scholarly journals Multilevel percutaneous vertebroplasty: safety, efficacy and long-term outcomes

2021 ◽  
Vol 8 (1) ◽  
pp. 54
Author(s):  
Sibasankar Dalai ◽  
Aravind V. Datla
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Invasive Procedure ◽  
Cost Effective ◽  
Cement Leakage ◽  
Effective Procedure ◽  
Vertebral Compression Fractures ◽  
Rapid Restoration ◽  
Reduced Mobility

<p><strong>Background:</strong> The pain in vertebral compression fractures is severe, leading to reduced mobility and quality of life. Percutaneous vertebroplasty is a minimally invasive procedure for treating various spinal pathologies. This study evaluated the usefulness and safety of multilevel PVP (two to three vertebrae) in managing VCF.</p><p><strong>Methods:</strong> This retrospective study evaluated 59 vertebral levels in 28 patients with VCF who had been operated on for multilevel PVP (two to three levels). There were 22 females and six males, and their ages ranged from 36 to 79 years, with a mean age of 68.95 years. We had injected two levels in 25 patients and three levels in 3 patients. The visual analogue scale was used for pain intensity measurement, and plain X-ray films, computed tomography scan and magnetic resonance imaging was used for radiological assessment. The mean follow-up period was 13.8 months (range, 11-19).</p><p><strong>Results:</strong> Significant pain improvement was recorded in 26 patients (92.85%). More remarkable improvement in pain was noticed in the immediate postoperative period than in the subsequent follow-ups. Asymptomatic bone cement leakage anteriorly and into the disk spaces in two patients. Isolated anterior leakage has occurred in one patient. There was no encounter of pulmonary embolism.</p><p><strong>Conclusions:</strong> Multilevel PVP for the treatment of VCF is a safe and effective procedure that can significantly reduce pain and improve patient condition without any significant morbidity. It is considered a cost-effective procedure allowing a rapid restoration of patient mobility.</p><p> </p>

scholarly journals Long-term evaluation of pain reduction after vertebroplasty and kyphoplasty

2021 ◽  
Vol 10 (7) ◽  
pp. 205846012110289
Author(s):  
Christoph B Hackbarth ◽  
Thomas J Vogl ◽  
Nagy Naguib ◽  
Moritz H Albrecht ◽  
Philipp L von Knebel-Doeberitz
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Pain Reduction ◽  
Long Term Results ◽  
Outcome Analysis ◽  
Vertebral Compression Fractures ◽  
Imaging Data ◽  
Cross Sectional ◽  
Vas Scores

Background Various studies have been made about the most effective and safest type of treatment for vertebral compression fractures (VCFs). Long-term results are needed for qualitative evaluation. Purpose The purpose of the study is to evaluate the effectiveness of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) procedures for VCFs. Materials and Methods Forty-nine patients who received either PVP or PKP between 2002 and 2015 returned a specially developed questionnaire and were included in a cross-sectional outcome analysis. The questionnaire assessed pain development by use of a visual analog scale (VAS). Imaging data (CT scans) were retrospectively analyzed for identification of cement leakage. Results Patients’ VAS scores significantly decreased after treatment (7.0 ± 3.4 => 3.7 ± 3.4), ( p < 0.001). The average pain reduction in patients treated with PVP was −3.3 ± 3.8 ( p < 0.001) (median −3.5) and −4.0 ± 3.9 ( p < 0.001) (median −4.5) in patients treated with PKP. Fifteen Patients (41.7%) receiving PVP and four patients (30.7%) receiving PKP experienced recurrence of pain. Cement leakage occurred in 10 patients (22.73%). Patients with cement leakage showed comparable VAS scores after treatment (6.8 ± 3.5 => 1.4 ± 1.6), ( p = 0.008). Thirty-nine patients reported an increase in mobility (79.6%) and 41 patients an improvement in quality of life (83.7%). Conclusion Pain reduction by means of PVP or PKP in patients with VCFs was discernible over the period of observation. Percutaneous vertebroplasty and PKP contribute to the desired treatment results. However, the level of low pain may not remain constant.

scholarly journals Comparison of vertebroplasty using directional versus straight needle

2015 ◽  
Vol 4 (3) ◽  
pp. 204798161556926
Author(s):  
Wai Cheong Soon ◽  
Ryan K Mathew ◽  
Jake Timothy
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Prospective Trial ◽  
Invasive Procedure ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Clinical Complications ◽  
Midline Crossing ◽  
Student’S T ◽  
Straight Needle ◽  
Steerable Needle

Background Percutaneous vertebroplasty is a minimally invasive procedure that can be performed to treat pain and immobility associated with vertebral compression fractures. Previous studies have shown that a single injection can achieve adequate fill across the midline of the vertebral body. Purpose To compare the radiological outcomes of using a novel steerable needle with using a conventional, straight needle in unipedicular vertebroplasty. Material and Methods Data were collected from 19 patients who were operated at our institute between 1 September 2010 and 31 March 2011. Outcomes were measured in terms of radiological evidence of midline crossing of cement. The available pre- and postoperative pain scores and complications were reviewed. Student’s t-test was used to compare mean cement projection across the midline in both groups with P < 0.05 considered to be statistically significant Results Mean fill across the midline was significantly greater with the steerable needle (58%) compared with the straight needle (35%) ( P = 0.046). Cement leakage was higher with the steerable needle (44% versus 30%); however no clinical complications were reported in either group. Conclusion Percutaneous vertebroplasty using a directional needle is an excellent example of advancement and refinement in spinal surgery without increased clinical risk. Our results indicate that the novel technique can potentially provide better radiological outcomes when compared with a straight needle. A larger, randomized multicenter prospective trial would be valuable in confirming these findings.

scholarly journals INNOVATIVE STRATEGIES AS A PROSPECTIVE DIRECTION OF PLANNING ACTIVITIES OF HOTEL AND RESTAURANT ENTERPRISES OF UKRAINE

2021 ◽  
Author(s):  
Ljudmila Neshchadym ◽  
Svetlana Тymchuk
Keyword(s):  
Internal State ◽  
Cost Effective ◽  
Restaurant Industry ◽  
Product Portfolio ◽  
Innovative Strategies ◽  
Reducing Costs ◽  
Fierce Competition ◽  
High Level

The article monitors and analyzes the main strategies for the development of hotel and restaurant enterprises and, accordingly, increase their efficiency and competitiveness; the process of organization and economic planning of hotel and restaurant enterprises has been improved. It is investigated that the enterprises of hotel and restaurant industry of Ukraine partially provide the necessary quality indicators for the provided services, and this is the reason for the insufficient level of competitiveness of services in the domestic market and in European countries. An urgent problem of planning and organizing the activities of hotel and restaurant enterprises is the use of innovative strategies and areas of long-term development to increase the level of competitiveness and quality of services provided. This will intensify innovation processes in Ukraine in the field of services. Innovative strategies and promising areas of development of hotel and restaurant enterprises are extremely important in the management of hotel and restaurant complexes. Innovative strategies in the hotel and restaurant industry are cost-effective and feasible provided a high level of profitability, improving the service process, expanding the range of services, reducing costs, increasing competitiveness, improve and optimize the work of all hotel or restaurant services. The application of innovative strategies in the process of hotel and restaurant enterprises allows them to compete in the field of service. In conditions of fierce competition and rapidly changing market conditions, it is very important not only to focus on the internal state of affairs of the enterprise, but also to develop a long-term strategy. Economic activity requires constant innovation. All services offered by hotel and restaurant enterprises must be introduced in modern innovative ways. This is the basis for successful business, maintaining a consistently high level of competitiveness and improving the quality of service. The selection of the optimal innovation strategy for a hotel or restaurant company is carried out by its management based on the analysis of key factors that characterize its condition and the state of the product portfolio.

EVALUATION OF SHORT AND LONG TERM BENEFITS/SIDE EFFECTS OF CEMENT AUGMENTATION IN PATIENTS WITH NON INFECTIVE PATHOLOGICAL OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES

2020 ◽  
pp. 44-48
Author(s):  
Abhay Singh ◽  
Rahul Gupta ◽  
Shachi Shachi
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Pain Relief ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Cement Augmentation ◽  
Vertebral Compression Fractures ◽  
Hybrid Technique

BACKGROUND: Vertebral compression fracture usually occurs in old age population with osteoporosis. Due to severity of pain, quality of life becomes very poor. During the study period 67 patients fullling the eligibility cri METHODS: teria underwent vertebroplasty/ kyphoplasty/ cement augmented screw xation/ hybrid procedures were included. Short term and long term benets /side effects were evaluated in all patients. Patients were evaluated on visual analogue score and modied ranking scale. RESULTS: Vertebroplasty was performed in 26(38.8%) whereas kyphoplasty, cement augmented screw xation and hybrid procedure were performed in 18(26.8%), 17(25.4%) and 6(9.0%) respectively. Signicant pain relief occurred in all patients which were evaluated by Visual Analogue Scale. Quality of life also improved which was evaluated with Modied Rankin Scale. In our study, complications which occurred were local cement leak, hematoma formation, infection in 8 (11.9%), 3(4.5%) and 2(3.0%) patients respectively. Use of biological cement has revolutionized CONCLUSION: the management of vertebral compression fracture. Both vertebroplasty and kyphoplasty procedures which are minimal invasive, almost cure the non infective pathological fractures with instant pain relief and very low procedure related morbidity. In cases requiring xation, cement augmentation signicantly improves the purchase of the screw and makes the construct more reliable. Hybrid technique helps to prevent extensive long level xation.

Percutaneous vertebroplasty with high- versus low-viscosity bone cement for osteoporotic vertebral compression fractures

2020 ◽  
Author(s):  
Feng Miao ◽  
Xiaojun Zeng ◽  
Wei Wang ◽  
Zhou Zhao
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Body Height ◽  
Cement Leakage ◽  
High Viscosity ◽  
Vertebral Compression Fractures ◽  
Vertebral Body Height ◽  
Low Viscosity ◽  
Pain Scores ◽  
Group A ◽  
Group B

Abstract Background: There is no consensus on the best choice between high- and low-viscosity bone cement for percutaneous vertebroplasty (PVP). This study aimed to compare the clinical outcomes and leakage between three cements with different viscosities in treating osteoporotic vertebral compression fractures.Methods: This is a prospective study comparing patients who were treated with PVP: group A (n = 99, 107 vertebrae) with high-viscosity OSTEOPAL V cement, group B (n = 79, 100 vertebrae) with low-viscosity OSTEOPAL V cement, and group C (n = 88, 102 vertebrae) with low-viscosity Eurofix VTP cement. Postoperative pain severity was evaluated using the visual analog scale. Cement leakage was evaluated using radiography and computed tomography.Results: There was no significant difference in the incidence of cement leakage between the three groups (group A 20.6%, group B 24.2%, group C 20.6%, P = 0.767). All three groups showed significant reduction in postoperative pain scores but did not differ significantly in pain scores at postoperative 2 days (group A 2.01 ± 0.62, group B 2.15 ± 0.33, group C 1.92 ± 0.71, P = 0.646). During the 6 months after cement implantation, significantly less reduction in the fractured vertebral body height was noticed in group B and group C than in group A (group A 19.0%, group B 8.1%, group C 7.3%, P = 0.009).Conclusions: Low-viscosity cement has comparable incidence of leakage compared to high-viscosity cement in PVP for osteoporotic vertebral compression fractures. It also can better prevent postoperative loss of vertebral body height.

The economic benefits of rehabilitation for neurological conditions

2020 ◽  
pp. 23-30
Author(s):  
Rory J. O’Connor
Keyword(s):  
Psychological Functioning ◽  
Cost Effective ◽  
Economic Benefits ◽  
Economic Evaluations ◽  
Healthcare Intervention ◽  
Effective Interventions ◽  
Neurological Conditions ◽  
Economic Analyses

Rehabilitation programmes are highly cost-effective interventions that restore people’s independence, dignity, and quality of life. In the past there was an impression that they appeared expensive, which resulted in a lack of enthusiasm to develop them by funding bodies and commissioners. However, the evidence demonstrating the long-term cost-effectiveness of rehabilitation is robust. Many people with long-term neurological conditions will live for many years after the onset of the condition and investment in their physical and psychological functioning early on will, over that person’s lifetime, will result in substantial savings. Nevertheless, calculating economic evaluations can be complicated and the correct measure must be chosen to identify the change produced by the rehabilitation intervention. These data must then be handled appropriately, and any ancillary costs included. The economic impact of the rehabilitation programme is wider than a purely healthcare intervention and will include potential earnings and reduced costs to social care. The economic analyses will also include housing, education, and vocational outcomes, and the effect of the long-term condition on family members who may have a caring role.

scholarly journals A case of multilevel percutaneous vertebroplasty for vertebral metastases resulting in temporary paraparesis

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051983508
Author(s):  
Guan Shi ◽  
Fei Feng ◽  
Chen Hao ◽  
Jia Pu ◽  
Bao Li ◽  
...  
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Spinal Nerve ◽  
Vertebral Compression Fractures ◽  
Vertebral Metastases ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Invasive Treatment ◽  
Compression Fractures ◽  
Cord Injury

Percutaneous vertebroplasty (PVP) is a minimally invasive treatment that has been widely used for the treatment of osteoporotic vertebral compression fractures and vertebral tumors. However, the maximum number of vertebral segments treated in a single PVP remains controversial. Furthermore, PVP may cause complications, including cement leakage, pulmonary embolism, bone cement toxicity, and spinal nerve-puncture injury. We report the rare case of a patient who underwent multilevel PVP for vertebral metastases, with no bone cement leakage or spinal cord injury, but who developed temporary paraparesis.

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.

Sign in / Sign up

Export Citation Format

Share Document