Risk factors for new vertebral compression fractures after vertebroplasty: a meta‐analysis

Cao, Jianzhong; Kong, Lingde; Meng, Fantao; Zhang, Yingze; Shen, Yong

doi:10.1111/ans.13428

Cited by 31 publications

(25 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Low BMD at admission was found to be the risk factor for new fractures in this study. A meta-analysis also demonstrated that low bone mineral density, the presence of multiple treated vertebrae, and a history of steroid usage were associated with the new OVCFs after vertebroplasty [ 29 ]. These risk factors should be considered in further analysis of our data.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty and Facet Blocking for Treating Back Pain Caused by Osteoporotic Vertebral Compression Fracture

Cheng

Shi

et al. 2020

Pain Research and Management

View full text Add to dashboard Cite

Background and Objectives. Back pains associated with osteoporotic vertebral compression fractures (OVCFs) may arise not just from vertebral body but also from posterior elements. Percutaneous vertebroplasty (PVP) and facet blocking (FB) combined therapy would relieve pain better, but it has not been elucidated. The purpose of this retrospective study was to compare the treatment effects of PVP and FB combined therapy with PVP alone in OVCFs patients. Methods. Clinical and radiological data of 204 patients were reviewed. The patients were divided into Group A (PVP alone) and Group B (PVP and FB combined therapy) according to treatments. Back pain was evaluated with Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). The operation, fluoroscopic exposure time, and bone cement leakage were recorded. The χ2 test, Student’s t-test, and repeated measures analysis of variance were used to compare the differences between the two groups. Results. There were 125 patients in Group A and 79 patients in Group B. Their baseline characteristics were similar (P>0.05). The mean VAS scores of Group A and Group B were 7.03 and 7.21 at admission, 4.7 and 3.2 at 1 day after operation, 4.0 and 3.0 at 3 months, and 2.2 and 2.2 at 12 months after operation, respectively. The mean ODI scores of Group A and Group B were 30.9 and 29.8 at admission, 17.6 and 17.7 at 3 months, and 10.5 and 10.9 at 12 months after operation, respectively. The mean operation time and fluoroscopic exposure time of Group A (35.6 minutes and 7.2 seconds, respectively) was significantly shorter than that of Group B (45.7 minutes and 11.7 seconds, respectively, P<0.01). The incidence of bone cement leakage and new fractures after operation did not have statistically significant difference between groups. Conclusion. PVP and FB combined therapy could provide better pain relief than PVP alone in short term after operation in patients with OVCFs associated back pains.

show abstract

Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty and Facet Blocking for Treating Back Pain Caused by Osteoporotic Vertebral Compression Fracture

Cheng

Shi

et al. 2020

Pain Research and Management

View full text Add to dashboard Cite

show abstract

“…Some authors [11] confirmed that new VFs are a natural result of osteoporosis and have no significant relationship with fractures after vertebroplasty. Cao et al [12] came to the same conclusion. However, they pointed out that 3 primary factors, that is, low bone mineral density, steroid usage, and the presence of multiple treated vertebrae, may be associated with a higher incidence of new fractures after vertebroplasty.…”

Section: Discussionmentioning

confidence: 52%

Vertebral collapse and polymethylmethacrylate breakage after vertebroplasty

et al. 2019

View full text Add to dashboard Cite

Rationale: Vertebral augmentation has become the main treatment for osteoporotic vertebral fractures (VFs). In this article, we report a very rare case of vertebral collapse and polymethylmethacrylate (PMMA) breakage after vertebroplasty. We describe the clinical characteristics and revision surgery performed to remove the broken PMMA cement, maintain stability, and corrects the kyphotic deformity, and we analyze the possible causes. Patient concerns: A 72-year-old man who suffered back pain underwent first lumbar vertebra (L1) percutaneous vertebroplasty (PVP) due to osteoporosis and a vertebral fracture in May 2013. Postoperatively, the patient's back pain was markedly alleviated. Unfortunately, his lumbar back pain recurred in November 2015. Diagnoses: Plain radiographs showed collapse of the L1 vertebral body, breakage of the PMMA cement, and severe kyphosis at the thoracolumbar junction. Interventions: The posterior pedicle was internally fixed and an anterior artificial vertebral body implant was placed to maintain stability and correct the kyphotic deformity in a 2-step surgical procedure. Outcomes: The back pain was alleviated and the patient returned to daily life for more than two years. Lessons: This case demonstrates that PVP is not a simple minimally invasive surgery, and significant postsurgical care is necessary. The true cause of this rare phenomenon remains unclear, but the long-term use of steroids, new injuries, and poorly corrected kyphosis after PVP may play a role. Surgeons must be aware of the kinds of complications that may occur, including rare complications such as vertebral lysis.

show abstract

“…However, another opinion about this phenomenon was that adjacent fractures might be the natural manifestations of severe osteoporotic spine. 15) Cao et al 4) showed that low bone mineral density, the presence of multiple treated vertebrae, and a history of steroid use were associated with the development of this new fracture around the augmented vertebra. In our study, one case of new compression fracture adjacent to the augmented vertebrae occurred at 1 month postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Cement Augmented Anterior Reconstruction and Decompression without Posterior Instrumentation: A Less Invasive Surgical Option for Osteoporotic Thoracolumbar Fracture with Cord Compression

Lee

et al. 2020

Korean J Neurotrauma

View full text Add to dashboard Cite

Objective We investigated the clinical and radiological outcomes of a cement augmented anterior reconstruction and decompression without pedicle screw fixation in patients with osteoporotic thoracolumbar vertebral fracture with myelopathy. Methods There were 2 male and 6 female patients with thoracolumbar fracture and myelopathy included in the study. The mean follow-up period was more than 1 years. The anterolateral decompression and cement augmented anterior reconstruction with poly(methyl methacrylate) (PMMA) was performed. Demographic data, clinical outcomes, perioperative parameters and radiologic parameter were retrospectively evaluated. Results The symptoms due to myelopathy were improved in all patients. The preoperative median visual analog scale score for lower back and leg were 8.5 that improved 4.25 and 3 at last follow up. The preoperative function state showed a median Oswestry Disability Index score 61.5 that improved 33. After surgery, preoperative encroachment of the spinal canal (5.12 mm, 37%) was disappeared. The median height of fractured vertebral body significantly increased from 7.83 to 12.63 mm. At the last follow-up point, the median height was 9.91 mm. The median kyphotic deformity was improved from 22.12° to 14.31°. At the final follow-up, the improvement was preserved (median value: 15.03). The acute complication according to PMMA such as leakage and embolization was none, but adjacent compression fracture as late complication according to cement augmentation was. One patient developed surgical site infection. Conclusion On the basis of the preliminary results, we considered that anterolateral decompression and PMMA augmentation might be an optimal method for treating osteoporotic fracture with myelopathy in elderly patients or those with multiple medical comorbidities.

show abstract

Risk factors for new vertebral compression fractures after vertebroplasty: a meta‐analysis

Abstract: The present analysis demonstrated that low bone mineral density, the presence of multiple treated vertebrae and a history of steroid usage were associated with the new VCFs after vertebroplasty. Patients with these factors should be informed of the potential increased risk.

Cited by 31 publications

References 31 publications

Percutaneous Vertebroplasty and Facet Blocking for Treating Back Pain Caused by Osteoporotic Vertebral Compression Fracture

Percutaneous Vertebroplasty and Facet Blocking for Treating Back Pain Caused by Osteoporotic Vertebral Compression Fracture

Vertebral collapse and polymethylmethacrylate breakage after vertebroplasty

Cement Augmented Anterior Reconstruction and Decompression without Posterior Instrumentation: A Less Invasive Surgical Option for Osteoporotic Thoracolumbar Fracture with Cord Compression

Contact Info

Product

Resources

About