scholarly journals Refracture of the Cemented Vertebrae after Percutaneous Vertebroplasty: Risk Factors and Imaging Findings

2021 ◽  
Author(s):  
Yu-chao Xiong ◽  
Wei Guo ◽  
Fan Xu ◽  
Ci-ci Zhang ◽  
Zhi-ping Liang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Wedge Angle ◽  
Reduction Rate ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Imaging Findings ◽  
Mineral Density ◽  
Independent Risk Factors ◽  
Multiple Logistic Regression Modeling

Abstract Background: To determine the related imaging findings and risk factors to refracture of the cemented vertebrae after percutaneous vertebroplasty (PVP) treatment. Methods: Patients who were treated with PVP for single vertebral compression fractures (VCFs) and met this study’s inclusion criteria were retrospectively reviewed from January 2012 to January 2019. The follow-up period was at least 2 years. Forty-eight patients with refracture of the cemented vertebrae and 45 non-refractured patients were included. The following variates were reviewed: age, sex, fracture location, bone mineral density (BMD), intravertebral cleft (IVC), kyphotic angle (KA), wedge angle, endplate cortical disruption, cement volume, surgical approach, non-PMMA-endplate-contact (NPEC), cement leakage, other vertebral fractures, reduction rate (RR), and reduction angle (RA). Multiple logistic regression modeling was used to identify the independent risk factors of refracture. Results: Refracture was found in 48 (51.6%) patients. Four risk factors, including IVC (P=0.005), endplate cortical disruption (P=0.037), larger RR (P=0.007), and NPEC (P=0.006) were found to be significant independent risk factors for refracture. Conclusions: Patients with IVC or larger RR, NPEC, or endplate cortical disruption have a high risk of refracture in the cemented vertebrae after PVP.

scholarly journals Refracture of the cemented vertebrae after percutaneous vertebroplasty: risk factors and imaging findings

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yu-chao Xiong ◽  
Wei Guo ◽  
Fan Xu ◽  
Ci-ci Zhang ◽  
Zhi-ping Liang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Wedge Angle ◽  
Reduction Rate ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Imaging Findings ◽  
Mineral Density ◽  
Independent Risk Factors ◽  
Multiple Logistic Regression Modeling

Abstract Background To determine the related imaging findings and risk factors to refracture of the cemented vertebrae after percutaneous vertebroplasty (PVP) treatment. Methods Patients who were treated with PVP for single vertebral compression fractures (VCFs) and met this study’s inclusion criteria were retrospectively reviewed from January 2012 to January 2019. The follow-up period was at least 2 years. Forty-eight patients with refracture of the cemented vertebrae and 45 non-refractured patients were included. The following variates were reviewed: age, sex, fracture location, bone mineral density (BMD), intravertebral cleft (IVC), kyphotic angle (KA), wedge angle, endplate cortical disruption, cement volume, surgical approach, non-PMMA-endplate-contact (NPEC), cement leakage, other vertebral fractures, reduction rate (RR), and reduction angle (RA). Multiple logistic regression modeling was used to identify the independent risk factors of refracture. Results Refracture was found in 48 (51.6%) patients. Four risk factors, including IVC (P = 0.005), endplate cortical disruption (P = 0.037), larger RR (P = 0.007), and NPEC (P = 0.006) were found to be significant independent risk factors for refracture. Conclusions Patients with IVC or larger RR, NPEC, or endplate cortical disruption have a high risk of refracture in the cemented vertebrae after PVP.

scholarly journals Establishment and validation of a nomogram and web calculator for the risk of new vertebral compression fractures and cement leakage after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures

2021 ◽  
Author(s):  
Wenle Li ◽  
Haosheng Wang ◽  
Shengtao Dong ◽  
Zhi-Ri Tang ◽  
Longhao Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Fractures ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Mineral Density ◽  
Clinical Value ◽  
Compression Fractures ◽  
Multiple Vertebral Fractures ◽  
New Onset

Abstract Purpose The aim of this work was to investigate the risk factors for cement leakage and new-onset OVCF after Percutaneous vertebroplasty (PVP) and to develop and validate a clinical prediction model (Nomogram). Methods Patients with Osteoporotic VCF (OVCF) treated with PVP at Liuzhou People’s Hospital from June 2016 to June 2018 were reviewed and met the inclusion criteria. Relevant data affecting bone cement leakage and new onset of OVCF were collected. Predictors were screened using univariate and multi-factor logistic analysis to construct Nomogram and web calculators. The consistency of the prediction models was assessed using calibration plots, and their predictive power was assessed by tenfold cross-validation. Clinical value was assessed using Decision curve analysis (DCA) and clinical impact plots. Results Higher BMI was associated with lower bone mineral density (BMD). Higher BMI, lower BMD, multiple vertebral fractures, no previous anti-osteoporosis treatment, and steroid use were independent risk factors for new vertebral fractures. Cement injection volume, time to surgery, and multiple vertebral fractures were risk factors for cement leakage after PVP. The development and validation of the Nomogram also demonstrated the predictive ability and clinical value of the model. Conclusions The established Nomogram and web calculator (https://dr-lee.shinyapps.io/RefractureApp/) (https://dr-lee.shinyapps.io/LeakageApp/) can effectively predict the occurrence of cement leakage and new OVCF after PVP.

scholarly journals Nomogram for Predicting Intradiscal Cement Leakage Following Percutaneous Vertebroplasty in Patients with Osteoporotic Related Vertebral Compression Fractures

2017 ◽  
Vol 4 (20;4) ◽  
pp. E513-E550
Author(s):  
Gao-Jun Teng
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Kummell’S Disease ◽  
Independent Risk Factors ◽  
The Mean ◽  
Kümmell’S Disease

Background: Intradiscal cement leakage (ICL) is a common complication following percutaneous vertebroplasty (PVP). However, the risk factors for such a complication are under debate and there is no accurate predictive nomogram to predict ICL. Objectives: To establish an effective and novel nomogram for ICL following PVP in patients with osteoporotic-related vertebral compression fractures (OVCFs). Study Design: This was a retrospective study approved by the Institutional Review Board of our institution. Setting: This study consists of patients from a large academic center. Methods: Patients with OVCFs who underwent their first PVP in our department between January 2007 and December 2013 were included in this study. All the potential risk factors of ICL after PVP were recorded. Univariate and multivariate analyses were used to identify the independent risk factors. The nomogram was then created based on the identified independent risk factors. Results: A total of 241 patients and 330 vertebrae were included. The mean age of the patients was 73.5 (SD 7.9) years old, and the mean number of treated vertebrae was 1.4 per person. ICL was observed in 93 (28.2%) of the treated vertebrae. Greater fracture severity (P = 0.016), cortical disruption of the endplate (P < 0.0001), absence of Kummell’s disease (P = 0.010), and higher computed tomography (CT) values (P = 0.050) were the independent risk factors for ICL. Limitations: The main limitation of this study is that it is a retrospective study. Conclusion: Greater fracture severity, cortical disruption of the endplate, absence of Kummell’s disease, and higher CT values are the independent risk factors for ICL. The novel nomogram gives an accurate prediction of ICL. Key words: Osteoporotic vertebral compression fracture, percutaneous vertebroplasty, intradiscal cement leakage, risk factors, prediction, nomogram

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

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.

scholarly journals ANVCFV Score System: Assessment for Probability of New Vertebral Compression Fractures after Percutaneous Vertebroplasty in Patients with Vertebral Compression Fractures

2015 ◽  
Vol 6;18 (6;11) ◽  
pp. E1047-E1057
Author(s):  
Gao-Jun Teng
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Validation Cohort ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Score System ◽  
Training Cohort ◽  
Compression Fractures ◽  
Independent Risk Factors ◽  
Risk Score System

Background: Percutaneous vertebroplasty (PVP) is widely used for the treatment of painful vertebral compression fractures (VCFs). However, new VCFs occur frequently after PVP. Objectives: We aim to establish an objective risk score system to assess the possibility of new vertebral fractures in patients with VCFs undergoing PVP. Study Design: This study was a retrospective study, and it was approved by the Institutional Review Board of our 2 institutions. Setting: This study consists of patients from 2 large academic centers. Methods: Patients with VCFs who underwent their first PVP and met the inclusion criteria between January 2007 and December 2013 at Hospital A (training cohort) and Hospital B (validation cohort) were included. In the training cohort, the independent risk factors for new VCFs after PVP were identified by multivariate stepwise backward Cox regression analysis from the risk factors selected by univariate analysis and Harrell’s C-statistics and used to develop the score system (assessment for new VCFs after PVP [ANVCFV]) to predict the probability of new VCFs. Results: In total, 397 patients (training cohort: n = 241; validation cohort: n = 156) were included in this study. In the training cohort, the ANVCFV score was developed based on 5 independent risk factors for the new VCFs after PVP, including lower computed tomography (CT) values, pre-existing old VCFs, intradiscal cement leakage, more than one vertebra treated, and superior or inferior marginal cement distribution in the vertebra. The patients were divided into 2 groups by the ANVCFV score of -1.5 to 8.5 vs. > 8.5 points in the probability of new VCFs (median fracture-free time: 1846 vs. 732 days; P < 0.001) in the training cohort. The accuracy of this score system was 77.4% for the training cohort and 85.3% for the validation cohort. Limitations: The main limitations of this study are that it is a retrospective study and that there is a significant difference of the treated vertebrae of PVP per session between the 2 cohorts. Conclusion: Patients who underwent their first PVP with an ANVCFV score > 8.5 points may exhibit an increased chance of suffering from new VCFs. Key words: Vertebral compression fracture, percutaneous vertebroplasty, newly developed, risk factors, risk score system, Cox regression model, accuracy, validation

Risk Factor Analysis of Bone Cement Leakage for Polymethylmethacrylate-Augmented Cannulated Pedicle Screw Fixation in Spinal Degenerative Diseases

2021 ◽  
Author(s):  
Yaoyao Liu ◽  
Jun Xiao ◽  
Lei He ◽  
Xiang Yin ◽  
Lei Song ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ankylosing Spondylitis ◽  
Pedicle Screw ◽  
Vertebral Body ◽  
Cement Leakage ◽  
Degenerative Diseases ◽  
Mineral Density ◽  
Lumbar Vertebral Body ◽  
Body Fracture ◽  
Independent Risk Factors

Abstract Background We investigated the risk factors of cement leakage (CL) for polymethylmethacrylate-augmented cannulated pedicle screw (CPS) in spinal degenerative diseases and provided technical guidance for clinical surgery. Methods This study enrolled 276 patients with spinal degenerative disease and osteoporosis who were augmented using CPSs (835 screws in total) from May 2011 to June 2018 in our hospital. The patients' age, sex, bone mineral density (BMD), diagnosis, augmented positions, number of CPS implanted, and CL during surgery were recorded. CL was observed by postoperative computed tomography (CT) and was classified by Yeom typing. Results A total of 74 (8.9%) CPSs in 64 patients leaked (23.2%), with 65 (87.83%), 3 (4.05%), and 6 (8.11%) screws showing Types S, B, and C leakage, respectively. CL was significantly correlated with the number and position of screws (P < 0.05), but not with sex, age, and BMD (P > 0.05). The position, number of CPSs, fracture, degenerative scoliosis, ankylosing spondylitis, and revision surgery were risk factors for CL (P < 0.05). Augmentation of the thoracic vertebral body, fracture, and ankylosing spondylitis were independent risk factors for Type S. Augmentation of the lumbar vertebral body, lumbar disc herniation, and lumbar spondylolisthesis were independent risk factors for Type B (P < 0.05). Conclusions CL has a high incidence in clinical practice. To avoid serious complications, high-risk factors for leakage should be addressed. Particularly, it is necessary to develop alternative solutions for the lack of holding force of internal fixation caused by CL during surgery.

scholarly journals Risk factors of the Secondary Fractures for Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebroplasty

2020 ◽  
Author(s):  
Xiao-kui Kang ◽  
Sheng-fu Guo ◽  
Hui-xin Liu ◽  
Li-li Huang ◽  
Qun-long Jiang
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Meta Analysis ◽  
Thoracolumbar Spine ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Secondary Fractures

Abstract Background Percutaneous vertebroplasty related postoperative secondary fractures risk factors were not consistent in patients with osteoporotic vertebral compression Fractures. The purpose was to identify the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty.Methods Potential academic articles were identified from Cochrane Library, Medline, PubMed, Embase, ScienceDirect and other databases. The time range we retrieved from was that from the inception of electronic databases to August 2019. Gray studies were identified from the references of included literature reports. STATA version 11.0 (Stata Corporation, College Station, Texas, USA) was used to analyze the pooled data.Results Fourteen studies involving 1910 patients, 395 of whom had secondary fracture following the surgery were included in this meta-analysis. The results of meta-analysis showed the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty was related to bone mineral density [WMD= -0.518, 95%CI(-0.784,-0.252), P=0.000], cement leakage [RR=0.596, 95%CI (0.444,0.798), P=0.001] and kyphosis after primary operation [WMD=4.510, 95%CI (3.061,6.004),P=0.000], but not to gender, age, body mass index (BMI), cement volume, thoracolumbar spine, and cement injection approaches.Conclusions BMD, cement leakage and kyphosis after primary operation are the risk factors closely correlative to the secondary fracture after percutaneous vertebroplasty. There has not been enough evidence to support the association between the secondary fracture and gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approach.

scholarly journals Risk factors for secondary fractures to percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wei Mao ◽  
Fei Dong ◽  
Guowei Huang ◽  
Peiliang He ◽  
Huan Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Mineral Density ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Secondary Fractures ◽  
At Home

Abstract Background Osteoporotic vertebral compression fracture (OVCF) is one of the most common fragile fractures, and percutaneous vertebroplasty provides considerable long-term benefits. At the same time, there are many reports of postoperative complications, among which fracture after percutaneous vertebroplasty is one of the complications after vertebroplasty (PVP). Although there are many reports on the risk factors of secondary fracture after PVP at home and abroad, there is no systematic analysis on the related factors of secondary fracture after PVP. Methods The databases, such as CNKI, Wan Fang Database and PubMed, were searched for documents on secondary fractures after percutaneous vertebroplasty published at home and abroad from January 2011 to March 2021. After strictly evaluating the quality of the included studies and extracting data, a meta-analysis was conducted by using Revman 5.3 software. Results A total of 9 articles were included, involving a total of 1882 patients, 340 of them diagnosed as secondary fractures after percutaneous vertebroplasty. Conclusion The additional history of fracture, age, bone mineral density (BMD), bone cement leakage, intravertebral fracture clefts and Cobb Angle might be risk factors related to secondary fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. The height of vertebral anterior and body mass index (BMI) were not correlated.

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