Repeated and Multiple New Vertebral Compression Fractures After Percutaneous Transpedicular Vertebroplasty

Tseng, Yuan Yun; Yang, Tao-Chieh; Tu, Po‐Hsun; Lo, Yu Lun; Yang, Shun Tai

doi:10.1097/brs.0b013e3181ac8f07

Cited by 73 publications

(73 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Various reasons and risk factors for fractures that occur following VP have been discussed: increased stiffness in the vertebra treated [34,42], cement formation of a solid mass rather than interdigitation [43], changes in load transfer [44,45], an altered loading direction [46], cement leakage into the disc (pro: [12,14,21,[47][48][49], contra: [50]), use of too much cement [15,49], the degree of vertebral height restoration [12,15] and persistent local kyphosis [20], deflection of the endplate and the intervertebral disc into adjacent vertebra [34], fracture shape [51], pre-existing fracture [12,23], advanced patient age [23], ongoing osteoporosis [16,20,24], and low BMD [12,16,19,21,23], and a high number of VPs at baseline [16,26]. In addition, patients with high parathyroid hormone concentrations, low body mass index, no use of back brace, no anti-osteoporosis therapy, history of metabolic disease, and use of drugs which influence bone metabolism tend to have a greater risk of recurrent fractures [16,17,47].…”

Section: Discussionmentioning

confidence: 99%

“…Reported complications, possibly due to the addition of a material that is stiffer than the surrounding bone, include fractures of the augmented and adjacent vertebrae. New osteoporotic vertebral compression fractures, in the months after VP, are reported in 7-63 % of VP patients, up to 82 % of these occur at the adjacent levels, with adjacent fractures occurring sooner than nonadjacent fractures; rates of recurrent fracture of the augmented vertebra itself range up to 63 % in the literature [1,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. It is still under debate whether new vertebral fractures appear more often in patients who received cement augmentation than in conservatively treated patients; some studies support this hypothesis [1,6,7,[27][28][29], while others question it [2,3,26,30].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanical comparison of vertebral augmentation with silicone and PMMA cement and two filling grades

et al. 2013

View full text Add to dashboard Cite

Purpose Vertebral augmentation with PMMA is a widely applied treatment of vertebral osteoporotic compression fractures. Subsequent fractures are a common complication, possibly due to the relatively high stiffness of PMMA in comparison with bone. Silicone as an augmentation material has biomechanical properties closer to those of bone and might, therefore, be an alternative. The study aimed to investigate the biomechanical differences, especially stiffness, of vertebral bodies with two augmentation materials and two filling grades. Methods Forty intact human osteoporotic vertebrae (T10-L5) were studied. Wedge fractures were produced in a standardized manner. For treatment, PMMA and silicone at two filling grades (16 and 35 % vertebral body fill) were assigned to four groups. Each specimen received 5,000 load cycles with a high load range of 20-65 % of fracture force, and stiffness was measured. Additional low-load stiffness measurements (100-500 N) were performed for intact and augmented vertebrae and after cyclic loading. Results Low-load stiffness testing after cyclic loading normalized to intact vertebrae showed increased stiffness with 35 and 16 % PMMA (115 and 110 %) and reduced stiffness with 35 and 16 % silicone (87 and 82 %). After cyclic loading (high load range), the stiffness normalized to the untreated vertebrae was 361 and 304 % with 35 and 16 % PMMA, and 243 and 222 % with 35 and 16 % silicone augmentation. For both high and low load ranges, the augmentation material had a significant effect on the stiffness of the augmented vertebra, while the filling grade did not significantly affect stiffness. Conclusions This study for the first time directly compared the stiffness of silicone-augmented and PMMAaugmented vertebral bodies. Silicone may be a viable option in the treatment of osteoporotic fractures and it has the biomechanical potential to reduce the risk of secondary fractures.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of vertebral augmentation with silicone and PMMA cement and two filling grades

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Tseng et al 36 followed up 852 patients (1131 vertebroplasties) over a period of six years, and concluded that the average time for a fracture of a vertebral body adjacent to the PV is 71.9 days and that non-adjacent fractures occur at around 289 days following the PV.…”

Section: A B Resultsmentioning

confidence: 99%

Treatment of vertebral pathological fractures by percutaneous vertebroplasty

Macedo¹,

Linhares²

2014

Coluna/Columna

View full text Add to dashboard Cite

Objective: To evaluate a consecutive series of patients undergoing vertebroplasty for pain control, according to results and complications in the short and medium follow-up. Methods: Retrospective analysis of medical records of 26 patients undergoing vertebroplasty from January 2007 to December 2010. Patients were evaluated by the questionnaire of assessment of low back pain (Oswestry Index) and the visual analog pain scale (VAS) on the day before surgery, on the second day and 12 months after the procedure. Results: Significant improvement of pain symptoms within 48 hours after surgery was reported in 22 patients (91.6%), two patients (8.32%) showed moderate improvement. Of the 22 patients with significant pain relief, 21 (95.4%) maintained the benefit and one (4.6%) had intense pain (new fracture in the body of L1) at a mean follow up of 12 months. Regarding the Oswestry Index, preoperative average was 52.9%. On the second day and 12 months after surgery this average was 23.6% and 24.5%, respectively; good results according to this index. Two patients were excluded from the study due to incomplete medical records. Conclusion: Despite the small sample size and short follow-up, the results of vertebroplasty were effective for the relief of pain symptoms and were safe as regards the risks of complications.Keywords: Low back pain; Spinal fractures; Osteoporosis; Vertebroplasty; Retrospective studies.

show abstract

“…In osteoporosis we often face the problem of multiple fractures, and about 20 % of patients with one previously diagnosed compression fracture develop new ones [3,17]. Some authors suggest even a prophylactic augmentation of decalcified vertebrae [3].…”

Section: Introductionmentioning

confidence: 99%

“…Vertebral compression fractures cause significant pain and some patients are debilitated by the pain due to the fracture [1][2][3]. Conventional surgery carries a high risk and has a poor outcome and is reserved only to patients with significant neurological deficit [4,5].…”

Section: Introductionmentioning

confidence: 99%

Treatment of multiple osteoporotic vertebral compression fractures by percutaneous cement augmentation

Saracen

Kotwica

2014

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

Purpose Vertebral compression fractures cause significant pain and some patients are debilitated by the pain due to the fracture. Conventional surgery carries a high risk and has a poor outcome. Vertebroplasty is a minimally invasive surgical procedure, which in vertebral fractures restores stability and diminishes pain. The aim of the study was to analyse the effectiveness and safety of vertebroplasty in multiple vertebral compression fractures with a 24-month follow-up. Methods Vertebroplasty was performed in 160 patients with multiple osteoporotic compression fractures under local anaesthesia, using a unilateral transpedicular approach. The level of pain was assessed according to a 10-cm visual analogue scale. The patients were observed for 24 months after surgery. Results Vertebroplasty significantly diminished the level of pain in 90 % of patients, and half of them were free of pain within 12 hours after surgery. Only 4 % of the patients did not benefit from this type of treatment. During the 24-month follow-up these results changed only slightly, and after two years almost 80 % still benefited, while the number of unsatisfactory results changed from 6 to 9 %. No serious clinical complications were noted; in three patients new fractures appeared during the two year observation period. Conclusions Vertebroplasty should be seriously taken into account as a primary method of treatment in patients with multiple osteoporotic vertebral compression fractures.

show abstract

Repeated and Multiple New Vertebral Compression Fractures After Percutaneous Transpedicular Vertebroplasty

Cited by 73 publications

References 37 publications

Biomechanical comparison of vertebral augmentation with silicone and PMMA cement and two filling grades

Biomechanical comparison of vertebral augmentation with silicone and PMMA cement and two filling grades

Treatment of vertebral pathological fractures by percutaneous vertebroplasty

Treatment of multiple osteoporotic vertebral compression fractures by percutaneous cement augmentation

Contact Info

Product

Resources

About