Risk factors and score for recollapse of the augmented vertebrae after percutaneous vertebroplasty in osteoporotic vertebral compression fractures

Yu, Weibo; Jiang, Xiaobing; Liang, De; Xu, Weixing; Ye, L Q; Wang, J

doi:10.1007/s00198-018-4754-8

Cited by 59 publications

(88 citation statements)

References 31 publications

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“…Although not mentioned in our included studies, the refracture in previously cemented vertebrae after PVP or PKP with the incidence of 0.56-2% is a complication that should not be ignored in patients with IVC [50,51]. Yu et al [52] had confirmed that IVC might be the most important predisposing factor for recollapse of the augmented vertebrae in OVCFs. Solid lump cement distribution due to the presence of IVC may intercept mechanical interlock with surrounding cancellous bones.…”

Section: Discussionmentioning

confidence: 92%

Analysis of two minimally invasive procedures for osteoporotic vertebral compression fractures with intravertebral cleft: a systematic review and meta-analysis

et al. 2020

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Background A systematic review and meta-analysis to assess the pros and cons of percutaneous vertebroplasty (PVP) versus kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral cleft (IVC) including all available evidence from controlled trials. Methods Databases including Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched to identify relevant studies comparing PVP and PKP for OVCFs with IVC. The outcomes mainly included visual analog scale (VAS), Oswestry Disability Index (ODI), local kyphotic angle (LKA), rate of vertebral height (VH%), and adverse events. Results Nine studies enrolling 688 patients were eligible for meta-analysis. The results indicated no significant differences between the two groups in the short-and long-term VAS, ODI, LKA, or VH% (P > 0.05). Compared with PVP, PKP was associated with significantly longer operation time (P < 0.05), higher cost (P > 0.05), and more injected cement volume (P < 0.05). In terms of adverse events, PKP has a lower risk of cement leakage (P < 0.05), while with no significant difference in adjacent-level fracture rates (P > 0.05). Conclusion The two procedures have similar short- and long-term pain relief, functional recovery, local kyphosis correction, and vertebral height maintenance in OVCFs with IVC. PKP is superior to PVP for the injected cement volume, and lower cement leakage rate, however, with longer operation time, more fluoroscopy times, and higher cost. Further randomized controlled trials (RCTs) should be conducted to confirm these results.

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Section: Discussionmentioning

confidence: 92%

Analysis of two minimally invasive procedures for osteoporotic vertebral compression fractures with intravertebral cleft: a systematic review and meta-analysis

et al. 2020

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“…In recent years, PKP and PVP seem to be the standard for treating OVCFs with IVC because these techniques have advantages of satisfactory pain relief and vertebral height recovery via a relatively minimally invasive approach. However, several studies [8,10] have reported a high incidence of recollapse of the augmented vertebrae during long-term follow-up after PKP to treat OVCFs with IVC, and some authors [27,29] have proposed that the preoperative IVC might be an independent risk factor for recollapse of the augmented vertebrae after PKP or PVP. Although Nakamae et al [19] proposed that PVP could be an alternative intervention for the effective and safe treatment of OVCFs with IVC associated with neurological deficits, more attention should be paid to performing PKP or PVP for OVCFs with IVC and the development of dynamic instability.…”

Section: Discussionmentioning

confidence: 99%

“…e demographic data (patient age, sex, lesion segment, bone mineral density (BMD), fusion levels, operative duration, blood loss, and duration of follow-up) of the 2 groups are presented in Table 1. OVCFs with IVC were radiographically diagnosed with the following criteria [4,19,21,27]: an IVC sign showing a transverse, linear, semilunar, or irregular region with radiolucent shadows on CT and/or plain radiographs of the spine; a fluid-containing IVC showing low-signal intensity on T1-weighted images and high-signal intensity on T2-weighted images and/or short-tau-inversion-recovery (STIR) MR images; an aircontaining IVC showing homogenous low-signal intensity on T1-weighted, T2-weighted, and/or STIR images; or both air and fluid-filled IVC showing mixed high-and low-signal intensity on T2-weighted and/or STIR images. e inclusion criteria were as follows: (1) osteoporosis identified before the operation by dual-energy X-ray absorptiometry (DXA) and calculated T-scores (T-score <− 2.5 was defined as osteoporosis); (2) single-level neurological deficits in OVCFs complicated by IVC; (3) follow-up period of at least 2 years; and (4) regular radiologic studies including preoperative and postoperative (immediately, 1 years, and 2 years) scans.…”

Section: Patientsmentioning

confidence: 99%

Posterior Fixation Combined with Vertebroplasty or Vertebral Column Resection for the Treatment of Osteoporotic Vertebral Compression Fractures with Intravertebral Cleft Complicated by Neurological Deficits

Wei

Dong

Zhu

2019

BioMed Research International

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Purpose. The aim of the current study was to evaluate the relative benefits of posterior fixation combined with vertebroplasty (PFVP) or vertebral column resection (PVCR) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral cleft (IVC) complicated by neurological deficits. Methods. From June 2010 to January 2015, 45 consecutive patients suffering OVCFs with IVC and spinal cord injuries were treated with PFVP or PVCR in our department. The visual analogue scale (VAS) score, anterior vertebral height (AVH), posterior vertebral height (PVH), local kyphotic angle (LKA), and neurologic function were evaluated and compared, and the operative duration, blood loss, and complications were also recorded. Results. They all achieved excellent pain relief, vertebral height recovery, and kyphosis correction one month after surgery, and no significant differences existed between the two groups. No significant differences were observed between the 1-month postoperative and final follow-up VAS, AVH, and LKA values in the PVCR group (P>0.05), while AVH and LKA worsened in the PFVP group at the final follow-up (P<0.05). Similarly, the initial improvements in VAS scores decreased over time (P<0.05). Neurologic function improved in both groups, and no significant differences were observed between the 2 groups either preoperatively or postoperatively (P>0.05). The blood loss and operative duration were significantly lower in the PFVP group than those in the PVCR group (P<0.05). Conclusion. Compared with PVCR, PFVP had equivalent short-term clinical outcomes with less blood loss and operative duration which can be very beneficial for treating elderly patients with extreme comorbidities in this condition. However, based on the long-term efficacy of pain relief, vertebral height maintenance, and deformity correction, PVCR is a more reasonable choice.

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“…In our study, the surgical vertebral recompression rate in Group A was 5.2%, which was signi cantly lower than that in group B (16.5%). Previous literatures reported a surgical vertebral recompression rate of 3.2%~27.6% with different criteria of recompression and follow-up time [11,12,13]. This kind of surgical vertebral recompression is multifactorial, often without a clear traumatic event, may be related to the degree of osteoporosis, daily activities and the distribution of bone cement [14].…”

Section: Discussionmentioning

confidence: 99%

“…There were 26 males and 111 females, with an average age of 69 ± 7.0 years old. The average follow-up time was 15.3 ± 6.3 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) months.…”

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confidence: 99%

The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

Tan

Wen²,

Guo

et al. 2020

Preprint

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Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: 137 patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 hours post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results: 24 hours post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6-24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. In subgroup analysis, there was no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.

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Risk factors and score for recollapse of the augmented vertebrae after percutaneous vertebroplasty in osteoporotic vertebral compression fractures

Cited by 59 publications

References 31 publications

Analysis of two minimally invasive procedures for osteoporotic vertebral compression fractures with intravertebral cleft: a systematic review and meta-analysis

Analysis of two minimally invasive procedures for osteoporotic vertebral compression fractures with intravertebral cleft: a systematic review and meta-analysis

Posterior Fixation Combined with Vertebroplasty or Vertebral Column Resection for the Treatment of Osteoporotic Vertebral Compression Fractures with Intravertebral Cleft Complicated by Neurological Deficits

The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

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