Rare Episode of Cement Leakage During Vesselplasty in a Case of Vertebral Compression Fracture

Yeh, Kuei-Lin; Wu, Shang-Lin; Wu, Shing‐Sheng; Chang, Shu‐Hao

doi:10.1016/j.wneu.2020.02.071

Cited by 5 publications

(8 citation statements)

References 20 publications

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“…In a 2015 study, a certain amount of cement leakage occurred during cement injection. This major complication of KP with vesselplasty resulted in symptomatic, irreversible sequelae, paraplegia due to thermal damage and spinal nerve compression by the cement, even though an emergent laminectomy was immediately performed[ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of different minimally invasive surgical treatments for vertebral compression fractures: An observational study

Yeh¹,

Wu²,

Liaw³

et al. 2021

WJCC

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BACKGROUND Osteoporosis with vertebral compression fractures is increasingly common in the elderly population. Cement augmentation is one of the effective surgical treatments for these patients. Currently, there are several different types of cement augmentation treatments. No studies have compared the safety and efficacy of different cement augmentation types for the treatment of such fractures; thus, we retrospectively compared vertebroplasty, balloon kyphoplasty, and kyphoplasty with SpineJack or an intravertebral expandable pillar. AIM To compare the postoperative safety and efficacy of each surgical intervention in treating vertebral compression fractures. METHODS We retrospectively analyzed 354 patients with acute vertebral compression fractures, defined as signal changes in the T1 weighted magnetic resonance imaging, and randomly divided the patients into five groups. Their visual analog scale scores for pain, kyphotic angle, average body height, rate of cement leakage, and occurrence of adjacent vertebral compression fractures were followed for 1 year. One-way analysis of variance, the post hoc Bonferroni test, and Fisher exact probability test were used for statistical analyses. RESULTS All pain scores significantly improved 12 mo postoperatively; however, there was no significant difference between the groups ( P = 0.325). Kyphoplasty with SpineJack significantly reduced the kyphotic angle ( P = 0.028) and restored the height of the vertebral body ( P = 0.02). The rate of adjacent compression fractures was the highest in the vertebroplasty group, with a statistically significant difference according to the Fisher exact probability test ( P = 0.02). The treatment with the lowest cement leakage rate cannot be identified because of the small sample size; however, kyphoplasty with SpineJack, an IVEP, and vesselplasty resulted in lower rates of cement leakage than balloon kyphoplasty and vertebroplasty. CONCLUSION Kyphoplasty with SpineJack has good outcomes in kyphotic angle reduction and body height restoration. Vertebroplasty has the highest cement leakage rate and adjacent compression fracture occurrence.

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Section: Discussionmentioning

confidence: 99%

“…VCFs destabilize the vertebral body, whereas back pain is attributed to macro- and micromotion at the fracture site. In addition to back pain, the sequelae of VCFs are sometimes related to kyphotic angulation of the spine, which can diminish forced vital capacity[ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of different minimally invasive surgical treatments for vertebral compression fractures: An observational study

Yeh¹,

Wu²,

Liaw³

et al. 2021

WJCC

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a 2015 study, a certain amount of cement leakage occurred during cement injection. This major complication of KP with a vessel resulted in symptomatic, irreversible sequelae, paraplegia due to thermal damage, and spinal nerve compression by the cement, even though an emergent laminectomy was immediately performed [4].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, SpineJack implants had not been introduced to our hospital until 5 years prior to this report; therefore, all SpineJack data were collected within 5 years. Moreover, we experienced a tragic episode from cement leakage during vesselplasty; since then, we have not had the con dence to perform this procedure again [4]. For this reason, there was no bias of treatment choice based on disease severity; this was a fully randomized retrospective study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Outcomes and Complications Among Various Surgical Treatments for Vertebral Compression Fractures: a Retrospective Study.

Yeh¹,

Wu²,

Wu³

et al. 2021

Preprint

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BackgroundOsteoporosis with vertebral compression fractures is increasingly common in the elderly. As no studies have compared the safety and efficacy of surgical techniques for the treatment of such fractures, we retrospectively compared vertebroplasty, balloon kyphoplasty, and kyphoplasty with SpineJack or an intravertebral expandable pillar (IVEP). In this study, we retrospectively compared the safety and efficacy, including visual analog scale scores for pain, kyphotic angle, average body height, rate of cement leakage, and occurrence of adjacent vertebral compression fractures of each surgical intervention mentioned above at Shin-Kong Wu Ho-Su Memorial Hospital. All patients underwent surgical treatment under Dr. Wu. MethodsWe retrospectively analyzed 10 years of data of 354 patients with vertebral compression fractures, randomly dividing them into five groups. All these patients were diagnosed with fresh compression fracture, defined as signal changes on T1 phase by magnetic resonance imaging examination. Their visual analog scale scores for pain, kyphotic angle, average body height, rate of cement leakage, and occurrence of adjacent vertebral compression fractures were followed up for 1 year. ANOVA, the post hoc Bonferroni test, and Fisher’s exact probability test were used for statistical analyses.ResultsAll pain scores significantly improved 12 months postoperatively; however, there was no significant difference between the groups. Kyphoplasty with SpineJack significantly reduced the kyphotic angle, restoring the vertebral body height; adjacent compression fracture rate was highest in the vertebroplasty group (p=0.020). The method with the lowest cement leakage rate remains unidentified due to the small sample size; however, kyphoplasty with SpineJack, intravertebral expandable pillar, and vesselplasty resulted in lower rates than balloon kyphoplasty or vertebroplasty.ConclusionsVertebroplasty and kyphoplasty were excellent treatments for vertebral compression fractures, with no differences in pain relief. Kyphoplasty with SpineJack entailed a lower risk of cement extravasation, resulting in greater vertebral body height restoration and kyphotic reduction than other groups. While the safest method remains unclear, Kyphoplasty with SpineJack, intravertebral expandable pillar, and vesselplasty resulted in low rates of cement leakage. Kyphoplasty with intravertebral expandable pillar resulted in the lowest adjacent compression fracture rate.

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“…As early as in the 1980s, Philips [ 4 ] wrote that the fear and avoidance of pain sensations resulted in a behaviour pattern that would lead to an exaggerated perception of pain itself. In patients with acute lumbar pain, it has been found that the fear of symptoms is also associated with reduced participation in daily tasks, especially those with different lifting tasks [ 5 ]. These people also perceive their disability as a much more serious phenomenon [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Stabilization Techniques Used in the Treatment of Low Back Pain on the Level of Kinesiophobia

Filipczyk

Saulicz

2021

IJERPH

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The aim of this study was to try to compare the effectiveness of manual therapy techniques in combination with stabilization techniques: the so-called Australian method and the Neurac method in relation to pain sensations and the level of kinesiophobia. A total of 69 people were examined, divided into three groups of 23 people each. The Visual Analogue Scale was used to assess the antalgic effect, and the Kinesiophobia Causes Scale questionnaire was used to assess the level of kinesiophobia. Patients improved over four weeks, during which they were assessed three times. The evaluation of the desired parameters was also performed over a 24-week period to assess long-term performance. Stabilization techniques are an effective extension of manual therapy techniques in patients with low back pain. People in the groups additionally improved in terms of stabilization techniques, which are characterized by a lower level of kinesiophobia. Its lowest level was found in the group additionally improved with the Neurac method. In the long-term study, the level of kinesiophobia in this group was still maintained at a reduced level. The use of stabilization techniques involving patients in action may significantly affect the level of kinesiophobia, and thus have a much wider effect than just pain reduction.

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Rare Episode of Cement Leakage During Vesselplasty in a Case of Vertebral Compression Fracture

Cited by 5 publications

References 20 publications

Outcomes of different minimally invasive surgical treatments for vertebral compression fractures: An observational study

Outcomes of different minimally invasive surgical treatments for vertebral compression fractures: An observational study

Comparison of Outcomes and Complications Among Various Surgical Treatments for Vertebral Compression Fractures: a Retrospective Study.

Influence of Stabilization Techniques Used in the Treatment of Low Back Pain on the Level of Kinesiophobia

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