A Tentative Study of Individual Puncture Path of PVP/ PKP in Treating OVCFs

Abstract Background: The prior objective of this study is to discuss individualized puncture path of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of the elderly with severe osteoporotic vertebral compression fractures (OVCFs).Previous studys have compared the clinical efficacy and safety of PVP and PKP. Based on their research results, we will make a further investigation about this two main operations in treating OVCFs and propose a set of original and feasible puncture plan in clinical work, which will improve efficiency and safety of PKP and PVP.Methods: We searched all the articles related to PVP and PKP in treating OVCFs on medicine database. Issues of the selected journals published from 1999 to 2020 were hand-searched by us, including experimental or review articles. Combining conclusions of these researches and clinical cases of our department, we are forged to find more common and preferred treatments for patients with OVCFs under different situations.Results: Most of thees studies revealed that there was no significant difference in relieving the back pain and improving the quality of patients’ life between PVP and PKP surgeries, which generally based on the VAS scores and Oswestry disability index(ODI) scores. However, PKP has a lower rate of bone cement leakage and incidence of adjacent vertebrae fracture than the PVP. Restoring the vertebral height and local kyphotic angle corrections of PKP are much better than that of PVP. On the other hand, more operation time, higher cost and rate of re-surgery of PKP should also be taken into consideration when we make better choice for patients. Therefore, we are forged to find individual methods for patients who are diagnosed as OVCFs.Conclusions: Both the two types of operation can significantly relieve the pain of the patients ,reduce the risk of occurring complication and mortality after OVCFs. There is no so-called best treatment for patients between PVP and PKP. We should take the comprehensive actual conditions into account when choosing surgical methods for patients with OVCFs, which is absolutely vital to us. However, individual puncture path is beneficial for us to make operations including both PKP and PVP.

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Comparison Between Percutaneous Kyphoplasty And Percutaneous Vertebroplasty In Terms of The Efficacy For Osteoporotic Vertebral Compression Fractures: A Meta-Analysis

10.21203/rs.3.rs-609136/v1 ◽

2021 ◽

Author(s):

Hai-Tao Zhu ◽

De-Gang Ding ◽

Shui Wang ◽

Yu-Long Zhu

Keyword(s):

Meta Analysis ◽

Operation Time ◽

The Elderly ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Beneficial Effects ◽

Radiographic Outcomes ◽

Vas Scores

Abstract Background & Aim: Osteoporotic vertebral compression fractures (OVCFs) are acknowledged as common occurred fractures among humans, especially for the elderly population. The minimally invasive percutaneous methods such as kyphoplasty as well as vertebroplasty have been valid and effective tools in terms of reducing clinical problems, which are associated with more beneficial effects as compared to traditional methods such as open surgery or conservative treatment. Hence, we conducted the current meta-analysis in order to gather updated evidence available for the systematical assessment of the clinical and radiographic outcomes of VP in comparison of KP.Methods: Publications on comparison kyphoplasty versus vertebroplasty in treatment of OVCFs were collected. After rigorous and thorough review of quality, we extracted the data on the basis of eligible trials, which analyzed the summary hazard ratios (HRs) of the endpoints of interested.Results: Totally, our inclusion criteria involved five studies. 561subjects involving 334 patients received VP and 227 patients received KP were included, of which patients receiving KP or VP failed to show any significant differences in the visual analog scale (VAS) scores (MD =-0.02, 95% CI -0.40 – 0.35; P = 0.91),and the risk of cement leakage (OR =1.60, 95% CI 0.82 – 3.12; P = 0.17). Nevertheless, the Oswestry Disability Index (ODI) scores (MD =-1.56, 95% CI -2.39 – -0.73; P = 0.0002), the injected cement volume (MD =-0.40, 95% CI -0.77 – -0.04; P = 0.03) and the operation time (MD =-9.67, 95% CI -11.55 – -7.80; P ＜0.00001) in VP group were linked to markedly lower trend in comparison of KP group with significant statistical difference.Conclusion: The present meta-analysis controls the acceptable level of the efficacy across the involved trials. The VP had ODI scores, the injected cement volume and the operation time exerted several advantages in this meta-analysis. Yet, VP failed to show benefits in terms of the VAS scores and cement leakage in comparison of KP therapy. Given the combined results of our study, the optimal treatment for patient harboring OVCFs should be determined by further high-quality and multi-center RCTs along with longer follow-ups as well as larger sample size.

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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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The Comparison of Ultrasound and Fluoroscopy-guided for Determining Puncture Entry Point of Percutaneous Vertebroplasty

10.21203/rs.3.rs-149179/v1 ◽

2021 ◽

Author(s):

Sen Ye ◽

Xiaorong Lai ◽

Lingjian Zhong ◽

Changzhang Yu ◽

Yanzhen Chen

Keyword(s):

Success Rate ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Entry Point ◽

Vertebral Compression Fractures ◽

Ultrasound Guided ◽

Significant Difference ◽

Fracture Nonunion ◽

Vas Scores ◽

The One

Abstract OBJECTIVE: The purpose of this study was to compare the safety and efficacy of ultrasound and fluoroscopy-guided for determining the puncture entry point of percutaneous vertebroplasty (PVP). Methods: From November 2018 to December 2019, a total of 50 eligible patients with thoracolumbar osteoporotic vertebral compression fractures (OVCFs) treated by PVP were retrospectively collected, of which 25 cases were in ultrasound-guided group and the other 25 cases were in fluoroscopy-guided group. Radiation doses, one-time localization success rate, operation time, clinical efficacy and complications incidence were compared between the two groups. Results: Ultimately, 46 patients completed followed-up, whose average follow-up time was 9 months, the dose and times of fluoroscopy and operation time in ultrasound-guided group statically significantly decreased compared with fluoroscopy-guided group (P<0.01). The one-time localization success rate in ultrasound-guided group and fluoroscopy-guided group were 68.2% and 37.5% respectively ( x 2 = 4.33, P=0.037), whose difference was statistically significant (P<0.01). However, there was no significant difference in the visual analog scale (VAS) scores of back pain relief between the two groups (P>0.05). There were no postoperative complications such as infection, hematoma formation and fracture nonunion observed between the two groups.Conclusion: Ultrasound-guided entry point determination for PVP puncture is safe, which can significantly improve the success rate of one-time localization and decrease radiation exposure and operation time.

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KYPHOPLASTY AND VERTEBROPLASTY IN THE TREATMENT OF OSTEOPOROTIC VERTEBRAL FRACTURES

Coluna/Columna ◽

10.1590/s1808-185120181702189429 ◽

2018 ◽

Vol 17 (2) ◽

pp. 124-128

Author(s):

García Ortiz Uriel Nahum ◽

Fuentes Rivera Miguel Ángel ◽

González Moga Amado ◽

Santos Benitez Hugo Alberto

Keyword(s):

Vertebral Compression Fractures ◽

Final Conclusion ◽

Level Of Evidence ◽

Compression Fractures ◽

Osteoporotic Vertebral Fractures ◽

Significant Difference ◽

Retrospective Comparative Study ◽

Effective Procedures ◽

Better Than

ABSTRACT Objective: To compare these procedures in the treatment of osteoporotic vertebral compression fractures. Methods: Patients who underwent vertebral augmentation procedures between March 2010 and October 2016 were selected for the study. Kyphosis, anterior vertebral height, Oswestry Disability Index (ODI), Visual Analog Scale (VAS), number of portals, cement volume, and complications were recorded. The results were analyzed by difference of the means. Results: Sixty-eight patients were selected, accounting for 105 procedures. A statistically significant improvement was observed in VAS and ODI with both procedures (p<0.001) without statistically significant difference between them, regardless of the number of portals or cement applied. There was a high correlation between kyphosis correction and ODI improvement (p =0.012). Conclusions: Both vertebroplasty and kyphoplasty are effective procedures for the treatment of vertebral compression fractures. We found no significant difference between both procedures. The high correlation between improvement of kyphosis and ODI suggests that these procedures are better than conservative treatment to improve the quality of life of patients, however more studies are required to reach a final conclusion. Level of Evidence III; Retrospective comparative study.

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The Comparation of Ultrasound and Fluoroscopy-guided for Determining Puncture Entry Point of Percutaneous Vertebroplasty

10.21203/rs.3.rs-44122/v1 ◽

2020 ◽

Author(s):

Sen Ye ◽

Xiaorong Lai ◽

Lingjian Zhong ◽

Changzhang Yu ◽

Wen Lu ◽

...

Keyword(s):

Success Rate ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Entry Point ◽

Vertebral Compression Fractures ◽

Ultrasound Guided ◽

Significant Difference ◽

Fracture Nonunion ◽

Vas Scores ◽

The One

Abstract Objective: The purpose of this study was to compare the safety and efficacy of ultrasound and fluoroscopy-guided for determining the puncture entry point of percutaneous vertebroplasty (PVP). Methods: From November 2018 to December 2019, a total of 50 eligible patients with thoracolumbar osteoporotic vertebral compression fractures (OVCFs) treated by PVP were retrospectively collected, of which 25 cases were in ultrasound-guided group and the other 25 cases were in fluoroscopy-guided group. Radiation doses, one-time localization success rate, operation time, clinical efficacy and complications incidence were compared between the two groups.Results: Ultimately, 46 patients completed followed-up, whose average follow-up time was 9 months, the dose and times of fluoroscopy and operation time in ultrasound-guided group statically significantly decreased compared to fluoroscopy-guided group (P<0.01). The one-time localization success rate in ultrasound-guided group and fluoroscopy-guided group were 68.2% and 37.5% respectively (x2= 4.33, P=0.037), whose difference was statistically significant (P<0.01). However, there was no significant difference in the visual analog scale (VAS) scores of back pain relief between the two groups (P>0.05). There were no postoperative complications such as infection, hematoma formation and fracture nonunion obsereved between the two groups.Conclusion: Ultrasound-guided entry point determination for PVP puncture is safe, which can significantly improve the success rate of one-time localization and decrease radiation exposure and operation time.

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Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Medicina ◽

10.3390/medicina57020135 ◽

2021 ◽

Vol 57 (2) ◽

pp. 135

Author(s):

Tomohide Segawa ◽

Hisashi Koga ◽

Masahito Oshina ◽

Katsuhiko Ishibashi ◽

Yuichi Takano ◽

...

Keyword(s):

Interbody Fusion ◽

Outcome Measure ◽

Operation Time ◽

Secondary Outcome ◽

Invasive Technique ◽

Lateral Interbody Fusion ◽

Surgical Methods ◽

Significant Difference ◽

Oblique Lateral Interbody Fusion ◽

Lateral Interbody

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

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Clinical Application of a 3D-Printed Positioning Module and Navigation Template for Percutaneous Vertebroplasty

Surgical Innovation ◽

10.1177/15533506211062404 ◽

2021 ◽

pp. 155335062110624

Author(s):

Jing Yang ◽

Penghui Ni ◽

Lina Zhang ◽

Zhanxin Lu ◽

Dapeng Liu ◽

...

Keyword(s):

Percutaneous Vertebroplasty ◽

Operation Time ◽

Vertebral Compression Fractures ◽

Control Group ◽

Compression Fractures ◽

Intraoperative Fluoroscopy ◽

3D Printed ◽

Vas Scores ◽

Experimental Group ◽

Navigation Template

Background This study aimed to evaluate a personalized 3D-printed percutaneous vertebroplasty positioning module and navigation template based on preoperative CT scan data that was designed to treat patients with vertebral compression fractures caused by osteoporosis. Methods A total of 22 patients with vertebral compression fractures admitted to our hospital were included in the study. Positioning was performed with the new 3D-printed positioning module, and the navigation template was used for patients in the experimental group, and the traditional perspective method was used for patients in the control group. The experimental group consisted of 11 patients, 2 males and 9 females, with a mean age of 67.27 ± 11.86 years (range: 48 to 80 years), and the control group consisted of 11 patients, 3 males and 8 females, with a mean age of 74.27 ± 7.24 years (range: 63 to 89 years). The puncture positioning duration, number of intraoperative fluoroscopy sessions, and preoperative and postoperative visual analog scale (VAS) scores were statistically analyzed in both groups. Results The experimental group had shorter puncture positioning durations and fewer intraoperative fluoroscopy sessions than the control group, and the differences were statistically significant (P < .05). There were no significant differences in age or preoperative or postoperative VAS scores between the two groups (P > .05). Conclusions The new 3D-printed vertebroplasty positioning module and navigation template shortened the operation time and reduced the number of intraoperative fluoroscopy sessions. It also reduced the difficulty in performing percutaneous vertebroplasty and influenced the learning curve of senior doctors learning this operation to a certain degree.

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Performance of elderly on the three words-three shapes test: A Brazilian study

Dementia & Neuropsychologia ◽

10.1590/s1980-57642008dn10400012 ◽

2007 ◽

Vol 1 (4) ◽

pp. 396-401

Author(s):

Cristiane Garcia da Costa Armentano ◽

Julieta Quayle

Keyword(s):

Educational Level ◽

The Elderly ◽

Test Method ◽

Delayed Recall ◽

Assessment Of Learning ◽

Significant Difference ◽

Males And Females ◽

Stored Information ◽

Better Than ◽

Years Of Schooling

Abstract The three words-three shapes test is a brief bedside technique for assessment of learning and memory using verbal and non-verbal material. To the best of our knowledge, performance of Brazilian elderly on this test has not yet been reported. Objective: To evaluate the performance of normal Brazilian elderly on the three words-three shapes test. Method: A total of 50 adult patients, 25 males and 25 females, with age ranging from 55 to 81 years (66.0±7.10 years), 1 to 8 years of schooling, different economic conditions and living in the São José do Rio Preto municipality, State of São Paulo, were evaluated. Results: There was no statistically significant difference between performance of males and females. Performance on incidental recall was significantly lower than in delayed recall. The performance in the learning phase improved following at least two further presentations of the stimuli. Approximately 50% of the participants did not remember the six stimuli and had to proceed to the recognition stage. The performance in the recognition stage was significantly better than during spontaneous recall. Patients with low educational level (less years of schooling) had poorer performance on the recall of shapes and on the total score of the test. Conclusions: The three words-three shapes test is rapid, efficient and straightforward to apply in the elderly, but low educational level was associated with poorer performance on this test. Normal elderly individuals had greater difficulty in the encoding process and in searching for stored information.

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Efficacy of carprostol tromethamine combined with mifepristone in the treatment of uterine fibroids

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v3i1.697 ◽

2019 ◽

Vol 3 (1) ◽

Author(s):

Jun Wang ◽

Xian Zhang

Keyword(s):

Estrogen Receptor ◽

Progesterone Receptor ◽

Treatment Effect ◽

Uterine Fibroids ◽

Operation Time ◽

Clinical Treatment ◽

Control Group ◽

Observation Group ◽

Significant Difference ◽

Better Than

ã€Abstractã€‘Objective: To investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids. METHODS: A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects. According to the two different treatment methods, patients were divided equally. The observation group and the control group, each group of 33 people. The oxytocin drug treatment was medicated to the control group, and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group. The treatment effect, adverse reaction, operation, and uterine muscle before and after surgery were observed in these two groups. Tumor tissue progesterone receptor and estrogen receptor levels. Results: The clinical treatment effect of the observation group was 93.94%, and the clinical treatment effect of the control group was 60.61%. The clinical treatment effect of the observation group was significantly higher than that of the control group; also the incidence of adverse reactions in the observation group in terms of rash, fatigue, nausea and vomiting was much lower than the control group, and could observe a significant difference. Finally in observation group, the amount of intraoperative blood loss, operation time and hospitalization time were better than those of the control group. The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group, it is worth to make further comparison. Conclusion: Carprostol tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.

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The Effectiveness of Hope Therapy on Improving the Elderly Quality of Life

Social Behavior Research & Health ◽

10.18502/sbrh.v3i1.1040 ◽

2019 ◽

Author(s):

Hassan Zareei Mahmoodabadi ◽

Mansoreh Nourian ◽

Seyed Reza Reza Javadian ◽

Elahe Fallah Tafti

Keyword(s):

Quality Of Life ◽

Elderly Women ◽

The Elderly ◽

Controlled Study ◽

Daily Care ◽

Significant Difference ◽

Quality Of Life Scale ◽

Hope Therapy ◽

Experimental Group

Background: Elderly is an era of life, which affects quality of life; aging changes the thinking ways and reduces the self-confidence. The present study was conducted to evaluate the effect of hope therapy on the elderly quality of life in Mehriz, Yazd in 2016 - 2017. Methods: In this controlled study with pre-test post-test design, the study population consisted of all elderly people who referred to daily care centers of Mehriz. The sample consisted of 24 elderly women in the daily care centers, who were divided into two groups of experimental (n = 12) and awaiting (n = 12).Hope therapy was provided in eight sessions for the experimental group. The instrument used in this research was Quality of Life Scale for the Elderly. Results: The MANOVA results showed a significant difference between the experimental and awaiting groups. In the experimental group, physical function, depression, anxiety, mental performance, and life satisfaction improved, but education did not affect the sex dimension. Hope therapy, was effective on improving the elderly quality of life. Conclusion: The studied training can be used as an effective treatment to improve the elderly quality of life.

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