Kyphoplasty: Report of Eighty-Two Thoracolumbar Osteoporotic Vertebral Fractures

Rhyne, Alfred L.; Banit, Daxes M.; Laxer, Eric B.; Odum, Susan M.; Nussman, Donna S.

doi:10.1097/00005131-200405000-00005

Cited by 114 publications

(39 citation statements)

References 14 publications

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“…The results of individual studies (Table 1) show significant improvements with any of the measurement instruments used, i.e., back function index [15], the Roland-Morris disability questionnaire [43] or walking status [13,28]. Moreover, the combined analysis of four studies [9,13,18,31] with 263 patients using the Oswestry Disability Index, confirms that BK affords significant improvement [WMD (95% CI): )23.8 ()34.0, )13.55), P=0.00].…”

Section: Resultsmentioning

confidence: 99%

“…Noncomparative studies: The results of eight studies [4,12,15,20,31,42,43] show that 87 of the 450 patients included developed new vertebral fractures during the follow-up period. The combined analysis of these studies shows (Fig.…”

Section: New Vertebral Fracturesmentioning

confidence: 99%

“…NK None NK Theodorou et al [53] None None NK Coumans et al [9] 2.7% Acute myocardial infarction MI 1 NK Garfin [15] 10% Rib fracture 1, Arrhythmia 1 11.5% Ledlie and Renfro [28] 9% Respiratory failure, Deep venous thrombosis NK Lieberman and Reinhardt [31] <5% NK 21% Phillips [40] 9.8% Acute myocardial infarction, Arrhythmia, Urinary retention 17% Wilhelm et al [40] 17.8% Transient lesion of L2 NK Berlemann et al [4] 33% Digestive bleeding 4% Crandall et al [10] None Arrhythmia NK Fribourg et al [12] NA NA 26% Gaitanis et al [13] 9.8% Transient fever 7.4% Grohs and Krepler [18] 2% NK 11% Harrop et al [20] NA NA 23% Heini and Orler [21] 33% None NK Hillmeier et al [22] 9% Epidural hemorrhage, Transient spinal cord lesion NK Masala et al [34] None None NK Rhyne et al [43] 9.8% None 13.5%…”

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confidence: 99%

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Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

et al. 2006

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Section: Resultsmentioning

confidence: 99%

Section: New Vertebral Fracturesmentioning

confidence: 99%

mentioning

confidence: 99%

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Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

et al. 2006

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“…This is confirmed with frequent fluoroscopy "snapshot" imaging to verify that the needle does not penetrate the medial wall of the pedicle. 22 Although this method is usually adequate, it can be very cumbersome and time-consuming. In addition, sometimes the pedicle cannot be cannulated with the aid of plane fluoroscopy, thus resulting either in failure to insert the introducing trocar successfully into the VB, or reliance on a potentially more dangerous extrapedicular approach.…”

Section: Discussionmentioning

confidence: 99%

“…4,7,11,13,18,22,24,25 Other potential surgical risks, such as cement leaks, have also reportedly been reduced in comparison with vertebroplasty. 11,13 Complication rates reported in the literature on kyphoplasty vary from 0 to 9.8%.…”

mentioning

confidence: 99%

Intraoperative three-dimensional fluoroscopy-based computerized tomography guidance for percutaneous kyphoplasty

Villavicencio

Burneikienė²,

Bulsara³

et al. 2005

FOC

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Object Percutaneous kyphoplasty is an established method for the treatment of pathological vertebral compression fractures (VCFs). This procedure is usually performed with the aid of biplanar fluoroscopic image guidance. There are currently no published clinical studies in which the use of three-dimensional (3D) image guidance to facilitate this technique has been evaluated. The purpose of this study was to evaluate the efficacy of isocentric fluoroscopy-based navigation for the kyphoplasty procedure, with special reference to operating time and the amount of radiation exposure. Methods A prospective clinical study was performed in which 11 consecutive patients with painful pathological VCFs that did not respond to conservative treatment underwent the kyphoplasty procedure. During this procedure, cannulation of the pedicle and vertebral body was performed with the aid of isocentric 3D fluoroscopy visualization. Total operating time and intraoperative fluoroscopy time for this group was compared with a cohort of nine patients who underwent the procedure prior to the availability of isocentric fluoroscopy (only biplanar fluoroscopy was used). Possible complications such as cement extravasations were evaluated during the procedure and on postoperative computerized tomography scans. The mean duration of surgery for the 3D isocentric fluoroscopic guidance group was 60 minutes (range 36–89 minutes) for one-level and 68.5 minutes (range 65–75 minutes) for two-level cases. Because of a learning curve with the equipment, the operating time for the initial cases was significantly longer than with the later ones. Even with the initial cases included, the mean operating time was shorter compared with the biplanar fluoroscopy-assisted procedures, which averaged 69.2 minutes (range 44–113 minutes) for one-level procedures. This difference was not statistically significant. The mean fluoroscopy exposure time was 41.3 seconds (range 25–62 seconds) in the isocentric fluoroscopy-assisted procedures, with an additional 40 seconds of fluoroscopy time used for the 3D fluoroscopy “spin,” compared with 293.2 seconds (range 180–400 seconds) in the biplanar fluoroscopy-assisted procedures. The difference was statistically significant (p = 0.02). All pedicles were accessed without difficulty and no complications were encountered in either group of patients. Conclusions The main advantage of isocentric fluoroscopy is the significant reduction in radiation exposure for the patient and surgical staff without an increase in the mean operating time. This technique is a significant advancement over biplanar fluoroscopy in this setting.

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Percutaneous vertebroplasty and kyphoplasty for the stand‐alone augmentation of osteoporosis‐induced vertebral compression fractures: Present status and future directions

Lewis

2006

J Biomed Mater Res

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Enormous research efforts are being expended on two minimally invasive procedures: percutaneous vertebroplasty (VP) and kyphoplasty (KP). The present report, which is a detailed critical review of VP and KP that emphasizes their biomechanics aspects, is divided into six parts. In the first two parts, succinct descriptions are given of osteoporosis-induced vertebral body (VB) compression fractures as the underlying pathology to be treated with VP and KP, the theory of VP and KP, and the techniques used in performing these procedures. Concerns about VP and KP, such as the high radiation exposure burden that may be imposed on both patient and medical personnel and extravasation of the injectable bone cement, are discussed in the third part. Detailed discussions of fourteen issues/questions, such as the extent to which VP or KP affects various biomechanical measures of the augmented VB and those adjacent to it and the appropriate volume of the cement to use, are presented in the fourth part. Ideas for future research, such as development of a new generation of injectable bone cements and identification of an appropriate animal model, are covered in the fifth part. The final section contains a summary of the most salient points/observations made in the report.

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Kyphoplasty: Report of Eighty-Two Thoracolumbar Osteoporotic Vertebral Fractures

Abstract: Balloon kyphoplasty safely improves vertebral body height and patient quality of life.

Cited by 114 publications

References 14 publications

Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

Intraoperative three-dimensional fluoroscopy-based computerized tomography guidance for percutaneous kyphoplasty

Percutaneous vertebroplasty and kyphoplasty for the stand‐alone augmentation of osteoporosis‐induced vertebral compression fractures: Present status and future directions

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