Thoracolumbar flexion dysfunction and thoracolumbar compression fracture in postmenopausal women: a single-center retrospective study

Abstract Objective To investigate whether thoracolumbar flexion dysfunctions increase the risk of thoracolumbar compression fractures in postmenopausal women. Methods The records of postmenopausal women with thoracolumbar vertebral compression fractures and without vertebral compression fractures were surveyed. Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compared between the groups. Chi-squared tests, unpaired t-tests, Spearman, and Mann–Whitney U were used to assess the group characteristics and proportions. The relationship between the risk of fracture and the difference of Cobb’s angle of thoracolumbar segment (DCTL) was evaluated by logistic regression. DCTL was calculated by subtracting thoracolumbar Cobb’s angles (TLCobb’s) from thoracolumbar hyperflexion Cobb’s angles (TLHCobb’s). Quantitative computed tomography (QCT) values and spinal osteoarthritis (OA) of postmenopausal women in the two groups were compared. Results 102 of 312 were enrolled to the study group of postmenopausal women with the fracture, and 210 of 312 were enrolled to the control group of postmenopausal women without the fracture. There were significant differences in QCT values and spinal OA including disc narrowing (DSN) and osteophytes (OPH) between the two groups (p < 0.001 for all four). The risk of thoracolumbar compression fractures in the postmenopausal women with DCTL ≤ 8.7° was 9.95 times higher (95% CI 5.31–18.64) than that with > 8.7° after adjusting for age, BMI, and QCT values. Conclusion Low DCTL may be a risk factor of thoracolumbar compression fractures in postmenopausal women, and a DCTL ≤ 8.7° can be a threshold value of thoracolumbar compression fractures.

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Dynamic spine hyperflexion is related to vertebral compression fractures in postmenopausal women

10.21203/rs.3.rs-379183/v1 ◽

2021 ◽

Author(s):

ZhiRong Zheng ◽

Tian Tian ◽

WeiBo Liu ◽

XiangYu Wang ◽

Meng Gao ◽

...

Keyword(s):

Postmenopausal Women ◽

Demographic Data ◽

Quantitative Computed Tomography ◽

Vertebral Compression Fractures ◽

Control Group ◽

Study Group ◽

Retrospective Case ◽

Compression Fractures ◽

Osteoporotic Vertebral Fractures ◽

Fracture Prevalence

Abstract Background: Previous studies on osteoporotic vertebral fractures are usually based on the neutral posture of the spine; however, the fractures are usually associated with the curvature of the spine. Therefore, we aimed to ascertain the relationship between vertebral compression fractures and thoracolumbar hyperflexion Cobb angles (TLHCobb) and determine the clinical cut-off of the TLHCobb angle.Methods: In this retrospective case-control study, TLHCobbs were collected from 154 postmenopausal women with thoracolumbar fractures (study group) and 310 postmenopausal women with lumbar instability or spondylolisthesis (control group). Demographic data, clinical data, and quantitative computed tomography (QCT) findings were compared between the groups. Chi-squared tests and unpaired t-tests were used to assess the group characteristics and proportions. Logistic regression was used to examine the association between vertebral compression fractures and TLHCobb.Results: Fracture prevalence was higher in the higher TLHCobb study group than that in the control group [OR = 2.81 (2.15–3.67)] after adjusting for age, BMI, and QCT findings. TLHCobbs at and > 20.05° were associated with an increased fracture prevalence and ORs of 2.79 (1.82–4.27) and 4.83 (3.24–7.20), respectively. TLHCobb and QCT values differed between the study and control groups (p < 0.001 for both). There were no significant differences in body mass index (BMI), disk height, or coronal TLCobb between the two groups.Conclusion: There was an association between the prevalence of vertebral compression fractures and TLHCobbs in postmenopausal women, and a TLHCobb > 20.05° can be an indicator of vertebral fracture.

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Efficacy of calcitonin for treating acute pain associated with osteoporotic vertebral compression fracture: an updated systematic review

CJEM ◽

10.1017/cem.2019.490 ◽

2020 ◽

Vol 22 (3) ◽

pp. 359-367 ◽

Cited By ~ 1

Author(s):

Emily Boucher ◽

Brianna Rosgen ◽

Eddy Lang

Keyword(s):

Adverse Events ◽

Acute Pain ◽

Salmon Calcitonin ◽

Meta Analysis ◽

Compression Fracture ◽

Cochrane Library ◽

Vertebral Compression Fractures ◽

Control Group ◽

Number Needed To Treat ◽

Compression Fractures

ABSTRACTObjectiveAcutely painful osteoporotic vertebral compression fractures are associated with hospitalization and mortality in older adults. Calcitonin may be an alternative to opioid or nonopioid analgesia for treating acute compression fracture pain in emergency and primary care settings. This review summarizes pain, function, and adverse events associated with calcitonin.MethodsWe searched MEDLINE, EMBASE, The Cochrane Library, clinical trials registries, and reference lists of included studies. Eligible studies evaluated the effect of synthetic calcitonins (salmon, eel, and human) on pain scores in adults ≥60 years old with a recent atraumatic compression fracture. Two reviewers screened studies, extracted data, and allocated bias in duplicate. A random effects meta-analysis evaluated standard mean difference (SMD) and heterogeneity (I2).ResultsOf 1,198 articles screened, 11 were included (9 in the meta-analysis). Treatment lasted from 14 days to 6 months. Pain was lower in the salmon calcitonin group (100–200 IU IM or NAS, daily) than the control group with high certainty of evidence at week 1 (SMD, -1.54; 95% confidence interval [CI], -2.02 – -1.06; I2 = 52%), representing a number needed to treat of two. The analgesic efficacy of salmon calcitonin at 4 weeks was unclear due to substantial heterogeneity. There was low certainty evidence that calcitonin did not increase the overall risk of adverse events, including nausea and vomiting (risk ratio, 2.10; 95% CI, 0.87–5.08; I2 = 47%).ConclusionsCalcitonin is beneficial and appears safe for treating acute pain associated with compression fractures. Further studies may improve the certainty of evidence.

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The analgesic efficacy of extracorporeal shock wave combined with percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women

BioMedical Engineering OnLine ◽

10.1186/s12938-021-00894-4 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Xiaowei Liu ◽

Hui Wang ◽

Yang Zhang ◽

Mingling Wang ◽

Yujin Qiu ◽

...

Keyword(s):

Shock Wave ◽

Postmenopausal Women ◽

Percutaneous Vertebroplasty ◽

Reduction Rate ◽

Compression Fracture ◽

Analgesic Efficacy ◽

Small Sample ◽

Compression Fractures ◽

Extracorporeal Shock Wave ◽

Post Operation

Abstract Background To explore the analgesic efficacy of extracorporeal shock wave (ESW) combined with percutaneous vertebroplasty (PVP) after reduction in overextension position in the treatment of osteoporotic thoracolumbar compression fractures in postmenopausal women. Methods The data of postmenopausal women with osteoporotic thoracolumbar compression fracture admitted in our department from January 2017 to October 2019 were analyzed retrospectively. They were divided into groups of unipedicular percutaneous kyphoplasty (U-PKP n = 21), bipedicular PKP (B-PKP n = 20), and ESW combined with PVP after reduction in overextension position (EP-PVP n = 18). The improvement of pain and vertebral height in three groups was compared. Results Postoperative compression rate and Cobb angle of vertebral fractures in the three groups were all lower than those before surgery, and the differences between pre-operation and post-operation were statistically significant (P < 0.05). The visual analog scale (VAS) and Oswestry dysfunction index (ODI) scores of the three groups decreased significantly after the operation (P < 0.05). The ODI scores of the EP-PVP group in the third months after the operation were significantly improved compared with the other two groups, and the difference was statistically significant (P < 0.05). Conclusions In our small-sample study, all three treatment schemes can treat osteoporotic compression fracture of thoracolumbar vertebrae in postmenopausal women, relieve pain, and improve quality of life. ESW combined with PVP after reduction in overextension position could achieve a good vertebral reduction rate and improve kyphosis, and may reduce the application of analgesic drugs.

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Risk factors for thoracolumbar pain following percutaneous vertebroplasty for osteoporotic vertebral compression fractures

Journal of International Medical Research ◽

10.1177/0300060521989468 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052198946

Author(s):

Xiaoguang Fan ◽

Sha Li ◽

Xianshang Zeng ◽

Weiguang Yu ◽

Xiangzhen Liu

Keyword(s):

Risk Factors ◽

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Vertebral Compression Fractures ◽

Mineral Density ◽

Eligibility Criteria ◽

Compression Fractures ◽

Logistic Analysis ◽

The Difference ◽

Poor Outcomes

Objective To explore possible risk factors for poor outcomes following percutaneous vertebroplasty (PV) for painful osteoporotic compression fractures of thoracolumbar vertebra. Methods This was a retrospective review of data from patients who underwent PV at our institution over a ten-year period to evaluate the association between possible risk factors and thoracolumbar pain (T11-L2). According to the difference between pre- and post-operative visual analogue scale (VAS) scores for pain, patients were separated into poor relief (PR; <4) and good relief (GR; ≥4) of pain. Results Of the 750 patients identified, 630 (PR group, n =310; GR group, n = 320) fulfilled the eligibility criteria. Multivariate binary logistic analysis showed that bone mineral density (BMD), >2 fractured vertebral bodies, maldistribution of bone cement, <5 ml bone cement injected into a single vertebral body and thoracolumbar fascia injury prior to surgery were independent risk factors associated with thoracolumbar pain following PV. Conclusion Although prospective controlled studies are required to confirm our results, this review suggests that the above factors should be taken into account when selecting patients for PV.

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Clinical Application of a 3D-Printed Positioning Module and Navigation Template for Percutaneous Vertebroplasty

Surgical Innovation ◽

10.1177/15533506211062404 ◽

2021 ◽

pp. 155335062110624

Author(s):

Jing Yang ◽

Penghui Ni ◽

Lina Zhang ◽

Zhanxin Lu ◽

Dapeng Liu ◽

...

Keyword(s):

Percutaneous Vertebroplasty ◽

Operation Time ◽

Vertebral Compression Fractures ◽

Control Group ◽

Compression Fractures ◽

Intraoperative Fluoroscopy ◽

3D Printed ◽

Vas Scores ◽

Experimental Group ◽

Navigation Template

Background This study aimed to evaluate a personalized 3D-printed percutaneous vertebroplasty positioning module and navigation template based on preoperative CT scan data that was designed to treat patients with vertebral compression fractures caused by osteoporosis. Methods A total of 22 patients with vertebral compression fractures admitted to our hospital were included in the study. Positioning was performed with the new 3D-printed positioning module, and the navigation template was used for patients in the experimental group, and the traditional perspective method was used for patients in the control group. The experimental group consisted of 11 patients, 2 males and 9 females, with a mean age of 67.27 ± 11.86 years (range: 48 to 80 years), and the control group consisted of 11 patients, 3 males and 8 females, with a mean age of 74.27 ± 7.24 years (range: 63 to 89 years). The puncture positioning duration, number of intraoperative fluoroscopy sessions, and preoperative and postoperative visual analog scale (VAS) scores were statistically analyzed in both groups. Results The experimental group had shorter puncture positioning durations and fewer intraoperative fluoroscopy sessions than the control group, and the differences were statistically significant (P < .05). There were no significant differences in age or preoperative or postoperative VAS scores between the two groups (P > .05). Conclusions The new 3D-printed vertebroplasty positioning module and navigation template shortened the operation time and reduced the number of intraoperative fluoroscopy sessions. It also reduced the difficulty in performing percutaneous vertebroplasty and influenced the learning curve of senior doctors learning this operation to a certain degree.

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FEATURES OF THE DIAGNOSIS OF UNCOMPLICATED COMPRESSION FRACTURE OF THE THORACIC SPINE IN CHILDREN

Российский педиатрический журнал ◽

10.18821/1560-9561-2017-20-5-307-311 ◽

2019 ◽

Vol 20 (5) ◽

pp. 307-311

Author(s):

Yakhya M. Yakhyaev ◽

M. I. Izrailov ◽

V. N. Merkulov ◽

A. M. Aliskandiev ◽

T. Ya. Yakhyaeva

Keyword(s):

Thoracic Spine ◽

Compression Fracture ◽

Diagnostic Process ◽

Vertebral Compression Fractures ◽

Thoracic Vertebrae ◽

Healthy Children ◽

X Ray ◽

Compression Fractures ◽

Fractures In Children ◽

Ct And Mri

X-ray diagnostics of compression fractures of bodies of the thoracic vertebrae in children not seldom causes great difficulties due to the fact that even in healthy children vertebrae have a number of features, particularly, the wedge shape. For the purpose of differential diagnosis there was performed chest X-ray examination of the thoracic vertebrae in healthy children and cases after the compression damage. The wedge index and the disk coefficient for various segments of the thoracic spine were calculated. The diagnostic efficiency of radionuclide studies was estimated to reaches 79%. The useof highly informative modern medical techniques (CT and MRI) in the diagnosis of vertebral compression fractures in children allows accurately and timely make the diagnosis and determine the condition of the surrounding tissues. Based on the analysis of medical records, radiographs, identification of options of radionuclide, CT and MRI studies, there was elaborated an algorithm for the diagnosis of compression fractures of vertebrae, which allowed optimize the diagnostic process. There are determined advantages of this algorithm.

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Effect of Rheumatoid Arthritis on Volumetric Bone Mineral Density and Bone Geometry, Assessed by Peripheral Quantitative Computed Tomography in Postmenopausal Women Treated with Bisphosphonates

The Journal of Rheumatology ◽

10.3899/jrheum.110579 ◽

2012 ◽

Vol 39 (6) ◽

pp. 1215-1220 ◽

Cited By ~ 5

Author(s):

SYMEON TOURNIS ◽

VASILIOS SAMDANIS ◽

SAVAS PSARELIS ◽

CHRYSA LIAKOU ◽

JULIA ANTONIOU ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Computed Tomography ◽

Bone Mineral Density ◽

Postmenopausal Women ◽

Bone Mineral ◽

Quantitative Computed Tomography ◽

Bone Geometry ◽

Peripheral Quantitative Computed Tomography ◽

Volumetric Bone Mineral Density ◽

Mineral Density

Objective.To investigate the effect of rheumatoid arthritis (RA) on volumetric bone mineral density (vBMD) and bone geometry in postmenopausal women treated with bisphosphonates.Methods.Fifty-three postmenopausal women with RA and 87 control subjects, comparable in terms of age, body mass index, and years since menopause, underwent peripheral quantitative computed tomography (pQCT) of the nondominant tibia.Results.At 4% (trabecular site), trabecular bone mineral content (BMC) and vBMD (p < 0.001) were lower in the RA group, while trabecular area was comparable. At 38% (cortical site), cortical BMC (p < 0.01), area (p < 0.05), and thickness (p < 0.001) were lower in the RA group, whereas vBMD was comparable. Endosteal circumference was higher (p < 0.05), whereas periosteal circumference was comparable, indicating cancellization of cortical bone. In the RA group, muscle area was lower (p < 0.001), while at 14% polar stress strength index was significantly lower (p < 0.01) in patients with RA, indicating impairment of bone mechanical properties.Conclusion.RA is associated with negative effects on both cortical and cancellous bone in postmenopausal women treated with bisphosphonates. Cortical geometric properties are also adversely affected mainly by increased endosteal circumference, whereas trabecular geometric properties are generally preserved.

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Therapeutic effect of percutaneous kyphoplasty combined with anti-osteoporosis drug on postmenopausal women with osteoporotic vertebral compression fracture and analysis of postoperative bone cement leakage risk factors: a retrospective cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1499-9 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 2

Author(s):

Shuaihao Huang ◽

Xiaowen Zhu ◽

Dan Xiao ◽

Jianxiong Zhuang ◽

Guoyan Liang ◽

...

Keyword(s):

Risk Factors ◽

Zoledronic Acid ◽

Bone Cement ◽

Postmenopausal Women ◽

Therapeutic Effect ◽

Compression Fracture ◽

Cement Leakage ◽

Control Group ◽

Height Ratio ◽

Vertebral Height

Abstract Background The purpose of this study is to explore the therapeutic effect of percutaneous kyphoplasty (PKP) combined with anti-osteoporosis drug, zoledronic acid, on postmenopausal women with osteoporotic vertebral compression fracture (OVCF) and to perform an analysis of postoperative bone cement leakage risk factors. Methods A total of 112 OVCF patients, according to therapeutic regimens, were divided into control group (n = 52, treated with PKP) and observation group (n = 60, treated with PKP and zoledronic acid injection). Results Postoperative tumor necrosis factor-α and interleukin-6 levels were significantly decreased in the two groups, compared with those before treatment (both P < 0.05); bone mineral density (BMD), serum bone gla protein (BGP), and vertebral height ratio of injured vertebrae were significantly increased, and procollagen type I N-terminal propeptide (PINP), Cobb angle, visual analogue scale/score (VAS), and Oswestry disability index (ODI) were significantly decreased compared with those before treatment (all P < 0.05). There were significantly higher changes in difference value of BMD, PINP, BGP, vertebral height ratio of injured vertebrae, Cobb angle, VAS, and ODI levels and significantly better therapeutic effect in the observation group than those in the control group (all P < 0.05). Multivariate logistic regression analysis showed that the use of zoledronic acid, vertebral height ratio of injured vertebrae, and ODI were independent factors affecting the therapeutic effect, and that the dosage of bone cement, and peripheral vertebrae wall damage were independent risk factors causing postoperative bone cement leakage. There were no significant differences in postoperative bone cement leakage rate between the two groups. Conclusions Peripheral vertebrae wall damage and the dosage of bone cement are independent risk factors causing bone cement leakage in OVCF patients treated with PKP. PKP combined with zoledronic acid has an improvement effect on the condition of postmenopausal women with OVCF and reduces the inflammation and pain in patients, which is beneficial to clinical treatment.

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Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture

Medicina ◽

10.3390/medicina55080426 ◽

2019 ◽

Vol 55 (8) ◽

pp. 426 ◽

Cited By ~ 1

Author(s):

Cornelis ◽

Joly ◽

Nouri-Neuville ◽

Ben-Ammar ◽

Kastler ◽

...

Keyword(s):

Vertebral Compression Fracture ◽

Clinical Performance ◽

Compression Fracture ◽

Treatment Decision ◽

Definitive Treatment ◽

Vertebral Compression Fractures ◽

Compression Fractures ◽

Good Pain Relief ◽

Severe Back Pain ◽

And Function

Background and objectives: Tumor-related vertebral compression fractures often result in severe back pain as well as progressive neurologic impairment and additional morbidities. The fixation of these fractures is essential to obtain good pain relief and to improve the patients’ quality of life. Thus far, several spine implants have been developed and studied. The aims of this review were to describe the implants and the techniques proposed to treat cancer-related vertebral compression fractures and to compile their safety and efficacy results. Materials and Methods: A systematic MEDLINE/PubMed literature search was performed, time period included articles published between January 2000 and March 2019. Original articles were selected based on their clinical relevance. Results: Four studies of interest and other cited references were analyzed. These studies reported significant pain and function improvement as well as kyphotic angle and vertebral height restoration and maintain for every implant and technique investigated. Conclusions: Although good clinical performance is reported on these devices, the small numbers of studies and patients investigated draw the need for further larger evaluation before drawing a definitive treatment decision tree to guide physicians managing patients presenting with neoplastic vertebral compression fracture.

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S289 – Effect of Pterygopalatine Injection on EBL in Sinus Surgery

Otolaryngology ◽

10.1016/j.otohns.2008.05.465 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P171-P171

Author(s):

Michael Bublik ◽

Jean A Eloy ◽

Brian Tse ◽

Ruiz Jose W ◽

Roy R Casiano

Keyword(s):

Statistical Significance ◽

Demographic Data ◽

Pterygopalatine Fossa ◽

Sinus Surgery ◽

Control Group ◽

Simple Method ◽

Injection Group ◽

Greater Palatine Foramen ◽

Estimated Blood Loss ◽

The Difference

Objectives We compare estimated blood loss (EBL) during functional endoscopic sinus surgery between patients receiving transoral pterygopalatine fossa and transnasal infiltration (combined) to patients receiving only transnasal infiltration. Variables such as CT-stage, revision surgery, presence of polyps, and operative time are considered. Methods Injection with 1% lidocaine with 1:100,000 epinephrine was performed through the greater palatine foramen and transnasally in the “combined” study group (20 patients) and only transnasally in the control group (22 patients). Charts, operative reports, and CT scans were reviewed and demographic data as well as pertinent information were collected. Patients were followed up and all additional procedures and events were recorded. Results 12 females and 8 males, average age of 48, underwent combined injections; 16 males and 6 females (average age of 50) were in the control group. Using the Wilcoxon/ Kruskal-Wallis Tests (Rank Sums), mean EBL calculated for the combined injection group was 347ml and 493ml for the transnasal injection group (CI 0.95, p=0.093). Average ratio of EBL over OR time was 2.89 ml/min for the combined group and 4.11 ml/min for the control group. We also compare EBL between groups in patients with polyps, endoscopic and CT stage, and revision cases. No complications were reported. Conclusions Combined injection of the pterygopalatine fossa and nasal cavity appears to be a safe and relatively simple method to decrease EBL during sinus surgery, but initial data analysis shows that the difference did not reach statistical significance.

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