Percutaneous balloon kyphoplasty in the treatment of painful vertebral compression fractures: Effect on local kyphosis and one-year outcomes in pain and disability

Zapałowicz, Krzysztof; Radek, Maciej

doi:10.1016/j.pjnns.2014.11.005

Cited by 16 publications

(12 citation statements)

References 24 publications

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“…Recently, a US large claims database analysis showed that PKP was associated with a significant reduction in mortality compared to conservative treatment and PVP. PKP is now considered to be as minimally invasive and effective as conventional PVP for rapid pain relief in patients with painful OVCFs resistant to conservative treatment [11,13,14]. …”

Section: Introductionmentioning

confidence: 99%

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Sun

Zhao

et al. 2017

Med Sci Monit

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BackgroundThe definition of a vertebral fracture is usually based on the presence of a deformation of the vertebral body and this can be misleading in the presence of a fracture without radiologic collapse with the definition of occult osteoporotic vertebral fractures (OOVFs). STIR sequence of MRI images showing hyperintensity signal was the most confirmative screening examination used to determine the presence of painful OOVFs. To date, clinical management of OOVFs has been rarely discussed.Material/MethodsBetween 2011 and 2013, 89 patients suffering from painful OOVFs underwent 142 percutaneous balloon kyphoplasty (PKP) procedures. Outcome data (mean variation of anterior and middle vertebral body height, visual analog scale [VAS] scores, Oswestry Disability Index [ODI] scores, and SF-36 scores) were recorded preoperatively, postoperatively, and at 1 month, 6 months, and 2 year after treatment, to evaluate the results.ResultsWe successfully treated 89 patients (142 vertebral bodies) with PKP. Cement leakages were observed in 12 (8.45%) treated vertebral bodies and there were 5 new adjacent vertebral fractures during the follow-up period. The mean variation of anterior and middle vertebral body height changed from 96.5±3.4% preoperatively to 97.2±2.5% postoperatively (p>0.05) and from 96.3±2.8% preoperatively to 97.9±3.1% postoperatively (p>0.05), respectively. The mean VAS scores were reduced significantly from pre-surgery to post-surgery (8.3±1.2 to 2.9±0.7; p<0.05), as was the ODI score (76.4±12.5 to 26.7±5.6; p<0.05). The SF-36 scores, including Bodily Pain (BF), Vitality (VT), Physical Function (PF), and Social Functioning (SF), all showed notable improvement (P<0.05). These variations were maintained during the 2-year follow-up period.ConclusionsPKP is a safe and effective method in the treatment of painful OOVFs.

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Section: Introductionmentioning

confidence: 99%

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Sun

Zhao

et al. 2017

Med Sci Monit

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“…3 Intraoperative images showed that several pieces of leaked cement fragments had been removed (a) and bone cement was exposed after pulling the dural sac aside (b) dilation, cement leakage is still considered the most common complication of PKP [13]. At present, the incidence of bone cement leakage has varied between 5 and 87% in the literature [14,15]. The most probable reason for the significant difference in the rate of bone cement leakage is that many studies mainly rely on x-ray examination for the diagnosis of bone cement leakage, rather than CT scan, which may result in missed diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Cement leakage following percutaneous kyphoplasty in a patient after a posterior lumbar fusion: a case report

Chang

et al. 2020

BMC Surg

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Background: Percutaneous kyphoplasty (PKP) has become an important minimally invasive surgical technique for fracture stabilization and pain relief in patients with vertebral compression fractures. However, intraspinal cement leakage following PKP is a serious postoperative complication that can lead to morbidity and mortality. Case presentation: We describe an uncommon case of epidural leakage of bone cement in an 81-year-old woman who underwent posterior lumbar decompression and fusion from L3-5 4 years prior and had an unremarkable postoperative course. The patient was admitted to Peking Union Medical College Hospital with complaints of muscle weakness and severe low back pain radiating to the left thigh 1 week after PKP of L5 due to an acute osteoporotic compression fracture. Computed tomographic imaging revealed massive leakage of cement into the spinal canal at L5-S1, and therefore, surgical decompression and removal of epidural cement were performed carefully without causing a dural tear. She improved remarkably and no neurologic deterioration was observed in the postoperative period during the one-year follow-up. Conclusions: We present the rare reported case, to our knowledge, of epidural cement leakage after PKP at the segment of internal fixation and discuss the most likely etiologies and preventive measures for this condition.

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“…Boger A. claimed that the injection of bone cement should be delayed as much as possible to prevent leakage and over ow [12] . The incidence rate of bone cement leakage has varied between 5 and 87% [13][14] , most of which was asymptomatic leakage and pulmonary cement embolism or spinal injury was rarely reported [15][16] . Yeom [17] .…”

Section: Discussionmentioning

confidence: 99%

High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion and leakage of bone cement

wang

Jin

2020

Preprint

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Background: Bone cement leakage causes severe complication following percutaneous vertebroplasty. This study probed the diffusion and leakage status of bone cement injected within diverged time duration, so as to find the optimal injection time for bone cement. Methods: A total of 70 patients with osteoporotic vertebral compression fractures with a symptom of low back pain, who underwent treatment at hospital were enrolled in this study. Patients were randomized into three groups: <180 s, 180-300, and >300 s of injection time duration from the beginning to the completion of the injection. The scenarios of vertebral bone cement leakage and diffusion were inspected using postoperative CT.Results: The diffusion coefficient was higher in group A than in group B whereas it was higher in group B than in group C, but without statistical significance among the three groups. The leakage rate was without statistical significance among the three groups. The injection time of bone cement was negatively correlated with the diffusion coefficient, at the correlation coefficient of -0.253. Conclusions: The diffusion coefficient of high-viscosity bone cement is negatively correlated with the injection time, and the leakage rate of high-viscosity bone cement does not reduce with the prolongation of injection time.

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Percutaneous balloon kyphoplasty in the treatment of painful vertebral compression fractures: Effect on local kyphosis and one-year outcomes in pain and disability

Abstract: Rapid significant pain relief after kyphoplasty followed by long-term pain release and disability reduction obtained in all patients was most probably the result of vertebral augmentation. The correction of local kyphosis had no influence on the outcome.

Cited by 16 publications

References 24 publications

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Cement leakage following percutaneous kyphoplasty in a patient after a posterior lumbar fusion: a case report

High-viscosity bone cement for vertebral compression fractures: a prospective study on intravertebral diffusion and leakage of bone cement

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