A Review of Osteoporotic Vertebral Fracture Nonunion Management

Yang, Huilin; Pan, Jun; Wang, Genlin

doi:10.1097/brs.0000000000000538

Cited by 48 publications

(52 citation statements)

References 39 publications

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“…Thus, it does not fuse well. In consideration to the overall health conditions of these patients and the affordability of expenses, vertebroplasty appears to be a good treatment option compared with open surgery [21,22] and kyphoplasty, due to its minimal invasion and low cost.…”

Section: Discussionmentioning

confidence: 99%

Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Guo¹,

Cai²,

Zhang³

et al. 2017

Medicine

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Osteoporotic vertebral compression fractures with intraosseous vacuum phenomena could cause persistent back pains in patients, even after receiving conservative treatment. The aim of this study was to evaluate the efficacy of using high-viscosity bone cement via bilateral percutaneous vertebroplasty in treating patients who have osteoporotic vertebral compression fractures with intraosseous vacuum phenomena.Twenty osteoporotic vertebral compression fracture patients with intraosseous vacuum phenomena, who received at least 2 months of conservative treatment, were further treated by injecting high-viscosity bone cement via bilateral percutaneous vertebroplasty due to failure of conservative treatment. Treatment efficacy was evaluated by determining the anterior vertebral compression rates, visual analog scale (VAS) scores, and Oswestry disability index (ODI) scores at 1 day before the operation, on the first day of postoperation, at 1-month postoperation, and at 1-year postoperation.Three of 20 patients had asymptomatic bone cement leakage when treated via percutaneous vertebroplasty; however, no serious complications related to these treatments were observed during the 1-year follow-up period. A statistically significant improvement on the anterior vertebral compression rates, VAS scores, and ODI scores were achieved after percutaneous vertebroplasty. However, differences in the anterior vertebral compression rate, VAS score, and ODI score in the different time points during the 1-year follow-up period was not statistically significant (P > 0.05).Within the limitations of this study, the injection of high-viscosity bone cement via bilateral percutaneous vertebroplasty for patients who have osteoporotic vertebral compression fractures with intraosseous vacuum phenomena significantly relieved their back pains and improved their daily life activities shortly after the operation, thereby improving their life quality. In this study, the use of high-viscosity bone cement reduced the leakage rate and contributed to their successful treatment, as observed in patients during the 1-year follow-up period.

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Section: Discussionmentioning

confidence: 99%

Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Guo¹,

Cai²,

Zhang³

et al. 2017

Medicine

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“…Some patients will occur the ischemic osteonecrosis even nonunion of the vertebral body, that manifested with intravertebral cleft (IVC) or intravertebral vacuum phenomen. [2][3][4][5][6][7] Thus, the definition of this type of OTF is widely divergent. In honor of Kummell's contributions, early scholars used the name Kummell's disease, followed by a series of names reflecting different pathological changes of OTF, such as vertebral ischemic osteonecrosis or vertebral nonunion.…”

Section: Introductionmentioning

confidence: 99%

“…In honor of Kummell's contributions, early scholars used the name Kummell's disease, followed by a series of names reflecting different pathological changes of OTF, such as vertebral ischemic osteonecrosis or vertebral nonunion. 1,5,6 The above names only address the symptoms or pathological changes of patients with OTF, but cannot fully summarize the imaging characteristics.…”

Section: Introductionmentioning

confidence: 99%

Reliability and application of the new morphological classification system for chronic symptomatic osteoporotic thoracolumbar fracture

Hao

Yang²,

Tuo³

et al. 2020

Preprint

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ObjectiveThis study proposed a new classification system for Chronic Symptomatic Osteoporotic Thoracolumbar Fracture (CSOTF) based on fracture morphology. Research on CSOTF has increased in recent years. However, the lack of a standard classification system has resulted in inconveniences regarding communication, research and treatment. Previous studies of CSOTF classification exhibit different defects, and none of these studies are widely accepted.MethodsWe collected 368 cases of CSOTF in our hospital from January 2010 to June 2017 and systematically analyzed the imaging data of all patients to develop a classification system. Imaging examinations included dynamic radiography, computed tomography scans and magnetic resonance imaging. Ten investigators systematically studied and fully understood the classification system grading 40 cases on two occasions, examined 1 month apart. Kappa coefficients (κ) were calculated to determine intraobserver and interobserver reliability.ResultsThe new classification system for CSOTF was divided into types I-V according to whether the CSOTF exhibited dynamic instability, spinal stenosis or kyphosis deformity. Intra- and interobserver reliability were excellent for all types (κ = 0.83 and 0.85, respectively).ConclusionsThe new classification system for CSOTF demonstrated excellent reliability in this initial assessment. The system is convenient for communication and research, but wide clinical application are needed to confirm its effectiveness and guide clinical treatment.

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“…Various surgical strategies have been developed, including percutaneous kyphoplasty (PKP) or vertebroplasty (PVP), anterior-only, posterior-only, and combined anterior and posterior procedures [8][9][10]. For stages I and II Kümmell disease, adequate pain relief, vertebral body height restoration, and kyphosis correction are achieved with PKP and PVP [11][12]. However, stage III Kümmell disease patients with spinal canal stenosis, particularly with nerve damage, PKP or PVP are less effective, with a higher risk of cement leakage, and potential severe neurological damage.…”

Section: Introductionmentioning

confidence: 99%

Long-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell diseaseLong-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease

Mo¹,

Zhou²,

Li³

et al. 2020

Preprint

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Purpose This study aimed to evaluate the efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease. Methods Twenty-five patients with stage III Kümmell disease who received bone cement-augmented pedicle screw fixation at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between June 2009 and December 2015 were enrolled. All patients were females with a history of osteoporosis. The vertebral Cobb angle (V-Cobb angle), the fixed segment Cobb Angle (S-Cobb angle), pelvic parameters, visual Analogue Scale (VAS) score, and Oswestry Disability Index (ODI) were assessed preoperatively, postoperatively and at the final follow-up. Complications, loosening rate, operation time, and intraoperative bleeding were recorded. Results The average lumbar vertebral density T-value was -3.68 ± 0.71 SD, and the average age was 71.84 ± 5.39. The V-Cobb angle, S-Cobb angle, and Sagittal Vertical Axis（SVA） were significantly smaller postoperatively compared to the preoperative values. The VAS and ODI at 1 month after surgery were 3.60 ± 1.00 and 36.04 ± 6.12%, respectively, which were both significantly lower than before surgery (VAS: 8.56±1.04, ODI: 77.80 ± 6.57%). Conclusion Bone cement-augmented pedicle screw fixation is a safe and effective treatment for stage III Kümmell disease. It can effectively correct kyphosis, restore and maintain sagittal balance, and maintain spinal stability.

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A Review of Osteoporotic Vertebral Fracture Nonunion Management

Cited by 48 publications

References 39 publications

Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilateral percutaneous vertebroplasty

Reliability and application of the new morphological classification system for chronic symptomatic osteoporotic thoracolumbar fracture

Long-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell diseaseLong-term efficacy and safety of bone cement-augmented pedicle screw fixation for stage III Kümmell disease

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