scholarly journals Clinical observation of two bone cement distribution modes of percutaneous vertebroplasty in the treatment of thoracolumbar Kümmell’s disease

2020 ◽  
Author(s):  
Ji-Bin Chen ◽  
Ya-Ping Xiao ◽  
Dong Chen ◽  
Jian-Zhong Chang ◽  
Te Li
Keyword(s):  
Bone Cement ◽  
Clinical Efficacy ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Vas Score ◽  
Significant Difference ◽  
Cement Distribution ◽  
Kummell’S Disease ◽  
Kümmell’S Disease

Abstract Background In recent years, percutaneous vertebroplasty (PVP) has provided a new option for the treatment of Kümmell’s disease (KD). The purpose of this study is to study the differences in clinical characteristics, clinical efficacy and related complications between two types of bone cement distribution patterns in the PVP treatment of KD. Methods Retrospective analysis from January 2016 to February 2018 showed that 63 patients with KD who received PVP treatment were included in the study. According to X-ray distribution modes of bone cement after treatment, all patients were divided into blocky group (30 cases ) and spongy group (33 cases). Clinical features and disease severity Preoperatively of the two groups, and clinical efficacy and related complications postoperatively were compared between the two groups. Results There was no significant difference in gender, injured segment, VAS and ODI preoperatively between the two groups (all P > 0.05). The duration of disease, age, Cobb angle and vertebral compression rate preoperatively were significantly higher in the blocky group than in the spongy group (P < 0.05, respectively). The height of vertebral anterior margin and BMD were significantly lower in the blocky group than in the spongy group (P < 0.05, respectively). The two groups were followed for at least 24 months. There were no statistically differences in the follow-up time, operation time, intraoperative blood loss, number of fluoroscopy, bone cement leakage and adjacent vertebral fracture between the two groups (all P > 0.05). The amount of bone cement injected into the blocky group was significantly higher than that of the spongy group (P = 0.000). VAS score and ODI postoperatively of the two groups were significantly reduced at 1 day, 1 year and the last follow-up (all P = 0.000), and were maintained at the last follow-up. VAS score and ODI postoperatively decreased significantly in the spongy group compared with the blocky group (P = 0.000). The correction degrees of kyphosis and vertebral compression postoperatively in the two groups were significantly corrected, but gradually decreased over time (P < 0.05), and these correction degrees of the blocky group was significantly higher than that of the spongy group and the postoperative loss was also more serious. Conclusions The treatment of KD by PVP can effectively relieve pain, improve function, restore vertebral height and correct kyphosis. The disease in the blocky group was more serious than that in the spongy group. The amount of bone cement, correction degrees of postoperative kyphosis and vertebral compression were significantly higher in the blocky group than in the spongy group, but the postoperative loss was also more serious in the blocky group. However, for pain relief and functional recovery, the spongy group was superior to the blocky group. Therefore, the spongy distribution pattern should be formed during the injection of bone cement to obtain better therapeutic effect.

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.

Comparison of the clinical outcomes and cement distribution patterns after percutaneous vertebroplasty in the treatment of thoracolumbar Kümmell’s disease and OVCFs

2020 ◽  
Author(s):  
Cheng-Liang Wang ◽  
Ji-Bin Chen ◽  
Te Li
Keyword(s):  
Bone Cement ◽  
Distribution Pattern ◽  
Operation Time ◽  
Distribution Patterns ◽  
Fracture Rate ◽  
Vas Score ◽  
Cement Distribution ◽  
Kummell’S Disease ◽  
Kümmell’S Disease ◽  
Time Point

Abstract Background The purpose of this study is to investigate and compare the therapeutic effect and distribution characteristics of bone cement in the PVP treatment for thoracolumbar Kümmell's diseases and OVCFs. Methods A prospective analysis of 35 patients with Kümmell ’s disease (K group) and 35 patients with OVCFs (O group) who underwent PVP treatment from February 2016 to February 2018 was conducted. The vertebral compression rate and degree of osteoporosis were more serious in the K group than in the O group ( P <0.05, respectively). Distribution pattern, volume and leakage rate of bone cement, operation time, VAS score, ODI, correction rates of vertebral compression and kyphosis, re-fracture rate of adjacent vertebrae in 2 years between the two groups were compared to assess clinical effect. Results The follow-up time of the two groups was 24-48 months. The amount of intraoperative bone cement injection was significantly higher in the K group than in the O group ( P =0.025). The cement distribution pattern of local solid lump was dominant in the K group (65.71%), while intercalation with trabeculae was dominant in the O group (74.29%) ( P <0.001). VAS score and ODI were significantly lower both in the two groups at 1 day, 1 year and 2 years after surgery than before surgery (all P <0.05), but significantly lower in the K group than in the O group at each time point after surgery (all P <0.05). The correction rates of kyphosis and vertebral compression in both groups was significantly corrected ( P <0.05, respectively) and gradually lost with time ( P <0.05, respectively). The correction rates of kyphosis and vertebral compression were significantly higher in the K group than in the O group at each time point after surgery (all P <0.05). Conclusions PVP has the advantages of simple operation, short operation time, small trauma and quick recovery in treating both Kümmell's disease and OVCFs. However, PVP can better restore partial vertebral height and correct kyphosis in the treatment of Kümmell's disease, while can better alleviate pain and improve ODI in the treatment of OVCFs.

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.

scholarly journals The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

2020 ◽  
Author(s):  
Lei Tan ◽  
Bingtao Wen ◽  
Zhaoqing Guo ◽  
Zhongqiang Chen
Keyword(s):  
Bone Cement ◽  
Vertebral Body ◽  
Kyphotic Angle ◽  
Vas Score ◽  
Angle Change ◽  
Significant Difference ◽  
Cement Distribution ◽  
Group A ◽  
Group B

Abstract Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: 137 patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 hours post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results: 24 hours post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6-24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. In subgroup analysis, there was no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.

scholarly journals Analysis of the effect of percutaneous vertebroplasty in the treatment of thoracolumbar Kümmell’s disease with or without bone cement leakage

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ya-Ping Xiao ◽  
Ming-Jian Bei ◽  
Cui-Qing Yan ◽  
Jian-Zhong Chang
Keyword(s):  
Visual Analogue Scale ◽  
Cobb Angle ◽  
Bone Cement ◽  
Analogue Scale ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Mineral Density ◽  
Kummell’S Disease ◽  
Kümmell’S Disease

Abstract Background Bone cement leakage is a major complication in the treatment of percutaneous vertebroplasty for Kümmell’s disease, and the focus of close attention during the surgery. The purpose of this article was to investigate the clinical outcomes of Kümmell’s disease treated by percutaneous vertebroplasty with or without bone cement leakage. Methods A total of 64 patients with Kümmell’s disease from December 2016 to February 2018 treated by percutaneous vertebroplasty were included in the study. After the treatment, 32 cases were respectively divided into two groups according to X-ray examination of bone cement leakage: leakage group and non-leakage group. Preoperative course, age, sex, bone mineral density, damaged segment, anterior vertebral height, vertebral compression rate, Cobb angle, visual analogue scale and Oswestry dysfunction index were compared between the two groups. After surgery, the amount of bone cement injected, operation time, adjacent vertebral refracture rate, visual analogue scale, Oswestry dysfunction index, the recovery value of vertebral anterior height and the improvement value of Cobb angle were compared between the two groups. Results The course, age and Cobb angle of the leakage group were significantly greater than those of the non-leakage group (P< 0.05, respectively). The height of anterior vertebral margin and bone mineral density in the leakage group were significantly lower than those in the non-leakage group (P< 0.05, respectively). The two groups were followed up for at least 24 months. The amount of bone cement injected was significantly greater in the leakage group than in the non-leakage group (P=0.000). Visual analogue scale and Oswestry dysfunction index of the two groups on the second day after surgery and at the last follow-up were significantly lower than these before surgery (P< 0.05, respectively), but there was no significant difference between the two groups. In the leakage group, the recovery value of the anterior edge height of the injured vertebra and the improvement value of the Cobb angle on the second day after surgery and at the last follow-up were significantly improved compared with the non-leakage group (P< 0.05, respectively). Conclusion Percutaneous vertebroplasty is an effective and minimally invasive treatment for Kümmell’s disease. The leakage group had longer course, older age, more serious kyphotic deformity, vertebral compression and osteoporosis, and higher amount of bone cement injected than these of the non-leakage group. However, there were not significant differences in the rate of adjacent vertebral refractures, visual analogue scale and Oswestry dysfunction index between the two groups. Therefore, the bone cement leakage does not affect the surgical effect.

scholarly journals Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

2020 ◽  
Author(s):  
Shouqian Dai ◽  
Rongqing qin ◽  
xiu shi ◽  
Hui-lin Yang
Keyword(s):  
Blood Loss ◽  
Bone Cement ◽  
Clinical Efficacy ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
Significant Difference ◽  
Neurologically Intact

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, and can be recommended as a preferred treatment options for KD.

scholarly journals The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case Cohort Study

2020 ◽  
Author(s):  
Lei Tan ◽  
Bingtao Wen ◽  
Zhaoqing Guo ◽  
Zhongqiang Chen
Keyword(s):  
Bone Cement ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Height ◽  
Significant Difference ◽  
Cement Distribution ◽  
Post Operation ◽  
Group A ◽  
Group B

Abstract Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: 137 patients withsinglelevelOVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cementdistribution. Group A:bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group Bwas divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) scoreat 24 hours post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR) and vertebral body recompression ratewere compared. Results: 24 hours post operation, the pain of all groups were significantly improved. At the last follow-up, the VAS score of group A was lower than that of group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At the last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. At the last follow-up, AVHLR in group B was higher than that in group A. In subgroup analysis, there was no significant difference in VAS score,vertebral recompression rate, AVHRR or AVHLR.Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral bodyand maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long term pain.

scholarly journals Clinical Observation of Two Bone Cement Distribution Modes After Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures

2021 ◽  
Author(s):  
Qiujiang Li ◽  
Xingxia Long ◽  
Yinbin Wang ◽  
Tao Guan ◽  
Xiaomin Fang ◽  
...  
Keyword(s):  
Bone Cement ◽  
Clinical Efficacy ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Cement Distribution ◽  
Local Kyphosis

Abstract Background:Current findings suggest that percutaneous vertebroplasty(PVP) is a suitable therapeutic approach for osteoporotic vertebral compression fractures (OVCFs).The present retrospective study aimed to investigate the differences in clinical efficacy and related complications between the two bone cement distribution modes. Methods:We retrospectively reviewed the medical records of the patients with single-segment OVCFs who underwent bilateral percutaneous vertebroplasty.Patients were divided into blocky and spongy group according to the type of postoperative bone cement distribution. Clinical efficacy and related complications was compared between the two bone cement distribution modes on 24h after the operation and last follow-up.RESULTS: The mean follow-up time was 17.54 months. The VAS and ODI after operation improved significantly in both two groups. The VAS and ODI in the spongy group was significantly lower than that in the blocky group, 24h postoperatively, and at the last follow-up. There were 42 cases (12.8%) of adjacent vertebral fractures, 26 cases (19.8%) in the blocky group and 16 cases (8.1%) in the spongy group. There were 57 cases (17.3%) of bone cement leakage, 18 cases (13.7%) in blocky group and 39 cases (19.7%) in the spongy group. At 24 hour postoperatively and at the last follow-up, local kyphosis and anterior vertebral height were significantly corrected in both groups, but gradually decreased over time, and the degree of correction was significantly higher in the spongy group than in the block group. Loss of local kyphosis and loss of vertebral body height were also less severe in the spongy group at the last follow-up.Conclusions: Compared with blocky group, spongy group can better maintain the height of the vertebral body, correct local kyphosis, reduce the risk of the vertebral body recompression, long-term pain and restore functions.

scholarly journals Clinical observation of two bone cement distribution modes after percutaneous vertebroplasty for osteoporotic vertebral compression fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Qiujiang Li ◽  
Xingxia Long ◽  
Yinbin Wang ◽  
Tao Guan ◽  
Xiaomin Fang ◽  
...  
Keyword(s):  
Bone Cement ◽  
Clinical Efficacy ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Cement Distribution ◽  
Local Kyphosis

Abstract Background Current findings suggest that percutaneous vertebroplasty(PVP) is a suitable therapeutic approach for osteoporotic vertebral compression fractures (OVCFs). The present retrospective study aimed to investigate the differences in clinical efficacy and related complications between the two bone cement distribution modes. Methods We retrospectively reviewed the medical records of the patients with single-segment OVCFs who underwent bilateral percutaneous vertebroplasty. Patients were divided into blocky and spongy group according to the type of postoperative bone cement distribution. Clinical efficacy and related complications was compared between the two bone cement distribution modes on 24 h after the operation and last follow-up. Results A total of 329 patients with an average follow up time of 17.54 months were included. The blocky group included 131 patients, 109 females(83.2 %) and 22 males(16.8 %) with a median age of 72.69 ± 7.76 years, while the Spongy group was made up of 198 patients, 38 females(19.2 %) and 160 males(80.8 %) with a median age of 71.11 ± 7.36 years. The VAS and ODI after operation improved significantly in both two groups. The VAS and ODI in the spongy group was significantly lower than that in the blocky group, 24 h postoperatively, and at the last follow-up. There were 42 cases (12.8 %) of adjacent vertebral fractures, 26 cases (19.8 %) in the blocky group and 16 cases (8.1 %) in the spongy group. There were 57 cases (17.3 %) of bone cement leakage, 18 cases (13.7 %) in blocky group and 39 cases (19.7 %) in the spongy group. At 24 h postoperatively and at the last follow-up, local kyphosis and anterior vertebral height were significantly corrected in both groups, but gradually decreased over time, and the degree of correction was significantly higher in the spongy group than in the block group. The change of local kyphosis and loss of vertebral body height were also less severe in the spongy group at the last follow-up. Conclusions Compared with blocky group, spongy group can better maintain the height of the vertebral body, correct local kyphosis, reduce the risk of the vertebral body recompression, long-term pain and restore functions.

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