The Risk of New Osteoporotic Vertebral Compression Fractures in the Year after Percutaneous Vertebroplasty

Voormolen, Maurits; Lohle, Paul N.M.; Juttmann, J.R.; Graaf, Yolanda van der; Fransen, H.; Lampmann, L. E. H.

doi:10.1097/01.rvi.0000190910.43602.3c

Cited by 172 publications

(144 citation statements)

References 20 publications

Supporting

Mentioning

135

Contrasting

Unclassified

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

“…Estudios prospectivos han demostrado mejoría en la alineación de la columna de los pacientes tratados por corrección de cifosis o restauración de la altura del cuerpo vertebral [12][13][14] . Algunos trabajos 15,16 han demostrado, sin embargo, un alto riesgo de nuevas fracturas, que entre el 40 y el 50% se dan en vértebras adyacentes a la vertebroplastia y más precoces que otras fracturas, lo que hace pensar en algún conflicto mecánico entre la vértebra osteoporótica y la cimentada. Un mes después de la intervención la paciente que presentamos permanecía con cierta limitación a la funcionalidad, pero no tomaba antiálgicos y mostraba un alto grado de satisfacción.…”

Section: Discussionunclassified

Osteonecrosis vertebral y vertebroplastia percutánea

Rosselló

Pallisó

Ferrer³

et al. 2008

Reumatología Clínica

View full text Add to dashboard Cite

“…New bone fracture occurs after 1-3 months in 10-20% of patients postvertebroplasty using PMMA. 14,15) New vertebral body fractures also occurred spontaneously after 1 year in about 18% of patients with old Vertebroplasty Using Hydroxyapatite Blocks vertebral body fracture. 7,8) In our series, since other old vertebral body fractures were recognized before first operation in all patients with a new fracture, the procedure is unlikely to have caused the new vertebral body fractures.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Vertebroplasty Using Hydroxyapatite Blocks for the Treatment of Vertebral Body Fracture

Nishioka

Imae

Kitayama

et al. 2009

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Fig. 1 Photograph showing hydroxyapatite blocks (upper), the special inserter (middle), and a hydroxyapatite plug (lower). The mean follow-up period was 16.6 months. The pain associated with this procedure, effects on adjacent vertebral bodies, and other complications were evaluated. The rate of recollapse after vertebroplasty was examined in 26 patients with 26 vertebral bodies treated and followed up for more than 3 months. Mean time of operation was 57 minutes and mean number of blocks used per vertebral body was 104. The mean visual analogue scale score was 7.0 preoperatively and 1.6 postoperatively. The mean decline in postoperative vertebral body height was 13%. New vertebral body fractures occurred postoperatively in 3 vertebral bodies in 2 patients. Leakage of blocks outside the vertebral body occurred in 2 patients during the operation, and after the operation in one patient, and the hydroxyapatite plug broke postoperatively in one patient. Hydroxyapatite blocks yielded good pain relief comparable to bone cement, with no serious complications such as a pulmonary embolism or leakage into the spinal canal, and are effective for percutaneous vertebroplasty.

show abstract

The Risk of New Osteoporotic Vertebral Compression Fractures in the Year after Percutaneous Vertebroplasty

Cited by 172 publications

References 20 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

Osteonecrosis vertebral y vertebroplastia percutánea

Percutaneous Vertebroplasty Using Hydroxyapatite Blocks for the Treatment of Vertebral Body Fracture

Contact Info

Product

Resources

About