Long-term prospective study of osteoporotic patients treated with percutaneous vertebroplasty after fragility fractures

Mazzantini, M; Carpeggiani, P.; d’Ascanio, A.; Bombardieri, Stefano; Munno, Ombretta Di

doi:10.1007/s00198-010-1341-z

Cited by 19 publications

(13 citation statements)

References 25 publications

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“…Clinical studies have differed in terms of the predominant location (i.e., superior/inferior) of adjacent vertebral fractures postvertebroplasty, with some studies finding an equal distribution of adjacent fractures and others finding a higher fracture incidence in the superior adjacent vertebrae. 1,14,29,30 For endplates specifically, Trout and colleagues found that the caudal endplate of the superior adjacent VB had significantly more fractures than any other endplate. 45 Our results are in good agreement with this study, as we observed an approximately 2-fold increase in endplate deformation for the SV cau endplate compared with the IV cra endplate in the vertebroplasty group.…”

Section: Discussionmentioning

confidence: 99%

Effects of vertebroplasty on endplate subsidence in elderly female spines

Nagaraja¹,

Awada²,

Dreher³

et al. 2015

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OBJECT The aim in this study was to quantify the effects of vertebroplasty on endplate subsidence in treated and adjacent vertebrae and their relationship to endplate thickness and underlying trabecular bone in elderly female spines. METHODS Vertebral compression fractures were created in female cadaveric (age range 51–88 years) thoracolumbar spine segments. Specimens were placed into either the control or vertebroplasty group (n = 9/group) such that bone mineral density, trabecular microarchitecture, and age were statistically similar between groups. For the vertebroplasty group, polymethylmethacrylate bone cement was injected into the fractured vertebral body under fluoroscopy. Cyclic compression (685–1370 N sinusoid) was performed on all spine segments for 115,000 cycles. Micro-CT scans were obtained before and after cyclic loading to quantify endplate subsidence. Maximum subsidence was compared between groups in the caudal endplate of the superior adjacent vertebra (SVcau); cranial (TVcra) and caudal (TVcau) endplates of the treated vertebra; and the cranial endplate of the inferior adjacent vertebra (IVcra). In addition, micro-CT images were used to quantify average endplate thickness and trabecular bone volume fraction. These parameters were then correlated with maximum endplate subsidence for each endplate. RESULTS The maximum subsidence in SVcau endplate for the vertebroplasty group (0.34 ± 0.58 mm) was significantly (p < 0.05) greater than for the control group (−0.13 ± 0.27 mm). Maximum subsidence in the TVcra, TVcau, and IVcra endplates were greater in the vertebroplasty group, but these differences were not significant (p > 0.16). Increased subsidence in the vertebroplasty group manifested locally in the anterior region of the SVcau endplate and in the posterior region of the TVcra and TVcau endplates (p < 0.10). Increased subsidence was observed in thinner endplates with lower trabecular bone volume fraction for both vertebroplasty and control groups (R2 correlation up to 62%). In the SVcau endplate specifically, these 2 covariates aided in understanding subsidence differences between vertebroplasty and control groups. CONCLUSIONS Bone cement injected during vertebroplasty alters local biomechanics in elderly female spines, resulting in increased endplate disruption in treated and superior adjacent vertebrae. More specifically, bone cement increases subsidence in the posterior regions of the treated endplates and the anterior region of the superior caudal endplate. This increased subsidence may be the initial mechanism leading to subsequent compression fractures after vertebroplasty, particularly in vertebrae superior to the treated level.

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Section: Discussionmentioning

confidence: 99%

Effects of vertebroplasty on endplate subsidence in elderly female spines

Nagaraja¹,

Awada²,

Dreher³

et al. 2015

SPI

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“…Although its short-term effect is satisfactory, bone cement is disincentive to bone healing. Therefore, bone formation is somewhat difficult on account of the cauterizing effect of bone cement on the surrounding tissues [25]. Although self-ilium graft conduces to good prognosis, it is limited by available bone mass.…”

Section: Discussionmentioning

confidence: 99%

Locking system strengthened by biomimetic mineralized collagen putty for the treatment of osteoporotic proximal humeral fractures

Peng

Wang

Yan

et al. 2017

Regenerative Biomaterials

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The current study is to observe the effect of the locking system strengthened by biomimetic mineralized collagen putty for the treatment of senile proximal humeral osteoporotic fractures. From January 2012 to December 2015, 80 cases of senile patients with osteoporotic proximal humeral fractures were randomly divided into an observation group and a control group, each group with a total of 40 cases. The control group was simply treated with locking plate. The observation group was treated with locking plate in combination with biomimetic mineralized collagen putty. The therapeutic effect thereby was observed. The excellent and satisfactory rate was 90% in observation group and was 72.5% in control group. The difference between the two groups was statistically significant (χ2 = 5.3312, P < 0.05). The fracture healing time was 11.82 ± 3.62 weeks in observation group and 19.78 ± 5.46 weeks in control group. The shoulder joint function score was 89.63 ± 8.12 in observation group and 76.92 ± 8.18 in control group. There was significant difference between the two groups (t = 7.1272; 12.7834, P < 0.05). The complication rate was 10% in the observation group and 32.5% in the control group (χ2 = 7.3786, P < 0.05). Locking system strengthened by biomimetic mineralized collagen putty has advantages such as accelerating healing of senile proximal humeral fracture, improving the therapeutic effect, reducing the complications. As one of the optimal internal fixation method, it provides a new option for better treatment of senile osteoporotic fracture.

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“…[2,10] However, only a few reports discussed about non-vertebral fracture, especially, hip fractures after percutanous vertebroplasty in osteoporotic spinal compression fracture. Mazzantini et al[11] reported in patients with osteoporosis treated with pecutaneous vertebroplasty, the incidence of new vertebral fractures was 27.8% and non-vertebral fractures occurred in only 7% (only one at the hip) in as few as 3.5% of the patients if exclude rib fractures after 39 months. In our study, only 13 patients (5.4%) had undergone percutaneous vertebroplasty in 240 patients who had undergone operation of hip fractures, retrospectively.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Clinical Features of Hip Fracture Patients with or without Prior Osteoporotic Spinal Compression Fractures

Kim

Chae

et al. 2013

J Bone Metab

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BackgroundTo analyze and compare the clinical characteristics including bone mineral density (BMD) in a group who had operation of hip fracture with or without prior osteoporotic spinal compression fractures.MethodsTwo hundred forty patients who had undergone operation of hip fractures were evaluated, 127 patients who had with prior osteoporotic spinal compression fractures were in group I, and 113 patients without prior spinal fractures were in group II. In each group, we measured age, gender, body mass index (BMI, kg/m2), BMD (mg/cm3), type of hip fractures, concomitant diseases, presence of secondary hip fracture and history of percutaneous vertebroplasty.ResultsThe mean age of group I was 79.4 years (male/female: 28/99) and that of group II was 77.6 years (male/female: 37/76). The mean BMI of group I was 21.3 kg/m2 and that in group II was 22.0 kg/m2. The mean BMD and T-score of group I were 41.1 mg/cm3 and -4.45 and those in group II were 51.0 mg/cm3 and -4.17 (P<0.05). The numbers of patients of neck and intertrochanter fracture of group I were 31 and 96 patients and those in group II were 61 and 52 patients. Sixty in group I and 45 in group II patients had concomitant diseases. Thirteen patients had undergone percutaneous vertebroplasty and 18 patients (7.5%) had second hip fractures.ConclusionsThe hip fracture patients who had with prior osteoporotic spinal compression fractures had lower BMD compared to the hip fracture patients without previous spinal compression fractures.

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Long-term prospective study of osteoporotic patients treated with percutaneous vertebroplasty after fragility fractures

Abstract: We found that in patients with OP treated with PVP, the incidence of new VFx was 27.8% after 39 months; low BMI, BMD, and vitamin D are factors associated with increased risk of new VFx in patients treated with PVP.

Cited by 19 publications

References 25 publications

Effects of vertebroplasty on endplate subsidence in elderly female spines

Effects of vertebroplasty on endplate subsidence in elderly female spines

Locking system strengthened by biomimetic mineralized collagen putty for the treatment of osteoporotic proximal humeral fractures

Analysis of Clinical Features of Hip Fracture Patients with or without Prior Osteoporotic Spinal Compression Fractures

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