Efficacy and safety of the target puncture technique for treatment of osteoporotic vertebral compression fractures with intravertebral clefts

Yu, Weibo; Liang, De; Jiang, Xiaobing; Yao, Zhensong; Qiu, Ting; Ye, Linqiang

doi:10.1136/neurintsurg-2016-012690

Cited by 14 publications

(24 citation statements)

References 28 publications

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“… 21 Yu et al concluded that due to the presence of fibroperichondrium on the inner wall of the cleft and sclerosis of the surrounding bone, bone cement is difficult to diffuse into the surrounding cancellous bone and form effective adhesion, only form solid lump in the cleft. 22 The limited bone cement mass cannot be connected with the upper and lower adjacent endplates and cannot strengthen cancellous bone of vertebrae, which is more prone to stress shielding leading to recollapse, and cannot support the normal physiological stress from the body resulting in the continued existence of pain symptoms caused by osteoporosis. 23 Hence, bone cement injection should fill both the cleft in the vertebral body and the bone tissue around the cleft to increase the stability and prevent later loss of average vertebral height.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell’s Disease

Pan

Chen

2022

Geriatr Orthop Surg Rehabil

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Objective: To compare the clinical efficacy of unipedicular and bipedicular percutaneous kyphoplasty (PKP) for Kummell’s disease. Methods: A retrospective study was performed to review 40 patients with stage I and II Kummell’s disease who underwent PKP in our hospital from January 2015 to June 2018. Based on the transpedicular approach of PKP, those patients were randomly divided into unipedicular group (n = 19) and bipedicular group (n = 21). Operative time, bone cement injection volume and cement leakage rate were compared in the two groups. Pre- and post-operative visual analogue score (VAS), local kyphotic angle and average vertebral height were also evaluated. Results: All patients underwent surgery successfully. Compared with preoperative condition, VAS was significantly decreased at 1 day after operation and the last follow-up in both groups ( P < .05), and local kyphotic angle and average vertebral height were restored markedly ( P < .05). Operative time of both groups had no significant difference ( P > .05). Bone cement injection volume was larger in bipedicular group ( P < .05). At 1 day after operation and the last follow-up, the local kyphotic angle and average vertebral height in bipedicular group were restored better than those in unipedicular group ( P < .05). There were 4 cases of cement leakage in both groups, with leakage rates of 21.1% and 19.0%, respectively, and the difference was not significant ( P > .05). Conclusion: Both unipedicular and bipedicular PKP are effective for treating patients with stage I and II Kummell’s disease, while postoperative pain relief and imaging results in bipedicular group were better than those in unipedicular group.

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Section: Discussionmentioning

confidence: 99%

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell’s Disease

Pan

Chen

2022

Geriatr Orthop Surg Rehabil

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“…Therefore, the spongy distribution pattern should be formed during the injection of bone cement to obtain better therapeutic effect [21] . Yu et al concluded that due to the presence of broperichondrium on the inner wall of the cleft and sclerosis of the surrounding bone, bone cement is di cult to diffuse into the surrounding cancellous bone and form effective adhesion, only form solid lump in the cleft [22] . The limited bone cement mass cannot be connected with the upper and lower adjacent endplates and cannot strengthen cancellous bone of vertebrae, which is more prone to stress shielding leading to recollapse, and cannot support the normal physiological stress from the body resulting in the continued existence of pain symptoms caused by osteoporosis [23] .Hence, bone cement injection should ll both the cleft in the vertebral body and the bone tissue around the cleft to increase the stability and prevent later loss of average vertebral height.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell's Disease

Peng¹,

Ouyang²,

Huang³

et al. 2020

Preprint

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Background: Percutaneous kyphoplasty (PKP) is effective for the treatment of Kummell's disease. However, controversy remains regarding whether a unipedicular or bipedicular PKP is superior.Methods: A retrospective study was performed to review 40 patients with stage I and II Kummell's disease who underwent PKP in our hospital from January 2015 to June 2018. Based on the transpedicular approach of PKP, those patients were randomly divided into unipedicular group (n = 19) and bipedicular group (n = 21) . Operative time, bone cement injection volume and cement leakage rate were compared in the two groups. Pre- and post-operative visual analogue score (VAS), local kyphotic angle and average vertebral height were also evaluated.Results: All patients underwent surgery successfully. Compared with preoperative condition, VAS was significantly decreased at 1 day after operation and the last follow-up in both groups (P < 0.05) , and local kyphotic angle and average vertebral height were restored markedly (P < 0.05). Operative time of both groups had no significant difference (P > 0.05). Bone cement injection volume was larger in bipedicular group (P < 0.05). At 1 day after operation and the last follow-up , the local kyphotic angle and average vertebral height in bipedicular group were restored better than those in unipedicular group (P < 0.05). There were 4 cases of cement leakage in both groups, with leakage rates of 21.1% and 19.0%, respectively, and the difference was not significant (P > 0.05).Conclusion: Both unipedicular and bipedicular PKP are effective for treating patients with stage I and II Kummell's disease, while postoperative pain relief and imaging results in bipedicular group were better than those in unipedicular group.

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“…A new pedicle entry point has been used for repeat puncture [9], but this is surgically time-consuming; also, sometimes, a new point cannot be chosen because, radiographically, the pedicle is obscured by the initially injected cement. Yu et al [2] used a puncture technique to treat clefted OVCFs. The needle tip was positioned in extra-cleft cancellous bone, and a balloon inflated to compact the surrounding bone until the periphery of the cleft was broken.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous vertebroplasty usually effectively treats osteoporotic vertebral compression fractures (OVCFs) with clefts [1,2]. However, recurrent back pain caused by re-fracture is not uncommon [3][4][5][6]; a cleft in the OVCF combined with poor cement dispersion within the fractured vertebra are the two prime risk factors [4,6,7].…”

Section: Introductionmentioning

confidence: 99%

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Creation of a planned or central-clefted puncture combined with a second puncture during vertebroplasty to treat osteoporotic vertebral compression fractures with large clefts

Zhou

Zhu

et al. 2020

J Orthop Surg Res

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Background Cemented vertebrae frequently re-fracture after vertebroplasty to treat osteoporotic vertebral compression fractures (OVCFs) with large clefts. We compared the efficacy of planned and central-clefted puncture, both followed by a second puncture, as treatments for OVCFs with large clefts. Methods We retrospectively studied 38 patients. 18 of whom underwent planned puncture (group A) and 20 central-clefted puncture (group B). A second puncture was performed when the initially injected cement was restricted to the cleft. We recorded a visual analog scale (VAS) pain scores, vertebral kyphotic angles (KAs), and compression ratios (CRs) preoperatively and at 2 days and 6 months postoperatively. We recorded the cement dispersion patterns and complications. Results Second punctures succeeded in 15/18 and 7/20 patients of groups A and B, respectively. At 2 days postoperatively, the VAS score, KA, and CR were significantly better than the preoperative values (P < 0.01); no significant difference was found between the two groups (P > 0.05). At the 6-month follow-up, all scores were poorer than at 2 days postoperatively (all P < 0.05), significantly more so in group B than group A (P < 0.05). Significant differences in terms of the cement dispersion patterns, and the cemented vertebral re-fracture and cement leakage rates, were observed between the two groups (all P < 0.05). Conclusion The two-puncture techniques were initially effective when treating large-clefted OVCFs. However, compared to the central-clefted puncture, the planned puncture improved the success rate of the second puncture, allowed better cement dispersion, and reduced the incidence of vertebral re-fracture during follow-up.

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Efficacy and safety of the target puncture technique for treatment of osteoporotic vertebral compression fractures with intravertebral clefts

Cited by 14 publications

References 28 publications

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell’s Disease

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell’s Disease

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell's Disease

Creation of a planned or central-clefted puncture combined with a second puncture during vertebroplasty to treat osteoporotic vertebral compression fractures with large clefts

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