Efficacy analysis of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with kyphosis

Abstract

Background: To investigate the clinical effect of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) in the treatment of osteoporotic compression vertebral fracture (OVCF) of the thoracolumbar vertebra with kyphosis. Methods: One hundred sixty-six patients before June 2017 were retrospectively analyzed, and patients were divided into PPSF + PVP group A and PVP group B. Operative time, bone mineral density, postoperative bed time, high compression ratio, bone cement leakage rate, and bone cement dose were recorded. Comparison of vertebral anterior edge height, Cobb angle, visual analogue score (VAS), and low back pain dysfunction index (ODI) between the two groups in preoperative, postoperative 3 days, postoperative 6 months, postoperative 12 months, and postoperative 24 months, postoperative complications were observed in the two groups. Results: The operation time of group A was longer than that of group B (59.0 ± 8.6 min, 26.6 ± 5.2 min), longer postoperative bed rest time (3.3 ± 0.7 days, 1.2 ± 0.5 days), the differences were statistically significant (P < 0.01), there was no difference in the amount of bone cement between the two groups (5.4 ± 0.6 ml, 5.3 ± 0.8 ml) (P > 0.05). The height of the anterior edge and Cobb angle of the two groups recovered significantly in postoperative 3 days. The height of anterior edge (2.7 ± 0.

Investigation of Preoperative Traction Followed by Percutaneous Kyphoplasty Combined with Percutaneous Cement Discoplasty for the Treatment of Severe Thoracolumbar Osteoporotic Vertebral Compression Fractures

“…On the one hand, the number of related literatures about PCD are quite limited and no literatures on bone cement leakage have been found; on the other hand, the compact and intact annulus fibrosus around the intervertebral disc can effectively avoid the leakage of bone cement. However, in this study, the incidence of cement leakage in the intervertebral space was higher (7,21), and it mainly occurred in front of the intervertebral space. Continuous hyperextension traction before surgery could release the contracture annulus or even the anterior longitudinal ligament in front of the intervertebral disc, which could effectively relieve kyphosis, but it might lead to fissures in the anterior annulus.…”

“…5,6 For OVCFs with disc and endplate injury, PKP cannot effectively relieve pain and prevent the aggravation of kyphosis, and thus it might not be an effective method to treat severe OVCFs with kyphosis. 7 As an emerging minimally invasive surgery, percutaneous cement discoplasty (PCD) has achieved satisfactory clinical results in the treatment of discogenic pain in the elderly and correction of degenerative scoliosis, which has aroused strong people's attention and has gradually been used in clinical practice. [8][9][10] In the treatment of severe spinal deformity, preoperative traction (PT) can effectively reduce the degree of deformity and the difficulty of operation.…”

A patient with Turner syndrome received the percutaneous vertebroplasty seven times: a case report and literature review

“…Recently researches have confirmed that pedicle screw fixation combined with PVP in the treatment of VCFs is superior to PVP alone to restore vertebral height and relieve pain [ 20 ]. This may be a new idea for the management of TS patients with osteoporosis who cannot receive hormone replacement therapy in the future.…”

Is unilateral transverse process-pedicle percutaneous kyphoplasty a better choice for osteoporotic thoracolumbar fractures in the old patients?

“…Nonetheless, this treatment might lead to related complications, such as deep vein thrombosis in lower extremities, muscle atrophy, decubitus ulcers, pulmonary or urinary infections [ 3 6 ]. On the other hand, pedicle screws fixation, as another common treatment for vertebral fracture, could also be performed to treat OVCF with high risk of surgical complication due to osteoporosis (e.g., screw misplacement, screw pullout, screw loosening and so on) [ 7 , 8 ]. In addition, poor cardiac and pulmonary conditions are common healthy issues in this population after a surgery under general anesthesia.…”