Polymethylmethacrylate-augmented Cannulated Pedicle Screw Fixation for High-energy Vertebral Compression Fracture with Osteoporosis

Abstract Background: High-energy vertebral compression fractures (HVCFs) with osteoporosis puts forward higher requirement for the stability of pedicle screw internal fixation system. However, few studies have concentrated on the clinical outcomes of cannulated pedicle screw to augment fixation with polymethylmethacrylate (PMMA) under this condition. This study aims to investigate the mid-term efficacy of bone cement-injectable cannulated pedicle screw (CICPS) in HVCFs with osteoporosis.Methods: Eighteen patients with HVCFs (T < -2.5) were underwent spinal fixation by CICPS from 2012 to 2017. The operation time, blood loss, and hospitalization time were recorded. Pain and functional recovery were evaluated by Visual Analog Scale VAS) and Oswestry Disability Index (ODI), respectively. X-ray films were taken to evaluate the loss of vertebral height, kyphosis angle, pedicle screw loosening, and bony fusion. Surgical related complications were also recorded.Results: The average follow-up time was 18.5 ± 8.7 months (range, 6-54 months). VAS and ODI scores indicated significant improvements in postoperative pain and activity function (P < 0.05). Comparing the last follow-up with the postoperative imaging findings, the loss of vertebral height and kyphosis angle was 3.4 ± 1.2 mm and 7.8 ± 3.8°, respectively. The rate of bone graft fusion was 100% while no case was involved in screw loosening or extraction. 1 case of superficial infection, 2 cases of PMMA leakage, and 1 case of cerebrospinal fluid leakage were found.Conclusions: CICPS fixation using PMMA augmentation may be suggested as a feasible surgical technique in osteoporotic patients with HVCFs.

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The effect and potential risks of using cement-augmented pedicle screw instrumentation on multiple segment fixation in osteoporotic spine with lumbar degenerative diseases

10.21203/rs.2.19693/v2 ◽

2020 ◽

Author(s):

Yong-chao Tang ◽

Hui-zhi Guo ◽

Dan-qing Guo ◽

Pei-jie Luo ◽

Yong-xian Li ◽

...

Keyword(s):

Pedicle Screw ◽

Perioperative Complications ◽

Pedicle Screws ◽

Operation Time ◽

Fusion Rate ◽

Screw Loosening ◽

Potential Risks ◽

Lumbar Degenerative Diseases ◽

Four Levels

Abstract Background: Cement-augmented pedicle screw instrumentation (CAPSI) has been found to significantly increase the pedicle screws anchorage in the osteoporotic vertebral body, however, with the increase of augmented level and bone cement dose, the incidence of cement leakage (CL) or side complication of CAPSI also increased. But the effect and potential risks of CAPSI for osteoporotic lumbar degenerative diseases (LDD) have not been investigated in the cases of multiple segment fixation. The purpose of this study was to investigate potential complications of using cement-augmented screws for multilevel fixation (three or four levels) and the effectiveness of this method for treating LDD with low bone quality.Methods: Our clinical database was reviewed for osteoporotic patients who using CAPSI or conventional pedicle screw (CPS) for multilevel fixation (three or four levels) between February 2010 to February 2017. A total of 93 patients with multilevel LDD were divided into the CAPSI group (46 subjects) and the CPS group (47 subjects), including 75 cases for three levels (L2-L5 21 cases、L3-S1 54 cases), 18 cases for four levels (L1-L5 2 cases、L2-S1 16 cases), and the average follow-up was 33.72±18.78 months (range: 24-108). Relevant data were recorded, including age, gender, body mass index (BMI), bone mineral density (BMD), diagnosis, fusion methods, bone graft, fusion level, lumbosacral fixation, different patterns of S1 pedicle screw placement, operation time, blood loss, hospital stay, complications, CL, pulmonary cement embolism (PCE), screw loosening and nonunion patients. Besides, the visual analogue scale (VAS) and Oswestry disability index (ODI) at pre-operation, post-operation, and follow-up were also assessed.Results: In the CAPSI group, a total of 336 augmented screws were placed bilaterally, and the average injection dose of bone cement was 1.85±0.65 ml (range: 1-4). The CL was observed in 44 patients (95.65%) and 116 screws (34.52%). Three cemented screws (0.89%) and twenty-four S1 conventional screws (44.44%) were found loosening during the follow-up and the overall fusion rate was 93.47%. For perioperative complications, two patients (4.35%) experienced PCE, one patient augmented vertebral fracture and three patients (6.52%) wound infection. And in the CPS group, seventeen patients (36.17%) and thirty-three screws (8.46%) suffered loosening in cranial or caudal segments (seven cranial cases and twenty-six of caudal), four cases experienced nonunion, the fusion rate was 91.49% in total. The operation time and hospital stay were longer in CAPSI group, but with a lower percentage of screw loosening (P＜0. 05). And in terms of blood loss, perioperative complications, fusion rate, VAS and ODI scores at the follow-up times, no significant differences were found between the two groups.Conclusions: Patients with osteoporotic LDD underwent CPS at multiple segments have a high rate of screw loosening in the cranial and caudal segment. The application of cemented pedicle screws on multilevel LDD can achieve better stability and less screw loosening, but it also accompanied by longer operating time, higher incidence of CL, PCE and wound infections. Selective cement-augmenting the cranial and caudal pedicle screws may be a worthy strategy to decrease the complications.

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Vertebral Compression Fractures Treated in Acute by Instrumented Kyphoplasty: Early and Mid-Term Clinical and Radiological Results

BioMed Research International ◽

10.1155/2019/1386510 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Jules Descamps ◽

Mayalen Lamerain ◽

Zied Chenguel ◽

Perrine Jubert ◽

Marc-Antoine Rousseau

Keyword(s):

Disc Degeneration ◽

Lumbar Lordosis ◽

Rating Scale ◽

Compression Fracture ◽

Vertebral Compression Fractures ◽

Vertebral Height ◽

Radiological Results ◽

Wide Range ◽

Adjacent Disc

The treatment of traumatic low-degree vertebral compression fracture remains in a wide range between functional treatment, bracing, vertebroplasty, kyphoplasty, and even surgical fixation. The objective was to assess the innovation of instrumented kyphoplasty and to report the early and mid-term functional and radiological results. This study is a retrospective review of patients enrolled from 2012 to 2017. 104 consecutive endovertebral implantations of instrumented kyphoplasty were reviewed for the study. There were 56 women and 48 men. 93 of 104 patients were evaluated, of whom 27 were evaluated only by retrospective medical record review and 66 with follow-up visit. Clinical parameters were the pain rating scale (VAS) and the Oswestry score questionnaire. The radiological parameters were the vertebral kyphosis, vertebral height, lumbar lordosis, and adjacent disc degeneration (UCLA scale). Statistical correlations between before/after surgery/last follow-up were performed. The average follow-up was 26.7 months (3 to 55). The average VAS decreased from 8.2 to 3.2 the day after surgery, allowing immediate standup. The average Oswestry score was 14.6 at follow-up. The average vertebral kyphosis decreased from 12.9° to 6.5° post-op and stabilized at 8.0° at the last follow-up, corresponding to 28% gain on vertebral height. The lumbar lordosis was restored (+6.6°). Adjacent disc degeneration increased by 1 UCLA grade in 17 patients (16.3%) at follow-up. The instrumented kyphoplasty in acute led to immediate and lasting pain relief, with no bracing or bed rest, short stay in hospital, and quick return to daily life including professional activities. The good clinical results were associated to a stable radiological restoration of the vertebral anatomy.

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Comparison of Unilateral and Bilateral Polymethylmethacrylate-augmented Cannulated Pedicle Screw Fixation for Management of Lumbar Spondylolisthesis with Osteoporosis

10.21203/rs.3.rs-46176/v1 ◽

2020 ◽

Author(s):

Yao-yao Liu ◽

Jun Xiao ◽

Huai-jian Jin ◽

Zhong Wang ◽

Xiang Yin ◽

...

Keyword(s):

Blood Loss ◽

Pedicle Screw ◽

Operation Time ◽

Cerebrospinal Fluid Leakage ◽

Posterior Fixation ◽

Screw Loosening ◽

Superficial Infection ◽

Lumbar Degenerative Disease ◽

Intervertebral Disc Height ◽

Lumbar Spondylolisthesis

Abstract Background: Many studies have shown that cannulated pedicle screw (CPS) augmented by polymethylmethacrylate (PMMA) can obtain a satisfactory clinical efficacy in the treatment of lumbar spondylolisthesis with osteoporosis. However, accurate application of CPSs will help to avoid the difficulty of screw revision and reduce the incidence of PMMA related complications. This study aims to investigate the mid-term efficacy of CPS comparing unilateral and bilateral application in this common lumbar degenerative disease. Methods: Between May 2011 and May 2018, 50 patients with posterior fixation and fusion using traditional pedicle screw or CPSs for lumbar spondylolisthesis with osteoporosis were included in the study. Patients were divided into 2 groups: those with unilateral PMMA-augmented CPSs (group UC n=29) and those with bilateral PMMA-augmented CPSs (group BC, n=21). Operation time, blood loss, average hospitalization time, PMMA leakage and other complications were recorded. Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were used to evaluate the recovery of symptoms. Radiographic results were compared for the intervertebral fusion and screw loosening. Results: There were no significant differences in the baseline data of the 2 groups.VAS and ODI scores were improved significantly after surgery (P<0.05), with no differences between the groups (P>0.05). The operation time and blood loss in group UC were significantly lower than those in groups BC (P<0.05). However, the loss of intervertebral disc height and Taillard index had no difference in group UC compared with group BC. And the rates of PMMA leakage in group UC and BC were 7.0% and 11.9%, respectively (P<0.05). Bony fusion was achieved in all groups without screw loosening at the last follow-up. And only one patient experienced superficial infection in both groups, meanwhile two patients of cerebrospinal fluid leakage was observed in group BC.Conclusions: Unilateral application of PMMA-augmented CPS may provide adequate clinical safety and effectiveness in surgical treatment of lumbar spondylolisthesis with osteoporosis.

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Comparison of unilateral and bilateral polymethylmethacrylate-augmented cannulated pedicle screw fixation for the management of lumbar spondylolisthesis with osteoporosis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01975-1 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Yao-yao Liu ◽

Jun Xiao ◽

Huai-jian Jin ◽

Zhong Wang ◽

Xiang Yin ◽

...

Keyword(s):

Blood Loss ◽

Pedicle Screw ◽

Pedicle Screws ◽

Operation Time ◽

Cerebrospinal Fluid Leakage ◽

Posterior Fixation ◽

Screw Loosening ◽

Superficial Infection ◽

Lumbar Degenerative Disease ◽

Lumbar Spondylolisthesis

Abstract Background Cannulated pedicle screw (CPS) augmented by polymethylmethacrylate (PMMA) can achieve satisfactory clinical efficacy in the treatment of lumbar spondylolisthesis with osteoporosis. However, accurate application of CPSs will help to avoid the difficulty of screw revision and reduce the incidence of PMMA-related complications. This study aimed to investigate the mid-term efficacy of CPS compared to unilateral and bilateral applications in this common lumbar degenerative disease. Methods May 2011 and May 2018, 50 patients with lumbar spondylolisthesis with osteoporosis who underwent posterior fixation and fusion using traditional pedicle screws or CPSs were included in the study. Patients were divided into two groups based on the application: the unilateral PMMA-augmented CPS group (UC, n = 29) and the bilateral PMMA-augmented CPS group (BC, n = 21). Operation time, blood loss, average hospitalization time, PMMA leakage, and other complications were recorded. The visual analog scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate symptom recovery. Radiographic results were compared for intervertebral fusion and screw loosening. Results There were no significant differences in the baseline data of the two groups. The VAS and ODI scores improved significantly after surgery (P < 0.05), with no significant differences between the groups (P > 0.05). The operation time and blood loss in the UC group were significantly lower than those in the BC group (P < 0.05). However, the loss of intervertebral disk height and Taillard index did not differ significantly between the groups. The rates of PMMA leakage in the UC and BC groups were 7.0% and 11.9%, respectively (P < 0.05). Bony fusion was achieved in all groups without screw loosening at the last follow-up. Only one patient experienced superficial infection in both groups, while cerebrospinal fluid leakage was observed in two patients in the BC group. Conclusions Unilateral application of PMMA-augmented CPS may provide adequate clinical safety and effectiveness in the surgical treatment of lumbar spondylolisthesis with osteoporosis.

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Comparison of unilateral and bilateral polymethylmethacrylate-augmented cannulated pedicle screw fixation for the management of lumbar spondylolisthesis with osteoporosis

10.21203/rs.3.rs-46176/v2 ◽

2020 ◽

Author(s):

Yao-yao Liu ◽

Jun Xiao ◽

Huai-jian Jin ◽

Zhong Wang ◽

Xiang Yin ◽

...

Keyword(s):

Blood Loss ◽

Pedicle Screw ◽

Pedicle Screws ◽

Operation Time ◽

Cerebrospinal Fluid Leakage ◽

Posterior Fixation ◽

Screw Loosening ◽

Superficial Infection ◽

Intervertebral Disc Height ◽

Lumbar Spondylolisthesis

Abstract Background: Cannulated pedicle screw (CPS) augmented by polymethylmethacrylate (PMMA) can achieve satisfactory clinical efficacy in the treatment of lumbar spondylolisthesis with osteoporosis. However, accurate application of CPSs will help to avoid the difficulty of screw revision and reduce the incidence of PMMA-related complications. This study aimed to investigate the mid-term efficacy of CPS compared to unilateral and bilateral applications in this common lumbar degenerative disease.Methods: Between May 2011 and May 2018, 50 patients with lumbar spondylolisthesis with osteoporosis who underwent posterior fixation and fusion using traditional pedicle screws or CPSs were included in the study. Patients were divided into two groups based on the application: the unilateral PMMA-augmented CPS group (UC, n = 29) and the bilateral PMMA-augmented CPS group (BC, n = 21). Operation time, blood loss, average hospitalization time, PMMA leakage, and other complications were recorded. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were used to evaluate symptom recovery. Radiographic results were compared for intervertebral fusion and screw loosening.Results: There were no significant differences in the baseline data of the two groups.The VAS and ODI scores improved significantly after surgery (P < 0.05), with no significant differences between the groups (P > 0.05). The operation time and blood loss in the UC group were significantly lower than those in the BC group (P < 0.05). However, the loss of intervertebral disc height and Taillard index did not differ significantly between the groups. The rates of PMMA leakage in the UC and BC groups were 7.0% and 11.9%, respectively (P < 0.05). Bony fusion was achieved in all groups without screw loosening at the last follow-up. Only one patient experienced superficial infection in both groups, while cerebrospinal fluid leakage was observed in two patients in the BC group.Conclusions: Unilateral application of PMMA-augmented CPS may provide adequate clinical safety and effectiveness in the surgical treatment of lumbar spondylolisthesis with osteoporosis.

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An analysis of the causes of transient paraplegia during percutaneous vertebral augmentation under local anesthesia: A case series of 12 patients

Journal of Orthopaedic Surgery ◽

10.1177/2309499019861879 ◽

2019 ◽

Vol 27 (3) ◽

pp. 230949901986187

Author(s):

Guan Shi ◽

Fei Feng ◽

Chen Hao ◽

Jia Pu ◽

Bao Li ◽

...

Keyword(s):

Spinal Cord ◽

Local Anesthesia ◽

Vertebral Body ◽

Case Series ◽

Operation Time ◽

Complete Recovery ◽

Vertebral Compression Fractures ◽

Vertebral Augmentation ◽

Anesthetic Drugs

Background: Percutaneous vertebral augmentation (PVA) under local anesthesia has been widely used to treat osteoporotic vertebral compression fractures and vertebral body tumors. However, the occurrence of spinal cord or nerve root dysfunction may result in poor prognosis for patients. The aim of this study was to analyze the causes of transient paraplegia in 12 patients undergoing PVA. Methods: The medical records of 12 patients with transient paraplegia during PVA in our hospital were analyzed. Data, including operation, vertebral, anesthetic dose, operation time, recovery time, and follow-up, were extracted. Results: Among the 12 patients, ranging in age from 62 years to 83 years, with a mean age of 74 years, 8 were females and 4 were males. The average anesthetic dose injected per vertebral body was 6.38 ml. Patients required an average of 218.75 min to recover sensation and movement completely. However, the amount of anesthetic injected into each vertebral body was not related to the time required for complete recovery. Follow-up showed that all patients had regained normal bilateral sensation and motor function. Postoperative visual analog scale and Oswestry Disability Index values of the 12 patients were significantly improved compared with preoperative values. Conclusion: The complication of transient paraplegia was caused by local anesthetic drugs infiltrating into the spinal canal and inhibiting nerve conduction in the spinal cord.

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Analysis of two minimally invasive procedures for osteoporotic vertebral compression fractures with intravertebral cleft: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01938-6 ◽

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.

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Unilateral curved versus bipedicular vertebroplasty in the treatment of osteoporotic vertebral compression fractures

BMC Surgery ◽

10.1186/s12893-019-0653-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Rui Zhong ◽

Jianheng Liu ◽

Runsheng Wang ◽

Yihao Liu ◽

Binbin Chen ◽

...

Keyword(s):

Compression Fracture ◽

Operation Time ◽

Cement Leakage ◽

Leakage Rate ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Significant Difference ◽

Vas Scores ◽

Postoperative Improvement

Abstract Background Vertebral compression fracture is one of the most common complications of osteoporosis. In this study an unilateral curved vertebroplasty device was developed, and the safety, effectiveness, and surgical parameters of curved vertebroplasty (CVP) in the treatment of painful osteoporotic vertebral compression fractures was investigated and compared with traditional bipedicular vertebroplasty (BVP). Methods We investigated 104 vertebral augmentation procedures performed over 36 months. CVP and BVP procedures were compared for baseline clinical variables, pain relief (Visual Analog Scale, VAS), disability improvement (Oswestry Disability Index, ODI), operation time, number of fluoroscopic images, volume of cement per level, and cement leakage rate for each level treated. Complications and refracture incidence were also recorded in the two groups. Results The VAS and ODI in both group had no significant difference preoperative (P > 0.05), and a significant postoperative improvement in the VAS scores and ODI was found in both group (P < 0.001). However, the CVP group had significantly lower operation time, number of fluoroscopic images, and cement leakage rate per level than the BVP group (P < 0.05); however, the volumes of cement per level were similar in the two groups (P > 0.05). Neither group had any serious complications. Five and two patients in the BVP group developed refractures at non-adjacent and adjacent levels, respectively, with one patient developing refractures twice; however, none of the patients in the CVP group developed refractures at any level. Conclusions Our findings revealed that both CVP and BVP were safe and effective treatments for osteoporotic vertebral compression fractures, and CVP entails a shorter operation time, less exposure to fluoroscopy, and lower rate of cement leakage.

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Posterior Fixation Combined with Vertebroplasty or Vertebral Column Resection for the Treatment of Osteoporotic Vertebral Compression Fractures with Intravertebral Cleft Complicated by Neurological Deficits

BioMed Research International ◽

10.1155/2019/4126818 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Hongyu Wei ◽

Chunke Dong ◽

Yuting Zhu

Keyword(s):

Blood Loss ◽

Neurological Deficits ◽

Vertebral Compression Fractures ◽

Posterior Fixation ◽

Osteoporotic Vertebral Compression Fractures ◽

Vertebral Height ◽

Vertebral Column Resection ◽

Operative Duration ◽

Neurologic Function

Purpose. The aim of the current study was to evaluate the relative benefits of posterior fixation combined with vertebroplasty (PFVP) or vertebral column resection (PVCR) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral cleft (IVC) complicated by neurological deficits. Methods. From June 2010 to January 2015, 45 consecutive patients suffering OVCFs with IVC and spinal cord injuries were treated with PFVP or PVCR in our department. The visual analogue scale (VAS) score, anterior vertebral height (AVH), posterior vertebral height (PVH), local kyphotic angle (LKA), and neurologic function were evaluated and compared, and the operative duration, blood loss, and complications were also recorded. Results. They all achieved excellent pain relief, vertebral height recovery, and kyphosis correction one month after surgery, and no significant differences existed between the two groups. No significant differences were observed between the 1-month postoperative and final follow-up VAS, AVH, and LKA values in the PVCR group (P>0.05), while AVH and LKA worsened in the PFVP group at the final follow-up (P<0.05). Similarly, the initial improvements in VAS scores decreased over time (P<0.05). Neurologic function improved in both groups, and no significant differences were observed between the 2 groups either preoperatively or postoperatively (P>0.05). The blood loss and operative duration were significantly lower in the PFVP group than those in the PVCR group (P<0.05). Conclusion. Compared with PVCR, PFVP had equivalent short-term clinical outcomes with less blood loss and operative duration which can be very beneficial for treating elderly patients with extreme comorbidities in this condition. However, based on the long-term efficacy of pain relief, vertebral height maintenance, and deformity correction, PVCR is a more reasonable choice.

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Vertebral body height changes in acute symptomatic osteoporotic vertebral compression fractures treated with vertebral cement augmentation. Which factors affect vertebral body height?

10.21203/rs.3.rs-430234/v1 ◽

2021 ◽

Author(s):

Jesús Payo-Ollero ◽

Rafael Llombart-Blanco ◽

Carlos Villas ◽

Matías Alfonso

Keyword(s):

Vertebral Body ◽

Body Height ◽

Cement Augmentation ◽

Vertebral Compression Fractures ◽

Vertebral Augmentation ◽

Vertebral Height ◽

Vertebral Body Height ◽

Post Surgery ◽

Osteoporotic Vertebral Fractures

Abstract Changes in vertebral body height depend on various factors which were analyzed in isolation and not as a whole. The aim of this study is to analyze what factors might influence restoration of vertebral body height after vertebral augmentation. We analyzed 48 patients (108 vertebrae) with osteoporotic vertebral fractures underwent vertebral augmentation when conservative treatment proved unsatisfactory. Analyses were carried out at the time of the fracture, during surgery (pre-cementation and post-cementation), at first medical check-up (6 weeks post-surgery) and at last medical check-up. Average vertebral height was measured and differences from preoperative values calculated at each timepoint. Pearson correlation coefficient and linear multivariable regression were carried out at the different timepoints. The time since vertebral fracture was 60.4 ± 41.7 days. Patients’ average age was 70.9 ± 9.3-years. The total follow-up was 1.43 ± 1-year. After vertebral cementation there was an increase in vertebral body height of + 0.3cm (13.6%). During post-operative follow-up, there was a progressive collapse of the vertebral body and pre-surgical height was reached. The factors that most influenced vertebral height restoration were: grade III collapse, intervertebral-vacuum-cleft (IVVC), and use of a flexible trocar before cement augmentation. The factor that negatively influenced vertebral body height restoration was location in the thoracolumbar spine.

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