Effect of Bone Cement Volume and Stiffness on Occurrences of Adjacent Vertebral Fractures after Vertebroplasty

Kim, Jin Myung; Shin, Dong Ah; Byun, Donghak; Kim, Hyung Sun; Kim, Sohee; Kim, Hyoung Ihl

doi:10.3340/jkns.2012.52.5.435

Cited by 53 publications

(33 citation statements)

References 17 publications

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“…In this study, we suggested as high as a 27.8% infusion ratio as an effective ratio for favorable outcomes. The ratio was similar to that of Kim et al14), whose in vitro study determined that a 30% infusion ratio was effective for strength and stiffness recovery. In our study, the mean infusion ratio of the favorable group was 25.21±7.14% in the first week follow up.…”

Section: Discussionsupporting

confidence: 79%

“…There are multiple studies, which investigated the correlation between the intravertebral cement volume and the clinical outcome through in vitro , in vivo and experimental studies 912131416171824). However, the consensus has not yet been established, since the optimal cut-off value varies according to each study.…”

Section: Discussionmentioning

confidence: 99%

“…Kim et al14), on the other hand, suggested 30% of infusion ratio for recovering the normal strength level of compressed vertebrae through experimental simulation study. Notwithstanding the difference of value, many studies assert that cement infusion ratio contributes to the recovery of the mechanical strength and stiffness 914161718). If the optimal amount of cement is determined solely based on each surgeon's experience, however, there is high possibility of inconsistency since the amount of cement may vary depending on the vertebral level, in addition to the surgeon bias.…”

Section: Discussionmentioning

confidence: 99%

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Appropriate Cement Volume in Vertebroplasty: A Multivariate Analysis with Short-Term Follow-Up

Kwon

Lee

Baek

et al. 2016

Korean J Neurotrauma

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ObjectiveThe optimal threshold of the infusion volume of cement has been a continuous subject in percutaneous vertebroplasty (PVP). This study verifies a causal relationship between the cement volume and the clinical outcome, and suggests the parameters of the appropriate volume of cement in PVP.MethodsThis is a retrospective study. One hundred nine patients, who underwent PVP between 2012 and 2015, were included in the study. Various factors such as patients' fracture levels, fracture types, fracture body volumes, fracture rates, bone mineral densities, and infused cement volumes were analyzed. Cement infusion ratios were calculated, using total amount of infused cement and fractured body volume. Follow up was done after one-week, one-month and three-months, postoperatively. Changes in the middle body height and the cement leakage levels were monitored and clinical outcomes were evaluated using a visual analogue scale.ResultsAmong the variables, the infusion ratio (r=-0.320, p=0.003, Pearson's correlation) was the only index that showed a significant cause and effect relationship with favorable clinical outcome, except the group with a T-score of higher than -2.5, and the group with a upper thoracic vertebral level. The patients with a cement infusion ratio of 27.8% or more of the fractured body volume had favorable results.ConclusionThis study showed that high cement infusion ratio revealed favorable outcome in the vertebroplasty of the osteoporotic compression fractures. Infusion ratio of more than 27.8% to osteoporotic compressed vertebrae is optimal for rapid recovery after PVP.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Appropriate Cement Volume in Vertebroplasty: A Multivariate Analysis with Short-Term Follow-Up

Kwon

Lee

Baek

et al. 2016

Korean J Neurotrauma

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“…As a treatment for Kummell disease, PKP may immediately alleviate pain and restore the stiffness and strength of the vertebral body through the stability and support provided by PMMA (20). Kim et al (21) reported that a bone cement volume of 30% of the vertebral body volume restored the level of stiffness to that of normal bone. However, if the bone cement volume exceeded 30% of the vertebral body volume, the stiffness exceeded that of normal bone.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of unilateral transverse process‑pedicle and bilateral puncture techniques in percutaneous kyphoplasty for Kummell disease

Xiong¹,

Sun²,

Song³

et al. 2019

Exp Ther Med

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In the present study, the efficacy of unilateral transverse process-pedicle and bilateral puncture techniques in percutaneous kyphoplasty (PKP) for Kummell disease was compared. Between March 2015 and June 2017, 63 patients with Kummell disease were recruited and underwent PKP with two different puncture techniques: A total of 38 patients were treated by unilateral transverse process-pedicle PKP and 25 patients were treated by bilateral PKP. The operative time, intra-operative fluoroscopy time, volume of bone cement injection and bone cement leakage were recorded. Prior to surgery and 1 day post-surgery, the visual analogue scale (VAS) pain score and Oswestry disability index (ODI) were determined, and the vertebral body height and Cobb angle were measured. The results indicated that the incidence of bone cement leakage in the unilateral group was similar with the bilateral group (15.79% vs. 16.00%), with no statistically significant difference between the two groups. None of the patients in the two groups had any obvious damage of the spinal cord. The operative time, intra-operative fluoroscopy time and volume of bone cement injection in the unilateral group were lower than those in the bilateral group. A chest X-ray examination at 1 day post-surgery revealed no pulmonary embolism in the two groups. The VAS score, ODI, vertebral body height and Cobb angle were significantly improved in the unilateral and bilateral groups at 1 day post-surgery and at the last follow-up (12 months post-surgery) as compared with these parameters prior to surgery. In conclusion, the unilateral transverse process-pedicle and bilateral puncture techniques in PKP exhibited good efficacy as a treatment for Kummell disease. The operative time, intra-operative fluoroscopy time and volume of bone cement injection were lower in the unilateral group.

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“…[132][133][134] An important component of any polymer to be used in drug delivery, is that the polymer must be biocompatible. Moreover, biocompatible polymers used for drug delivery are often biodegradable and have byproducts, which are nonharmful, such as non-toxic alcohols, acids, and other relatively easily eliminated products.…”

Section: A Polymers In Drug Deliverymentioning

confidence: 99%

Drug Delivery Systems: Possibilities and Challenges

Spitler¹,

Zanganeh²,

Jafari³

et al. 2017

Drug Delivery Systems

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Effect of Bone Cement Volume and Stiffness on Occurrences of Adjacent Vertebral Fractures after Vertebroplasty

Cited by 53 publications

References 17 publications

Appropriate Cement Volume in Vertebroplasty: A Multivariate Analysis with Short-Term Follow-Up

Appropriate Cement Volume in Vertebroplasty: A Multivariate Analysis with Short-Term Follow-Up

Efficacy of unilateral transverse process‑pedicle and bilateral puncture techniques in percutaneous kyphoplasty for Kummell disease

Drug Delivery Systems: Possibilities and Challenges

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