Influence of the distribution of bone cement along the fracture line on the curative effect of vertebral augmentation

Xu, Kai; Li, Yaling; Song, Fei; Liu, Huawei; Yang, Huadong; Xiao, Shifu

doi:10.1177/0300060519864183

Cited by 11 publications

(12 citation statements)

References 36 publications

(39 reference statements)

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“…Hence, Cement distribution in the vertebra during vertebroplasty is closely linked to pain relief and durability of curative effect after surgery. This is because the distribution of bone cement affects the strength and biomechanical stability of the strengthened vertebral body ( 13 ). There is currently no simple and practical approach for evaluating the distribution of bone cement in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Effect of cement distribution type on clinical outcome after percutaneous vertebroplasty for osteoporotic vertebral compression fractures in the aging population

et al. 2022

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ObjectiveThe study aimed to investigate the effect of the type of bone cement distribution on clinical outcomes following percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF) in the elderly.MethodsRetrospective analysis of 160 patients diagnosed with OVCF who underwent PVP treatment from March 2018 to December 2020. Based on the kind of postoperative bone cement distribution, bone cement was classified as types I, II, III, IV, and V. Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Cobb angle, anterior vertebral height ratio, refracture rate of injured vertebrae, and incidence of adjacent vertebral fractures were compared for the five types before and after three days, and one year of operation.ResultsVAS and ODI at three days and one year postoperative were significantly lower than those preoperative (P < 0.05) for all five distribution types. VAS and ODI for types I, II, and III were lower at one year postoperatively than for types IV and V (P < 0.05). There was no significant difference in Cobb angle and anterior vertebral body height ratio between preoperative and three days postoperative groups (P < 0.05); however, there were significant differences between three days and one-year postoperative and preoperative groups (P < 0.05). Following one year of surgery, the Cobb angle and the anterior vertebral height ratio of types IV and V were significantly different from those of types I, II, and III (P < 0.05), and there was a statistically significant difference between types IV and V (P < 0.05). In terms of the incidence of injured vertebral refractures and adjacent vertebral fractures, the evenly distributed types I, II, and III were significantly lower than the unevenly distributed types IV and V, and the incidence of type V was higher (P < 0.05).ConclusionsThe clinical efficacy of cement distribution following PVP of types I, II, and III is better than that of types IV and V, which can better relieve pain with long-lasting efficacy and minimize the occurrence of refractures of injured vertebrae and adjacent vertebral body fractures.

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Section: Discussionmentioning

confidence: 99%

Effect of cement distribution type on clinical outcome after percutaneous vertebroplasty for osteoporotic vertebral compression fractures in the aging population

et al. 2022

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“…Insufficient filling of bone cement is an important cause of recompression, especially the uneven distribution in the sagittal plane [15]. If the cement is in full contact with the upper and lower endplates, it will fill the whole vertebral body and play a full role of "bonding" for the cancellous bone and the endplate, which can better restore the strength of the vertebral body [16]. When the cement only touches the upper or lower endplates, vertebral strength only increases about 2 times.…”

Section: Discussionmentioning

confidence: 99%

“…There were 26 males and 111 females, with an average age of 69 ± 7.0 years old. The average follow-up time was 15.3 ± 6.3 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) months.…”

Section: General Datamentioning

confidence: 99%

The effect of bone cement distribution on the outcome of percutaneous Vertebroplasty: a case cohort study

Tan

Wen

Guo

et al. 2020

BMC Musculoskelet Disord

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Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: One hundred thirty seven patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 h post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results: 24 h post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6-24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. Analysis in subgroup B revealed no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.

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“…Insu cient lling of bone cement is an important cause of recompression, especially the uneven distribution in the sagittal plane [15]. If the cement is in full contact with the upper and lower endplates, it will ll the whole vertebral body and play a full role of "bonding" for the cancellous bone and the endplate, which can better restore the strength of the vertebral body [16]. When the cement only touches the upper or lower endplates, vertebral strength only increases about 2 times.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

Tan

Wen²,

Guo

et al. 2020

Preprint

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Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: 137 patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 hours post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results: 24 hours post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6-24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. In subgroup analysis, there was no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.

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Influence of the distribution of bone cement along the fracture line on the curative effect of vertebral augmentation

Cited by 11 publications

References 36 publications

Effect of cement distribution type on clinical outcome after percutaneous vertebroplasty for osteoporotic vertebral compression fractures in the aging population

Effect of cement distribution type on clinical outcome after percutaneous vertebroplasty for osteoporotic vertebral compression fractures in the aging population

The effect of bone cement distribution on the outcome of percutaneous Vertebroplasty: a case cohort study

The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

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