postoperatively. The loss of angular correction and fractured segment height in group A were greater than those in group B. A total of 15 cases of cement leakage were observed in group A and 8 cases in group B, and no complications or revision surgeries were observed in either group. Thirteen new fractures occurred (11 in group A and 2 in group B), which was significant. Conclusion PV with IBPSF could provide effective restoration and maintenance of fractured segment height and segment alignment as well as a lower rate of complications of OF 4 in OVCFs.

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Thoracic spondylotic myelopathy presumably caused by diffuse idiopathic skeletal hyperostosis in a patient who underwent decompression and percutaneous pedicle screw fixation

SAGE Open Medical Case Reports ◽

10.1177/2050313x20987796 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2098779

Author(s):

Shota Miyoshi ◽

Tadao Morino ◽

Haruhiko Takeda ◽

Hiroshi Nakata ◽

Masayuki Hino ◽

...

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Diffuse Idiopathic Skeletal Hyperostosis ◽

Pedicle Screw Fixation ◽

Vertebral Bone ◽

Bone Bridge ◽

Percutaneous Pedicle Screw ◽

Bilateral Lower Limb ◽

Upper Thoracic ◽

Percutaneous Pedicle Screw Fixation

A 74-year-old man developed bilateral lower limb spastic paresis. He was diagnosed with thoracic spondylotic myelopathy presumably caused by mechanical stress that was generated in the intervertebral space (T1-T2) between a vertebral bone bridge (C5-T1) due to diffuse idiopathic skeletal hyperostosis after anterior fixation of the lower cervical spine and a vertebral bone bridge (T2-T7) due to diffuse idiopathic skeletal hyperostosis in the upper thoracic spine. Treatment included posterior decompression (T1-T2 laminectomy) and percutaneous pedicle screw fixation at the C7-T4 level. Six months after surgery, the patient could walk with a cane, and the vertebral bodies T1-T2 were bridged without bone grafting. For thoracic spondylotic myelopathy associated with diffuse idiopathic skeletal hyperostosis, decompression and percutaneous pedicle screw fixation are effective therapies.

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Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series

The Surgery Journal ◽

10.1055/s-0036-1594248 ◽

2016 ◽

Vol 02 (04) ◽

pp. e131-e138 ◽

Cited By ~ 2

Author(s):

Nitin Agarwal ◽

Phillip Choi ◽

Raymond Sekula

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Burst Fracture ◽

Pedicle Screw Fixation ◽

Thoracolumbar Burst Fracture ◽

Thoracolumbar Burst Fractures ◽

Percutaneous Pedicle Screw ◽

Percutaneous Pedicle Screw Fixation

Introduction Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation. Methods Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course. Results The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification and Severity Scale score was 4 (range 2 to 9). All patients had proper screw placement and uneventful postoperative courses given the severity of their individual traumas. Five of seven patients were reached for long-term follow-up of greater than 28 months. Six of seven patients had excellent pain control and stability at their last follow-up. One patient required revision surgery for noncatastrophic hardware failure. Conclusion Percutaneous pedicle screw fixation for the treatment of unstable thoracolumbar burst fracture may provide patients with durable benefits and warrants further investigation.

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