Percutaneous vertebroplasty under local anaesthesia: feasibility regarding patients’ experience

Bonnard, Eric; Foti, Pauline; Kastler, Adrian; Amoretti, N.

doi:10.1007/s00330-016-4521-1

Cited by 38 publications

(27 citation statements)

References 14 publications

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“…Percutaneous kyphoplasty (PKP) is an effective and currently widely used method for the treatment of osteoporotic vertebral compression fracture (OVCF), the procedure was done usually under local anesthesia, and the patient was well tolerated [1]. Early studies have shown that patients could obtain promising clinical outcome of immediate pain relief and functional improvement, especially among the elderly [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Wei

Yao

et al. 2019

J Orthop Surg Res

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Background The purpose of this study was to assess the clinical outcome of percutaneous kyphoplasty (PKP) assisted with mixed reality (MR) technology in treatment of osteoporotic vertebral compression fracture (OVCF) with intravertebral vacuum cleft (IVC). Method Forty cases of OVCF with IVC undergoing PKP were randomized into a MR technology-assisted group (group A) and a traditional C-arm fluoroscopy group (group B). Both groups were performed PKP and evaluated by VAS scores, ODI scores, radiological evidence of vertebral body height, and kyphotic angle (KA) at pre-operation and post-operation. The volume of injected cement, fluoroscopy times, and operation time were recorded. And cases of non-PMMA-endplates-contact(NPEC) in radiological evidence was also recorded postoperatively. The clinical outcomes and complications were evaluated afterwards. All patients received 10 to 14 months follow-up, with an average of 12 months. Result This MR-assisted group (group A) acquired more about the amount of the polymethyl methacrylate (PMMA) injection and postoperative vertebral height and less about postoperative KA, fluoroscopy times, and operation time compared with the control group (group B) ( P < 0.05). The VAS scores and ODI scores in both groups have improved, but more significantly in group A ( P < 0.05). Also, more cases achieve both-endplates-touching of cement in group A ( P < 0.05). And there are less of the loss of vertebral height, KA, and occurrence of re-collapse of the vertebra in group A during the follow-up ( P < 0.05). Conclusion PKP assisted with MR technology can accurately orientate the position of IVC area, which can be augmented by the balloon leading to more satisfied vertebral height improvement, cement diffusion, and pain relief. Trial registration ClinicalTrials.gov Identifier: NCT03959059 . Registered 25 September 2016.

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Section: Introductionmentioning

confidence: 99%

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Wei

Yao

et al. 2019

J Orthop Surg Res

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“…Some scholars believed that the lower dose of bone cement can restore the mechanical properties of the fractured vertebral body, and the volume of bone cement has no obvious correlation with the analgesic effect [13]. 1.5 ml bone cement injected in the fractured vertebral body can obtain satisfactory analgesic effect [14]. However, some scholars held the opposite view that bone cement should be injected to make a higher filling rate of the vertebral body, which helps to restore the strength and rigidity of the vertebral body and obtains better clinical outcomes [15].…”

Section: Discussionmentioning

confidence: 99%

The clinical efficacy and experience of bipedicular percutaneous vertebroplasty combined with postural reduction in the treatment of Kümmell’s disease

Jiang

et al. 2020

BMC Musculoskelet Disord

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Background: Kümmell's disease is a special type of osteoporotic vertebral fracture that causes chronic low back pain and deformity, which seriously affects the living quality of patients. PVP is commonly used to treat osteoporotic vertebral fractures and can quickly relieve low back pain. So, the objective of this study was to analyze the clinical efficacy and experience of bipedicular percutaneous vertebroplasty combined with postural reduction for the treatment of Kümmell's disease. Methods: A retrospective analysis of patients with Kümmell's disease who underwent bipedicular percutaneous vertebroplasty was conducted from February 2016 to May 2018. Operative time, VAS, bone cement injection volume, cement leakage rate, compression improvement of vertebral front edge and vertebral center, and correction degree of kyphosis were collected and analyzed meticulously. Results: The operative time was 45.33 ± 7.64 min. The volume of bone cement injected was 5.38 ± 1.33 ml. The compression improvement of vertebral front edge was 7.31 ± 1.21%. The compression improvement of vertebral center was 10.34 ± 1.15% and the correction degree of kyphosis was − 2.73 ± 0.31゜. Bone cement leakage occurred in 6 of 39 patients (15.38%), but no clinical symptoms were observed. The VAS scores were significantly lower at 1 day after the surgery, 6 months and at the last follow-up than before the surgery (P = 0.000, respectively). The VAS score was lower at the last follow-up than at 1 day after the surgery (P = 0.001). Conclusion: Bipedicular percutaneous vertebroplasty combined with postural reduction could achieve satisfactory analgesic effect in the treatment of Kümmell's disease, and restore the height of the vertebral body and improve kyphosis to some extent.

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“…Furthermore, the use of local anesthesia avoids the potential complications of sedative and general anesthesia. However, the local anesthetic often results in a painful response, discomfort, anxiety and agitation, and not be well coordinated with the doctor to complete the operation [5,16,17]. Therefore, it's necessary to find an alternative anesthesia method for these patients undergoing PKP.…”

Section: Discussionmentioning

confidence: 99%

“…However, some patients with local anesthesia have severe pain and restlessness during surgery and cannot cooperate with the doctor to complete the operation [5]. Thoracic epidural block has a high failure rate and the risk of severe complications such as epidural abscess and spinal hematoma [6].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided thoracic paravertebral block for percutaneous kyphoplasty: A prospective non-randomized comparative study

Tang

Xia

TANG

et al. 2020

Preprint

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Introduction Kyphoplasty for osteoporotic vertebral compression fractures was short but painful. The purpose of the current study was to investigate the effects and safety of ultrasound-guided thoracic paravertebral block in patients undergoing percutaneous kyphoplasty (PKP). Methods A prospective study of 195 patients with thoracic compression fracture undergoing PKP was conducted. The patients were non-randomly assigned to receive an ultrasound-guided thoracic paravertebral block (Group P, n=96) and local infiltration anesthesia (Group L, n=99), and were compared along with intraoperative parameters and anesthetic effects. Visual analog scale (VAS) of pain, systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured at pre-anesthesia (T0), post-anesthesia (T1), trocar insertion (T2), balloon dilatation (T3), cement injection (T4) and post-operation (T5). Results The anesthesia time was significantly longer in group P than in group L. There were no significant differences in the epidemiological data, operation time, blood loss, hospitalization time complications and costs between the two groups. The additional analgesics rate was significantly lower in group P than in group L. The investigators’ satisfaction scores, patients’ anesthesia satisfaction scores and intention rate of re-administration anesthesia were significantly higher in group P than in group L. Intraoperative VAS score (T1-T4) was significantly lower in group P than in group L. There was no significant difference in VAS scores (T0 and T5), SBP, DBP and HR between these two groups. Conclusion Ultrasound - guided thoracic paravertebral block achieved more effective analgesia in comparison to local infiltration groups in patients undergoing percutaneous kyphoplasty.

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Percutaneous vertebroplasty under local anaesthesia: feasibility regarding patients’ experience

Cited by 38 publications

References 14 publications

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study

The clinical efficacy and experience of bipedicular percutaneous vertebroplasty combined with postural reduction in the treatment of Kümmell’s disease

Ultrasound-guided thoracic paravertebral block for percutaneous kyphoplasty: A prospective non-randomized comparative study

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