Risk factors of recompression of cemented vertebrae after kyphoplasty for osteoporotic vertebral compression fractures

Li, Dapeng; Wu, Yan; Huang, Yonghui; Augustine, Balaara; Yue, Jiawei

doi:10.1007/s00264-016-3203-6

Cited by 17 publications

(12 citation statements)

References 24 publications

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“…Some scholars also found that the presence of non-PMMA-endplate-contact (NPEC) plays an important role in inducing the augmented vertebra recompression after PVA. Li et al [ 17 ] considered that the distance between the bone cement and the upper or lower endplates of the injured vertebrae can reflect the dispersion degree of bone cement more accurately. If the distance is too large, the risk of the augmented vertebra recompression will be increased, and the augmented vertebra recompression mainly occurs in the upper part of the vertebral body where it is not filled with bone cement.…”

Section: Discussionmentioning

confidence: 99%

Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

Chen

Wang

et al. 2021

J Orthop Surg Res

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Objective To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF) and analyze the correlation between these factors and augmented vertebra recompression after PVA. Methods A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to the inclusion criteria. All cases meeting the inclusion and exclusion criteria were divided into two groups: 82 patients in the recompression group and 175 patients in the non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density (BMD) during follow-up, intravertebral cleft (IVC) before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery, and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA. Results A total of 257 patients from 353 patients were included in this study. The follow-up time was 12–24 months, with an average of 13.5 ± 0.9 months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P < 0.05). Among them, multiple factors logistic regression elucidated that more injected cement (P < 0.001, OR = 0.558) and high BMD (P = 0.028, OR = 0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B < 0). Preoperative IVC (P < 0.001, OR = 3.252) and bone cement not in contact with upper or lower endplates (P = 0.006, OR = 2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P = 0.007, OR = 0.337). Conclusions The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.

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Section: Discussionmentioning

confidence: 99%

Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

Chen

Wang

et al. 2021

J Orthop Surg Res

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“…The cases after PKP were particularly serious, which might be the result of different contact between bone cement surfaces in PKP balloons. There are many reasons for vertebral height loss after vertebral augmentation, for example, the severity of osteoporosis, the choice of surgical methods, the different surgical approaches, the different degrees of preoperative vertebral compression, the different distributions of bone cement, the different amounts of bone cement injection, or the existence of intravertebral cleft and other reasons [16][17][18][19][20][21][22][23]. Therefore, vertebroplasty alone is not appropriate for the treatment of OVF with severe compression and kyphosis.…”

Section: Compared With Previous Studiesmentioning

confidence: 99%

Efficacy analysis of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with kyphosis

Wang

et al. 2020

J Orthop Surg Res

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Background: To investigate the clinical effect of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) in the treatment of osteoporotic compression vertebral fracture (OVCF) of the thoracolumbar vertebra with kyphosis. Methods: One hundred sixty-six patients before June 2017 were retrospectively analyzed, and patients were divided into PPSF + PVP group A and PVP group B. Operative time, bone mineral density, postoperative bed time, high compression ratio, bone cement leakage rate, and bone cement dose were recorded. Comparison of vertebral anterior edge height, Cobb angle, visual analogue score (VAS), and low back pain dysfunction index (ODI) between the two groups in preoperative, postoperative 3 days, postoperative 6 months, postoperative 12 months, and postoperative 24 months, postoperative complications were observed in the two groups. Results: The operation time of group A was longer than that of group B (59.0 ± 8.6 min, 26.6 ± 5.2 min), longer postoperative bed rest time (3.3 ± 0.7 days, 1.2 ± 0.5 days), the differences were statistically significant (P < 0.01), there was no difference in the amount of bone cement between the two groups (5.4 ± 0.6 ml, 5.3 ± 0.8 ml) (P > 0.05). The height of the anterior edge and Cobb angle of the two groups recovered significantly in postoperative 3 days. The height of anterior edge (2.7 ± 0.

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“…To us, the instrumented KP allows effective restoration on the central part of the vertebra. We did not notice any recollapse of cemented vertebra although we had a population with risk factors [20, 21]. In our worst case shown in Figure 5, no.…”

Section: Discussionmentioning

confidence: 72%

Vertebral Compression Fractures Treated in Acute by Instrumented Kyphoplasty: Early and Mid-Term Clinical and Radiological Results

Descamps

Lamerain

Chenguel

et al. 2019

BioMed Research International

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The treatment of traumatic low-degree vertebral compression fracture remains in a wide range between functional treatment, bracing, vertebroplasty, kyphoplasty, and even surgical fixation. The objective was to assess the innovation of instrumented kyphoplasty and to report the early and mid-term functional and radiological results. This study is a retrospective review of patients enrolled from 2012 to 2017. 104 consecutive endovertebral implantations of instrumented kyphoplasty were reviewed for the study. There were 56 women and 48 men. 93 of 104 patients were evaluated, of whom 27 were evaluated only by retrospective medical record review and 66 with follow-up visit. Clinical parameters were the pain rating scale (VAS) and the Oswestry score questionnaire. The radiological parameters were the vertebral kyphosis, vertebral height, lumbar lordosis, and adjacent disc degeneration (UCLA scale). Statistical correlations between before/after surgery/last follow-up were performed. The average follow-up was 26.7 months (3 to 55). The average VAS decreased from 8.2 to 3.2 the day after surgery, allowing immediate standup. The average Oswestry score was 14.6 at follow-up. The average vertebral kyphosis decreased from 12.9° to 6.5° post-op and stabilized at 8.0° at the last follow-up, corresponding to 28% gain on vertebral height. The lumbar lordosis was restored (+6.6°). Adjacent disc degeneration increased by 1 UCLA grade in 17 patients (16.3%) at follow-up. The instrumented kyphoplasty in acute led to immediate and lasting pain relief, with no bracing or bed rest, short stay in hospital, and quick return to daily life including professional activities. The good clinical results were associated to a stable radiological restoration of the vertebral anatomy.

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Risk factors of recompression of cemented vertebrae after kyphoplasty for osteoporotic vertebral compression fractures

Abstract: The distance between polymethylmethacrylate and endplate is an important risk factor of recompression of cemented vertebrae after kyphoplasty for patients with osteoporotic vertebral compression fractures.

Cited by 17 publications

References 24 publications

Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

Efficacy analysis of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with kyphosis

Vertebral Compression Fractures Treated in Acute by Instrumented Kyphoplasty: Early and Mid-Term Clinical and Radiological Results

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