scholarly journals Correlation of Sagittal Imbalance and Recollapse after Percutaneous Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Compression Fracture: A Multivariate Study of Risk Factors

2021 ◽  
Author(s):  
Whoan Jeang Kim ◽  
Sang Beom Ma ◽  
Hyun Min Shin ◽  
Dae Geon Song ◽  
Jae Won Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Sagittal Imbalance ◽  
Multivariate Study

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.

“Targeted Percutaneous Vertebroplasty” Versus Traditional Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fracture

2019 ◽  
Vol 26 (5) ◽  
pp. 551-559
Author(s):  
JunChuan Xu ◽  
JiSheng Lin ◽  
Jian Li ◽  
Yong Yang ◽  
Qi Fei
Keyword(s):  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Operation Time ◽  
Cement Leakage ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Controlled Study ◽  
Radiation Doses ◽  
Group A ◽  
Group B

Objective. In this randomized, nonblinded, controlled study, the feasibility and precision of “targeted percutaneous vertebroplasty” (“targeted PVP”) for osteoporotic vertebral compression fracture (OVCF) was evaluated. Methods. A total of 42 patients, aged 50 to 87 years, with OVCF were randomly divided into 2 groups: A and B. Group A underwent “targeted PVP,” and group B underwent traditional PVP with the guidance of C-arm fluoroscopy. Fluoroscopy times for skin puncture points (FTSPP), total radiation doses (TRD), total fluoroscopy times (TFT), and operation time were set as the main evaluation indicators. Results. FTSPP (1.52 ± 0.51 in group A vs 6.62 ± 2.58 in group B, U < .001), TRD (6.26 ± 1.51 in group A vs 11.32 ± 4.21 in group B, P < .001), TFT (16.57 ± 2.79 in group A vs 26.05 ± 6.18 in group B, P < .001), and operation time (20.05 ± 3.38 in group A vs 25.43 ±5.11 in group B, U < .001) were statistically different in the 2 groups. The incidence of cement leakage that occurred in group A (1/21, 4.76%) was significantly less than that in group B (9/21, 42.9%, P < 0.05). Conclusions. “Targeted PVP” may achieve (1) less skin positioning fluoroscopy times, less total fluoroscopy times and dose, shorter operation time, which is more precise than traditional PVP; (2) less incidence of cement leakage; and (3) visualization of the fractured vertebra, which is probably more valuable for the treatment of complicated OVCF patients.

scholarly journals Impact of Different Sarcopenia Stages on the Postoperative New Osteoporotic Vertebral Compression Fracture After Percutaneous Kyphoplasty

2021 ◽  
Author(s):  
Chaowei Lin ◽  
Minyu Zhu ◽  
Kelun Huang ◽  
Sheng Lu ◽  
Honglin Teng
Keyword(s):  
Risk Factors ◽  
Vertebral Compression Fracture ◽  
Univariate Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Advanced Age ◽  
Percutaneous Kyphoplasty ◽  
European Working ◽  
Independent Risk Factors ◽  
The Impact

Abstract PurposeThe purpose of this study was to evaluate the impact of different sarcopenia stages on osteoporotic vertebral compression refracture (OVCRF) and identify other risk factors of new osteoporotic vertebral compression fracture (OVCF).MethodsWe conducted a large, retrospective study of patients who underwent percutaneous kyphoplasty (PKP) for OVCF. Sarcopenia was staged as “presarcopenia”, “sarcopenia”, and “severe sarcopenia” according to the definition of the European Working Group on Sarcopenia in Older People. Univariate and multivariate analyses evaluating the risk factors for OVCRF were performed. ResultsA total of 329 patients were included, in which 20.4%, 13.1%, and 7.3% of the patients were identified as having “presarcopenia”, “sarcopenia”, and “severe sarcopenia” respectively. Advanced sarcopenia stage was associated with lower BMI, lower serum albumin level and higher NRS 2002 scores. Subsequent fractures developed in 72 (21.8 %) of 329 patients during the one year follow-up. In univariate analysis, female (p = 0.012), advanced age (≥ 75 years; p = 0.004), lower BMD (p =0.000), stage of sarcopenia (p = 0.009) were associated with OVCRFs. Multivariable analysis revealed that female (OR 6.325; 95% CI 2.176-18.368, p = 0.001), age (OR 1.863; 95% CI 1.002-3.464, p =0.049), lower BMD (OR 1.736; 95% CI 1.294-2.328, p = 0.000), sarcopenia (OR 2.536; 95% CI 1.130-5.692, p = 0.024) and severe sarcopenia (OR 4.579; 95% CI 1.615-12.968, p = 0.004) were independent risk factors of OVCRFs. ConclusionsSarcopenia and severe sarcopenia were independent risk factors for OVCRF, as well as low BMD, advanced age and female.

scholarly journals Risk Factors Analysis of Pulmonary Cement Embolism during Percutaneous Vertebroplasty or Kyphoplasty for Osteoporotic Vertebral Compression Fracture.

2021 ◽  
Author(s):  
Dexin Zou ◽  
Shengjie Dong ◽  
Wei Du ◽  
Bing Sun ◽  
Xifa Wu
Keyword(s):  
Risk Factors ◽  
Vertebral Compression Fracture ◽  
Demographic Data ◽  
Multiple Logistic Regression Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Increased Risk ◽  
Significant Difference ◽  
Cement Embolism ◽  
Pulmonary Ct

Abstract Objective: The purpose of this research is to evaluate the risk factors and incidence of PCE during PKP or PVP for osteoporotic vertebral compression fracture (OVCF) based on postoperative computed tomography (CT).Methods: A total of 2344 patients who underwent PVP or PKP due to OVCF in our spine centre were analyzed retrospectively. According to the detection of postoperative pulmonary CT, the patients were divided into two groups: pulmonary cement embolism group (PCE group) and non pulmonary cement embolism group (NPCE group). Demographic data in both groups were compared using the χ2 test for qualitative data and the unpaired t test for quantitative data. Multiple logistic regression analysis was carried out to identify risk factors that were significantly related to the PCE resulting from cement leakage.Results: PCE was found in 34 patients (1.9% 34/1782) with pulmonary CT examination after operation. There was no statistically significant difference in the parameters such as age, gender, body mass index (BMI) and cement volume in the two groups. Patients with three or more involved vertebrae had a significantly increased risk to suffer from PCE than those with one involved vertebra (p=0.046 OR 2.412 [95% CI 1.017-5.722]). Patients who suffered thoracic fracture had a significantly increased risk to suffer from PCE than those suffered thoracolumbar fracture (p=0.001 OR 0.241 [95% CI 0.105-0.550]). And significantly increased PCE risk also was observed in thoracic fracture compared with Lumbar fracture patients (p=0.028 OR 0.094 [95% CI 0.114-0.779]). The risk of PCE within two weeks after fracture was significantly higher than that after two weeks of fracture (p=0.000 OR 0.178 [95% CI 0.074-0.429]). Patients who underwent PVP surgery had a significantly increased PCE risk than those underwent PKP surgery (p=0.001 OR 0.187 [95% CI 0.069-0.509])Conclusion: The real incidence of PCE is underestimated due to the lack of routine postoperative pulmonary imaging examination. The number of Involved vertebrae, fracture location, operation timing and operation methods are independent risk factors for PCE.

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