scholarly journals Could Teriparatide Replace Percutaneous Vertebral Augmentation for Patients with Osteoporotic Vertebral Compression Fracture to Some Extent? [Letter]

2019 ◽  
Vol Volume 14 ◽  
pp. 2095-2096
Author(s):  
Jiaming Zhou ◽  
Yuan Xue
Keyword(s):  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Augmentation

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

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

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

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

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

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

scholarly journals Kyphoplasty for the treatment of an atypical osteoporotic vertebral compression fracture of the lumbar spine: A case report

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774498
Author(s):  
Sanjeev Kumar ◽  
Leon Anijar ◽  
Rishi Agarwal
Keyword(s):  
Older Patients ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Clinical Scenario ◽  
Vertebral Augmentation ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Lumbar Vertebral Body

Vertebral augmentation is a minimally invasive but sometimes technically challenging intervention typically reserved for the treatment of older patients with painful vertebral compression fractures due to osteoporosis or neoplasms. We report the successful treatment of osteoporotic vertebral compression fractures of the first lumbar vertebral body (L1) using kyphoplasty in a paraplegic young patient with multiple comorbidities. Despite the unusual and complicated clinical scenario, kyphoplasty was nonetheless performed with immediate and lasting pain relief.

scholarly journals Percutaneous Vertebroplasty Versus Kyphoplasty for Thoracolumbar Osteoporotic Vertebral Compression Fractures in Patients with Distant Lumbosacral Pain

2021 ◽  
pp. E349-E356
Author(s):  
Qihang Su
Keyword(s):  
Cobb Angle ◽  
Oswestry Disability Index ◽  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Augmentation ◽  
Lumbosacral Region ◽  
Vas Score

Background: In clinical practice, we have found that the pain caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) is sometimes not limited to the level of the fractured vertebrae but instead occurs in areas far away from the injured vertebrae, such as the lower back, area surrounding the iliac crest, or buttocks, and this type of pain is known as distant lumbosacral pain. The pathogenesis of pain in distant regions caused by thoracolumbar OVCF remains unclear. Objectives: To compare the clinical efficacy and imaging outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of distant lumbosacral pain accompanied by thoracolumbar OVCF and to explore the possible pathogenesis of distant lumbosacral pain caused by thoracolumbar OVCF. Study Design: Retrospective study. Setting: A university hospital spinal surgery departments. Methods: A total of 62 patients who underwent vertebral augmentation for thoracolumbar OVCF with lumbosacral pain were included and divided into the PVP group (28 cases) and the PKP group (34 cases). The Visual Analog Scale (VAS) was used to evaluate the severity of local and distant lumbosacral pain, and the Chinese modified Oswestry Disability Index (CMODI) was used for functional assessment. The anterior vertebral height (AVH) of the fractured vertebrae and local kyphotic angle were measured on plain radiographs. The average follow-up time was 28.62 ± 8.43 months in the PVP group and 29.22 ± 9.09 months in the PKP group. Results: Within the 2 groups, the VAS score of local pain, VAS score of distant lumbosacral pain, and CMODI score at 3 days postoperatively and at the last follow-up improved significantly compared with the scores before surgery. However, there was no significant difference between the 2 groups. At 3 days postoperatively and at last follow-up, the AVH and Cobb angle in the 2 groups improved significantly compared with those before surgery, but the magnitudes of AVH improvement and Cobb angle correction were significantly larger in the PKP group than in the PVP group. Limitations: First, this study is retrospective and may be prone to selection bias. Second, because of cultural and linguistic differences, the original version of the Oswestry Disability Index could not be properly understood and completed by people in mainland China. Therefore in this study, the CMODI was used, but the correlation coefficients of the CMODI within and between groups were 0.953 and 0.912, respectively. Third, a pain diagram was not used to accurately reflect the location of pain in the distant lumbosacral region. Conclusions: Both PVP and PKP can effectively alleviate pain in the distant lumbosacral region caused by thoracolumbar OVCF, and distant lumbosacral pain associated with thoracolumbar OVCF may be considered vertebrogenic referred pain. Key words: Osteoporotic vertebral compression fracture, distant pain, non-midline pain, kyphoplasty, vertebroplasty, vertebral augmentation, lumbosacral pain, Chinese modified Oswestry Disability Index

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

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

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

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