Osteoporotic thoracolumbar compression fractures: long-term retrospective comparison between vertebroplasty and conservative treatment

Abstract

Percutaneous vertebroplasty represents a safe treatment for osteoporotic vertebral compression fractures, although it may be associated with a higher incidence of adjacent fractures and therefore worse thoracolumbar kyphosis and long-term follow-up than conservative treatment. These slides can be retrieved under Electronic Supplementary Material.

Risk factors of adjacent segmental fractures when percutaneous vertebroplasty is performed for the treatment of osteoporotic thoracolumbar fractures

“…advised for treating OTFs in clinical routine practice, and we are unable to determine whether PV causes new symptomatic vertebral fractures and/or serious adverse events as well as an increased risk of PV in acute OTFs [9][10][11][12] . There are no severe complications due to treatment, and although PMMA leakage frequently occurs, it is always asymptomatic [13][14][15] .…”

Re-expansion of Osteoporotic Compression Fractures Using Bilateral SpineJack Implants: Early Clinical Experience and Biomechanical Considerations

“…It has been observed that even though the patient may be asymptomatic with regard to pain at the treated level, they can later present with adjacent vertebral fractures or progressive deformity. In a study with over a 12-month follow-up, it was found that even with the initial restoration of height and correction of kyphosis after balloon kyphoplasty, the correction is often lost over time, causing partial recurrent vertebral collapse and deformity [1,3-4,8]. Larger amounts of bone cement, especially if over 4 cc, and over correction of height plus fluid filled vertebral clefts are at least statistically related to an increased incidence of adjacent fractures [2,4,9,16].…”

“…Vertebroplasty (VP), also known as vertebral augmentation (VA) and balloon kyphoplasty (BKP), have been used for over 30 years for the treatment of osteoporotic vertebral compression fractures for both persistent pain after conservative treatment and correction of vertebral collapse and deformity. Deformity and the development of adjacent level fractures at and above these osteoporotic fractures are significant long-term problems seen commonly at the thoraco-lumbar junction [1-2]. Anatomic studies show that osteoporotic vertebral compression fractures are essentially comminuted 'eggshell' like fractures of the vertebrae initially affecting the cortical endplates with progression to various degrees of compression and collapse of the vertebral body [2].…”

“…The comminuted vertebral fracture is pushed around the balloon and this 'dilated' area is then filled with polymethylmethacrylate (PMMA) bone cement to try and maintain the height correction [2]. Balloons vary in size from 10.0 mm x 2.00 mm to 20.00 mm x 6.00 mm and can be straight or curved, all in an attempt to make larger cavities to better expand the vertebra and subsequently restore vertebral height and maintain this height correction by filling the cavities with cement [1-2]. However, creating one large central cavity or two bilateral cavities through balloon expansion dramatically alters the biomechanics of a comminuted osteoporotic compression fracture [6].…”

Quality of life after percutaneous vertebroplasty in patients after traumatic vertebral compression fractures

“…У б і л ь ш о с т і д о с л і д ж е н ь п р о а н а л і з о в а н о к лінічні результати ПВП при ос теопоротичних (низькоенергетичних) КПТХ і, відповідно, у хворих переважно старших вікових груп [16,17]. Значно менше праць присвячено КПТХ, отриманим унаслідок дії великого травмувального чинника, і лише окремі з них висвітлюють функціональні результати ПВП у віковому аспекті.…”