scholarly journals Management Trend and Attitude Regarding Osteoporotic Vertebral Compression Fracture: A Comparative Study Between Surgeons and Internists

2020 ◽  
Author(s):  
Zhihao Zhang ◽  
Junjun Fan ◽  
Tao Liu ◽  
Siguo Sun ◽  
Xiaoxiang Li ◽  
...  
Keyword(s):  
Comparative Study ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Osteoporosis Treatment ◽  
Osteoporotic Vertebral Compression Fracture ◽  
First Line ◽  
Mineral Research ◽  
Significant Difference ◽  
Pattern Diagnosis ◽  
Management Choice

Abstract Background: Osteoporotic vertebral compression fracture (OVCF) is the most common form of osteoporotic fracture, both surgeons and internists included in the management of that. This study aimed to identify whether a discrepancy exists between spinal surgeons and internists in the diagnosis and management of OVCF.Method: This comparative study included 124 spinal surgeons and 47 internists in the WeChat group of the Society of Osteoporosis and Bone Mineral Research. They were sent a self-administered electronic questionnaire that asked about practice pattern, diagnosis trend, and management choice in OVCF management. The validity of the survey was examined in advance.Results: A significantly higher percentage of surgeons obtained T2-weighted images scan with fat suppression than internists. A significantly higher proportion of spinal surgeons provided surgical treatment as first-line treatment and considered fracture as the most important aspect in OVCF management than internist. No significant difference was observed in the use of dual-energy X-ray absorptiometry scan, in performing laboratory examination, or in the collaboration rate between the two groups.Conclusion: Differences exist between internists and spinal surgeons in imaging diagnosis, choice of therapeutic schedule, and attitude to osteoporosis treatment in the management of OVCF.

scholarly journals Risk Factors Analysis of Pulmonary Cement Embolism during Percutaneous Vertebroplasty or Kyphoplasty for Osteoporotic Vertebral Compression Fracture.

2021 ◽  
Author(s):  
Dexin Zou ◽  
Shengjie Dong ◽  
Wei Du ◽  
Bing Sun ◽  
Xifa Wu
Keyword(s):  
Risk Factors ◽  
Vertebral Compression Fracture ◽  
Demographic Data ◽  
Multiple Logistic Regression Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Increased Risk ◽  
Significant Difference ◽  
Cement Embolism ◽  
Pulmonary Ct

Abstract Objective: The purpose of this research is to evaluate the risk factors and incidence of PCE during PKP or PVP for osteoporotic vertebral compression fracture (OVCF) based on postoperative computed tomography (CT).Methods: A total of 2344 patients who underwent PVP or PKP due to OVCF in our spine centre were analyzed retrospectively. According to the detection of postoperative pulmonary CT, the patients were divided into two groups: pulmonary cement embolism group (PCE group) and non pulmonary cement embolism group (NPCE group). Demographic data in both groups were compared using the χ2 test for qualitative data and the unpaired t test for quantitative data. Multiple logistic regression analysis was carried out to identify risk factors that were significantly related to the PCE resulting from cement leakage.Results: PCE was found in 34 patients (1.9% 34/1782) with pulmonary CT examination after operation. There was no statistically significant difference in the parameters such as age, gender, body mass index (BMI) and cement volume in the two groups. Patients with three or more involved vertebrae had a significantly increased risk to suffer from PCE than those with one involved vertebra (p=0.046 OR 2.412 [95% CI 1.017-5.722]). Patients who suffered thoracic fracture had a significantly increased risk to suffer from PCE than those suffered thoracolumbar fracture (p=0.001 OR 0.241 [95% CI 0.105-0.550]). And significantly increased PCE risk also was observed in thoracic fracture compared with Lumbar fracture patients (p=0.028 OR 0.094 [95% CI 0.114-0.779]). The risk of PCE within two weeks after fracture was significantly higher than that after two weeks of fracture (p=0.000 OR 0.178 [95% CI 0.074-0.429]). Patients who underwent PVP surgery had a significantly increased PCE risk than those underwent PKP surgery (p=0.001 OR 0.187 [95% CI 0.069-0.509])Conclusion: The real incidence of PCE is underestimated due to the lack of routine postoperative pulmonary imaging examination. The number of Involved vertebrae, fracture location, operation timing and operation methods are independent risk factors for PCE.

scholarly journals Percutaneous Kyphoplasty in Treating Osteoporotic Vertebral Compression Fracture With Kyphotic Deformity: A Compared Study

2020 ◽  
Author(s):  
Wenye Yao ◽  
Runsheng Guo ◽  
Qi Lai ◽  
Bin Zhang
Keyword(s):  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Operation Time ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Kyphotic Deformity ◽  
Percutaneous Kyphoplasty ◽  
Bilateral Group ◽  
Significant Difference ◽  
Unilateral Group

Abstract Objective: To evaluate the efficacy and safety of percutaneous kyphoplasty (PKP) for thoracolumbar osteoporotic vertebral compression fracture (OVCF) with kyphosis via unilateral versus bilateral approach.Methods: All patients suffered OVCF with kyphosis were retrospectively reviewed. Of those, performed unilateral PKP or underwent bilateral PKP with random. The clinical and radiological data such as the correction of deformity, sagittal profle and record of the perioperative morbidity of the patients were analyzed.Results: All patients (76±3.6 years) were enrolled in this investigation, including 47 in the unilateral and 39 in the bilateral group. No significant difference in general data was detected between the two groups (p >0.05). Howere, the operation time and cement amount 28.2±3.4 min, 3.8±0.6 ml in the unilateral group, while 50.1±4.6 min, 5.4±0.5 ml in the bilateral group, respectively (P <0.05).In addition,The preoperative visual analog scale(VAS) and Vertebral local kyphosis angle were 8.8±0.65 and 16.3 ± 6.5°compared to last follow-up 3.15±0.78 and 14.26± 2.16°in unilateral group, while 8.5±0.78 and 16.5 ± 7.1°compared to last follow-up 2.66±0.86 and 13.81±2.38°in bilateral group, respectively (P < 0.05). Furthermore, Oswestry Disablility Index (ODI) and prevertebral height ratio in both groups were significantly different before and after surgery, but no significant difference between the two groups (p >0.05).Conclusion: Both bilateral and unilateral PKP are relatively safe and provide effective treatment for patients with painful thoracolumbar osteoporotic vertebral compression fracture with mild kyphotic deformity. However, unilateral PKP need less operation time and volume of cement.

scholarly journals Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhongcheng An ◽  
Chen Chen ◽  
Junjie Wang ◽  
Yuchen Zhu ◽  
Liqiang Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Bone Cement ◽  
Vertebral Compression Fracture ◽  
Univariate Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Augmentation ◽  
Surgical Methods

Abstract Objective To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF) and analyze the correlation between these factors and augmented vertebra recompression after PVA. Methods A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to the inclusion criteria. All cases meeting the inclusion and exclusion criteria were divided into two groups: 82 patients in the recompression group and 175 patients in the non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density (BMD) during follow-up, intravertebral cleft (IVC) before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery, and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA. Results A total of 257 patients from 353 patients were included in this study. The follow-up time was 12–24 months, with an average of 13.5 ± 0.9 months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P < 0.05). Among them, multiple factors logistic regression elucidated that more injected cement (P < 0.001, OR = 0.558) and high BMD (P = 0.028, OR = 0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B < 0). Preoperative IVC (P < 0.001, OR = 3.252) and bone cement not in contact with upper or lower endplates (P = 0.006, OR = 2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P = 0.007, OR = 0.337). Conclusions The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.

scholarly journals Radiological and clinical outcomes of balloon kyphoplasty for osteoporotic vertebral compression fracture in patients with rheumatoid arthritis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ji Guo ◽  
Weifeng Zhai ◽  
Licheng Wei ◽  
Jianpo Zhang ◽  
Lang Jin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Vertebral Fractures ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Balloon Kyphoplasty ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Control Group ◽  
Compression Rate ◽  
Kyphotic Angle

Abstract Background This study was conducted to investigate the outcomes and complications of balloon kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in patients with rheumatoid arthritis (RA) and compare its radiological and clinical effects with OVCF patients without RA. Methods Ninety-eight patients in the RA group with 158 fractured vertebrae and 114 patients in the control group with 150 vertebrae were involved in this study. Changes in compression rate, local kyphotic angle, visual analog scale (VAS) and Oswestry disability index (ODI) scores, conditions of bone cement leakage, refracture of the operated vertebrae, and new adjacent vertebral fractures were examined after KP. In addition, patients in the RA group were divided into different groups according to the value of erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and whether they were glucocorticoid users or not to evaluate their influence on the outcomes of KP. Results KP procedure significantly improved the compression rate, local kyphotic angle, and VAS and ODI scores in both RA and control groups (p<0.05). Changes in compression rate and local kyphotic angle in the RA group were significantly larger than that in the control group (p<0.05), and patients with RA suffered more new adjacent vertebral fractures after KP. The outcomes and complications of KP from different ESR or CRP groups did not show significant differences. The incidence of cement leakage in RA patients with glucocorticoid use was significantly higher than those who did not take glucocorticoids. In addition, RA patients with glucocorticoid use suffered more intradiscal leakage and new adjacent vertebral fractures. Conclusions OVCF patients with RA obtained more improvement in compression rate and local kyphotic angle after KP when compared to those without RA, but they suffered more new adjacent vertebral fractures. Intradiscal leakage and new adjacent vertebral fractures occurred more in RA patients with glucocorticoid use. Trial registration Retrospectively registered.

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