scholarly journals Unilateral Percutaneous Vertebroplasty For Osteoporotic Lumbar Compression Fractures: A Comparative Study Between Transverse Process Root-Pedicle Approach And Conventional Transpedicular Approach

2020 ◽  
Author(s):  
Wenwu Zhang ◽  
Shenpeng Liu ◽  
Xianhua Liu ◽  
Xiang Li ◽  
Le Wang ◽  
...  
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Transverse Process ◽  
Cement Leakage ◽  
Clinical Results ◽  
Clinical Effects ◽  
Advantages And Disadvantages ◽  
Transpedicular Approach ◽  
Distribution Type

Abstract Purpose: Percutaneous Vertebroplasty (PVP) is a routine operation for the treatment of osteoporotic lumbar compression fracture (OLCF). Because of bilateral puncture takes a long operation time and patients receive more X-ray irradiation, more and more scholars deem that the unilateral approach should be adopted. But, with conventional transpedicular approach (CTPA), the cement may asymmetrically dispersed, so some surgeons use the transverse process root-pedicle approach (TPRPA). The objective of this study is to compare the clinical results and bone cement distribution of PVP for OLCF with unilateral TPRPA and CTPA, determine the advantages and disadvantages of the two surgical options.Patients and methods: From January 2016 to June 2019, seventy-two elderly patients who underwent unilateral PVP for single-level OLCF were retrospectively reviewed. Operation time, injection amount and distribution type of bone cement, and bone cement leakage and surgical complication were recorded. The visual analogue scale (VAS) scores and Oswestry disability index (ODI) scores were used to evaluate the clinical results. All patients were followed up for at more than 12 months and the assessment was based primarily on clinical and radiological outcomes.Results: There were significant difference in the surgical time, the volume and distribution type of bone cement between the two groups. But, there was no statistical difference in bone cement leakage. Moreover, there were no significant differences in VAS and ODI between the two groups at 2 days and 12 months after operation.Conclusion: Unilateral TPRPA and CTPA are practical and feasible methods in PVP for treatment of OLCF, with similar clinical effects. However, TPRPA has the advantages of fair distribution of bone cement and short operation time, without increasing the rate of bone cement leakage.

scholarly journals Unilateral percutaneous vertebroplasty for osteoporotic lumbar compression fractures: a comparative study between transverse process root-pedicle approach and conventional transpedicular approach

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wenwu Zhang ◽  
Shenpeng Liu ◽  
Xianhua Liu ◽  
Xiang Li ◽  
Le Wang ◽  
...  
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Transverse Process ◽  
Cement Leakage ◽  
Clinical Results ◽  
Clinical Effects ◽  
Compression Fractures ◽  
Transpedicular Approach ◽  
Cement Distribution

Abstract Purpose Percutaneous vertebroplasty (PVP) is a routine operation for the treatment of osteoporotic lumbar compression fractures (OLCFs). As is well known, unilateral puncture is a common method. However, with the conventional transpedicular approach (CTPA), the cement may be asymmetrically dispersed, so some surgeons use the transverse process root-pedicle approach (TPRPA). The objective of this study was to compare the clinical results and bone cement distribution of PVP for OLCF with unilateral TPRPA and CTPA to identify the advantages and disadvantages of the two surgical options. Patients and methods From January 2016 to June 2019, seventy-two elderly patients who underwent unilateral PVP for single-level OLCF were retrospectively reviewed. Operation time, injection amount and type of bone cement distribution, and bone cement leakage and surgical complications were recorded. The visual analog scale (VAS) scores and Oswestry disability index (ODI) scores were used to evaluate the clinical results. All patients were followed up for more than 12 months, and the assessment was based primarily on clinical and radiological outcomes. Results There were significant differences in the surgical time and the volume and the type of bone cement distribution and the lost of operative vertebra height between the two groups. However, there was no significant difference in bone cement leakage. Moreover, there were no significant differences in VAS and ODI between the two groups at 2 days and 12 months after the operation. Conclusions Unilateral TPRPA and CTPA are practical and feasible methods in PVP for the treatment of OLCF, and they have similar clinical effects. However, TPRPA has the advantages of a better distribution of bone cement and a shorter operation time and a better maintenance effect of injured vertebra height, without increasing the rate of bone cement leakage.

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.

Comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures

2020 ◽  
Author(s):  
Juan Long ◽  
Chun Jing He ◽  
Zikun Duan ◽  
Xinguo Kang ◽  
Jinfeng Zou
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Needle Position ◽  
Relieve Pain ◽  
Group A ◽  
Group B

Abstract BACKGROUND The purpose of this study was to comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures. METHODS Sixty-four severe vertebral compression fractures patients were treated in our hospital were randomly divided into group A and group B(n = 32). Group A received Percutaneous vertebroplasty (PVP) treatment by unilateral vertebral pedicle approach. Group B received PVP treatment by bilateral vertebralpedicle approach. Visual Analogue scale (VAS) score and Oswesty Disability Index (ODI) were recorded before surgery, and at 1d,1 month, and 6 months after operation. Also, the puncture path, needle position, intraoperative bone cement injection volume, bone cement dispersion, intra-operative and postoperative complications were observed. RESULTS Sixty-four vertebrae were successfully punctured.The postoperative VAS,ODI were lower than preoperative, showed statistical difference compared with the preoperative VAS, ODI, but there are no difference between Group A and Group B.The cement leakage and operation time is lower in group A than that in Group B. CONCLUSION PVP by unilateral vertebral pedicle approach in treating severe vertebral compression fractures can significantly relieve pain and promote functional recovery, which has advantages such as convenient operation and low complication rate.

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 Comparison of a flexible versus rigid bone cement injection system in unilateral percutaneous vertebroplasty.

2020 ◽  
Author(s):  
yuwei li ◽  
wei cui ◽  
peng zhou ◽  
cheng li ◽  
yan wen ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Radiation Exposure ◽  
Bone Cement ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Cement Leakage ◽  
X Ray ◽  
Cement Injection ◽  
Significant Difference

Abstract Background: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector.Methods: We undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture Percutaneous vertebroplasty from our institution from June 2013 to July 2015. Operation time, radiation exposure, bone cement injection amount, and the incidence of bone cement leakage were recorded on presentation, the cement leakage was measured by x-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes.Results: There was no significant difference in the operation time, radiation exposure time and incidence of bone cement leakage between the two groups. There was significant difference in the amount of bone cement injection and the difference between the two groups. there were no significant differences in VAS and the relative height of the vertebral body and local Cobb angle and QUALEFFO between 2 groups at 1 week after PVP, only significant difference was observed between 12 months after operation.Conclusions: Application of flexible cement injector is safe and feasible,Compared with the application of straight bone cement injector, without prolonging the operative time, radiation exposure time and the incidence of bone cement leakage, it has the advantages of good long-term effect and low incidence of vertebral fracture recurrence.

scholarly journals Comparison of a flexible versus rigid bone cement injection system in unilateral percutaneous vertebroplasty

2020 ◽  
Author(s):  
yuwei li ◽  
wei cui ◽  
peng zhou ◽  
cheng li ◽  
yan wen ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Radiation Exposure ◽  
Bone Cement ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Cement Leakage ◽  
X Ray ◽  
Cement Injection ◽  
Significant Difference

Abstract Background: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector. Methods: We undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture Percutaneous vertebroplasty from our institution from June 2013 to July 2015. Operation time, radiation exposure, bone cement injection amount, and the incidence of bone cement leakage were recorded on presentation, the cement leakage was measured by x-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes. Results: There was no significant difference in the operation time, radiation exposure time and incidence of bone cement leakage between the two groups. There was significant difference in the amount of bone cement injection and the difference between the two groups. there were no significant differences in VAS and the relative height of the vertebral body and local Cobb angle and QUALEFFO between 2 groups at 1 week after PVP, only significant difference was observed between 12 months after operation. Conclusions: Application of flexible cement injector is safe and feasible,Compared with the application of straight bone cement injector, without prolonging the operative time, radiation exposure time and the incidence of bone cement leakage, it has the advantages of good long-term effect and low incidence of vertebral fracture recurrence.

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 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.

“Targeted Percutaneous Vertebroplasty” Versus Traditional Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fracture

2019 ◽  
Vol 26 (5) ◽  
pp. 551-559
Author(s):  
JunChuan Xu ◽  
JiSheng Lin ◽  
Jian Li ◽  
Yong Yang ◽  
Qi Fei
Keyword(s):  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Operation Time ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Controlled Study ◽  
Radiation Doses ◽  
Group A ◽  
Group B

Objective. In this randomized, nonblinded, controlled study, the feasibility and precision of “targeted percutaneous vertebroplasty” (“targeted PVP”) for osteoporotic vertebral compression fracture (OVCF) was evaluated. Methods. A total of 42 patients, aged 50 to 87 years, with OVCF were randomly divided into 2 groups: A and B. Group A underwent “targeted PVP,” and group B underwent traditional PVP with the guidance of C-arm fluoroscopy. Fluoroscopy times for skin puncture points (FTSPP), total radiation doses (TRD), total fluoroscopy times (TFT), and operation time were set as the main evaluation indicators. Results. FTSPP (1.52 ± 0.51 in group A vs 6.62 ± 2.58 in group B, U < .001), TRD (6.26 ± 1.51 in group A vs 11.32 ± 4.21 in group B, P < .001), TFT (16.57 ± 2.79 in group A vs 26.05 ± 6.18 in group B, P < .001), and operation time (20.05 ± 3.38 in group A vs 25.43 ±5.11 in group B, U < .001) were statistically different in the 2 groups. The incidence of cement leakage that occurred in group A (1/21, 4.76%) was significantly less than that in group B (9/21, 42.9%, P < 0.05). Conclusions. “Targeted PVP” may achieve (1) less skin positioning fluoroscopy times, less total fluoroscopy times and dose, shorter operation time, which is more precise than traditional PVP; (2) less incidence of cement leakage; and (3) visualization of the fractured vertebra, which is probably more valuable for the treatment of complicated OVCF patients.

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