A review of vertebroplasty for osteoporotic and malignant vertebral compression fractures

Montagu, Alexandra; Speirs, Archie; Baldock, James; Corbett, James R.; Gosney, Margot

doi:10.1093/ageing/afs024

Cited by 24 publications

(21 citation statements)

References 24 publications

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“…In this study pain was reduced by an average of 5.3 postoperatively and 4.9 at the final follow-up (p<0.005). This reduction of 74% is within the range of the results of the majority of previously published articles (12,25,29,32) at 1-month follow-ups. At the 6-month follow-up, the results remained stable (5, 21); our study entailed longer follow-up periods for the majority of the patients (i.e., 38.2 months for the hematologic and 22.8 for the metastatic patients).…”

Section: Survivalsupporting

confidence: 84%

“…The cement leakage ratios were within the lower margin of the various relevant publications, which range from 4 to 72.5% (4, 8, 10,11,14,24,32). In our series, none of the leakages were located in the spinal canal or the foraminal area.…”

Section: █ Conclusionsupporting

confidence: 58%

“…Previous publications have focused on pain treatment in this group of patients (32) and not on evaluations of methods to control the biomechanical changes and the clinical consequences of these changes (9,37,40). Due to an increase in the life expectancy of this group of patients (3,7,10,19,20), these biomechanical changes are increasingly likely to occur and result in clinical symptoms.…”

Section: █ Introductionmentioning

confidence: 99%

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Long-term benifts of percutaneous anatomical restoration of vertebral compression fractures linked to malignancy

Noriega

Krüger²,

Ramajo³

et al. 2015

Turkish Neurosurgery

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ABSTRACTwill develop spine symptoms, and approximately 40% to 70% of these patients will have multiple-level involvement (1,28,34).The development of VCF associated with malignancy deteriorates quality of life and increases pain, sagittal imbalance and abdominal and respiratory problems (2, 41). All of these symptoms are of great importance when dealing with the osteoporotic population (18) and are even more relevant for the cancer population (13,19,20,22,33). █ INTRODUCTIONSpine disease due to malignant lesions is common among cancer patients. The incidence of spine malignant disease varies from 30% to 70%, depending on the primary tumor (14, 30), although not all of these cases are symptomatic. The incidence of vertebral compression fracture (VCF) in multiple myeloma is 24%, 14% in breast cancer and 6% among prostate cancer. Approximately 10% of lung cancer patients AIM: To evaluate the efficacy, feasibility and safety of a percutaneous anatomical vertebral body reduction for the treatment of VCF (vertebral compression fracture) linked to malignancy. Vertebroplasty and percutaneous kyphoplasty have played essential roles in the treatment of painful vertebral metastasis, although there are few reports with long survival that have evaluated the long-term efficacy, adjacent fractures and vertebral body (VB) re-collapse associated with these procedures. We aimed to evaluate the longterm efficacy and the complications associated with malignancy and changes in spinal biomechanics. MATERIAL and METHODS:The retrospective study examined 32 patients with osteolytic VCF due to malignant infiltration of the vertebral body. A visual analogue scale, the EQ5 and radiological analysis (i.e., X-ray and CT scan) were used to assess back pain, quality of life and complications.RESULTS: Statistically significant reductions in anterior and central vertebral body heights (6.2 mm-19.6 ± 4.2 mm-and 5.8 mm-16.7 ± 7.8 mm-, respectively) that resulted in reductions of the regional Cobb angles exceeding 30% were observed. There was also a statistically significant improvement in quality of life. The average survival was longer than those reported in most published articles, and the average follow-up period was 30.9 months. CONCLUSION:Anatomical restoration (i.e., cortical ring reduction with endplate rebalancing) is potentially beneficial for a wellselected group of patients with spine metastases and long life expectancies because this procedure avoids the complications typical of these types of treatments (e.g., leakage, adjacent fractures and re-collapse).

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Section: Survivalsupporting

confidence: 84%

Section: █ Conclusionsupporting

confidence: 58%

Section: █ Introductionmentioning

confidence: 99%

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Long-term benifts of percutaneous anatomical restoration of vertebral compression fractures linked to malignancy

Noriega

Krüger²,

Ramajo³

et al. 2015

Turkish Neurosurgery

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“…BMD measurements were not taken, and thus could not be factored in during fracture generation or statistical analysis. Also, all sheep used in this study were assumed to be healthy with normal BMD, whereas non-traumatic compression fractures in humans usually occur on pathological spine, most commonly in osteoporotic or metastatic vertebrae (1). Additionally, the augmentation procedure was not ideal.…”

Section: Discussionmentioning

confidence: 99%

“…Osteoporosis is the leading cause of non-traumatic vertebral compression fractures (1), and is responsible for approximately 750,000 vertebral fractures per annum in the United States alone (2). Conservative management involving bed rest, analgesia, external fixation and rehabilitation is effective for the majority of patients (3); however, about one-third will remain refractory, suffering from chronic pain (4), immobility, kyphotic deformity, decline in respiratory function and deterioration in quality of life (5).…”

Section: Introductionmentioning

confidence: 99%

Effects of cement augmentation on the mechanical stability of multilevel spine after vertebral compression fracture

Tan¹,

Wang²,

Pelletier³

et al. 2016

J. Spine Surg.

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Background: Studies on the effects of cement augmentation or vertebroplasty on multi-level spine after vertebral compression fractures are lacking. This paper seeks to establish a 3-vertebrae ovine model to determine the impact of compression fracture on spine biomechanics, and to discover if cement augmentation can restore mechanical stability to fractured spine.Methods: Five lumbar spine segments (L1-L3) were obtained from 5-year-old female Merino sheep.Standardized wedge-compression fractures were generated in each L2 vertebra, and then augmented with polymethyl methacrylate (PMMA) cement mixed with 30% barium sulphate powder. Biomechanical pure moment testing in axial rotation (AR), flexion/extension (FE) and lateral bending (LB) was carried out in the intact, fractured and repaired states. Range of motion (ROM) and neutral zone (NZ) parameters were compared, and plain radiographs taken at every stage.Results: Except for a significant increase in ROM between the intact and fractured states in AR between L1 and L2 (P<0.05), there were no other significant differences in ROM or NZ between the other groups.There was a trend towards an increase in ROM and NZ in all directions after fracture, but this did not reach significance. Normal biomechanics was only minimally restored after augmentation. Conclusions:Results suggest that cement augmentation could not restore mechanical stability of fractured spine. Model-specific factors may have had a role in these findings. Caution should be exercised when applying these results to humans.

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Gelenk- und Muskelschmerzen

Bernateck

Kuipers

Zeidler

et al. 2013

Praktische Schmerzmedizin

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A review of vertebroplasty for osteoporotic and malignant vertebral compression fractures

Cited by 24 publications

References 24 publications

Long-term benifts of percutaneous anatomical restoration of vertebral compression fractures linked to malignancy

Long-term benifts of percutaneous anatomical restoration of vertebral compression fractures linked to malignancy

Effects of cement augmentation on the mechanical stability of multilevel spine after vertebral compression fracture

Gelenk- und Muskelschmerzen

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