The therapeutic effect of intravertebral vacuum cleft with osteoporotic vertebral compression fractures: A systematic review and meta-analysis

Yu, Weibo; Liang, De; Yao, Zhensong; Qiu, Ting; Ye, Linqiang; Jiang, Xiaobing

doi:10.1016/j.ijsu.2017.02.019

Cited by 31 publications

(39 citation statements)

References 18 publications

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“…So Kümmell's disease is also referred to as delayed post-traumatic vertebral collapse disease, nonunion of vertebral fractures, and vertebral ischemic necrosis [1,2,17]. Previous studies have suggested that IVC is mainly located in the thoracolumbar region [4,18], which is similar to the segmental distribution of the two groups of patients in this study. 87.5% of the fractured vertebral bodies were located in the thoracolumbar segment, most of which were wedge fractures.…”

Section: Discussionsupporting

confidence: 72%

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Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Chang¹,

Bei

Shu³

et al. 2020

Preprint

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Background Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease. Methods The clinical data that 56 cases of OVCF treated with either PVP (28 cases) or PKP (28 cases) and met the selection criteria from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, BMD, VAS, ODI, imaging measurement indexes before surgery between the two groups showed no significant difference (all P>0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy. Results The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebra between the two groups (all P > 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 d, 1 year and 2 years after surgery than before surgery (all P <0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P> 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P <0.05, respectively) and decreased significantly with time (all P <0.05), But there was not significant difference between the two groups at any time point (all P> 0.05). Conclusion Both PVP and PKP can achieve similar effects in the treatment of Kümmell's disease. Because the cost, operation time, blood loss, radiation exposure and surgical procedure of PVP are less than those of PKP, PVP has more clinical priority value.

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Section: Discussionsupporting

confidence: 72%

“…examination can discover the late-onset collapse of vertebrae and characteristic change of intravertebral vacuum cleft (IVC), which is considered the one of important inducing factors of injured vertebral progress after the collapse, deformity of kyphosis, intractable back pain and spinal cord damage after OVCF [4].…”

mentioning

confidence: 99%

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Chang¹,

Bei

Shu³

et al. 2020

Preprint

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“…the IVC refers to a significant radiolucency (gas containing), which is located centrally or adjacent to the vertebral body endplates as seen on CT or plain radiographs. On MRI, it is usually shown as a low signal intensity on a T1-weighted image and as a high signal or a low signal on a T2weighted image, depending on whether the fluid or gas fills the cleft [4]; ④ Dual energy X-ray measurement of bone mineral density (BMD) T value was less than − 2.5; ⑤ PVP or PKP was conducted with bilateral pedicle; ⑥ Follow-up time was more than 2 years; ⑦ Postoperative calcium supplementation and anti-osteoporotic drugs were applied; ⑧ No fall or other trauma occurred. Exclusion criteria are as follows: ① Patients with severe cardiopulmonary dysfunction; ② Patients with coagulopathy; ③ Patients with local or systemic infection; ④ Patients with nerve root or spinal cord compression symptoms; ⑤ Patients with pathological fractures other than osteoporosis.…”

Section: Selection Criteriamentioning

confidence: 99%

“…Kümmell's disease is also known as nonunion after OVCF, delayed vertebral osteonecrosis after trauma, and delayed vertebral collapse [2,3]. Imaging examination can discover the late-onset collapse of vertebrae and characteristic change of intravertebral vacuum cleft (IVC), which is considered one of important inducing factors for injured vertebral progress after the collapse, deformity of kyphosis, intractable back pain and spinal cord damage after OVCF [4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Chang

Bei²,

Shu

et al. 2020

BMC Musculoskelet Disord

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Background: Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease. Methods: The clinical data that 56 cases of Kümmell's disease treated with either PVP (28 cases) or PKP (28 cases) from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, bone mineral density (BMD), visual analogue scale (VAS), Oswestry disability index (ODI), imaging measurement indexes before surgery between the two groups showed no significant difference (all P > 0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy. Results: The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebrae between the two groups (all P > 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 day, 1 year and 2 years after surgery than before surgery (all P < 0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P > 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P < 0.05, respectively) and decreased significantly with time (all P < 0.05), But there was not significant difference between the two groups at any time point (all P > 0.05).

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“…PVP surgery can reduce the risk of vertebral wedge change and nerve injury in Kümmell's disease, so early PVP surgery should be performed [7]. However, between OVCFs and Kümmell's disease, the clinical e cacy, clinical characteristics, and complications of PVP treatment are still uncertain [8].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical manifestations and cement distribution after percutaneous vertebroplasty between thoracolumbar Kümmell’s disease and OVCFs

Wang¹,

Chen

2020

Preprint

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Background：Kümmell's disease is a chronic, non-healing osteoporotic vertebral compression fractures (OVCFs), which is associated with ischemic necrosis and vertebral pseudarthrosis. The purpose of this study was to compare the therapeutic effect and distribution characteristics of bone cement in the percutaneous vertebroplasty (PVP) treatment between thoracolumbar Kümmell's diseases and OVCFs.Methods: A total of 70 patients with Kümmell ’s disease (K group) or OVCFs (O group) who underwent PVP surgery from February 2016 to February 2018 were included in this study. The follow-up time was 24-48 months. The course of disease was significantly longer in the K group than in the O group (P=0.000). Most cases in the K group had no history of trauma, while most cases in the O group had a history of falls (P=0.001). The vertebral compression rate and degree of osteoporosis were more serious in the K group than in the O group (P<0.05, respectively). Distribution pattern, volume and leakage rate of bone cement, operation time, VAS score, ODI, correction rates of vertebral compression and kyphosis, re-fracture rate of adjacent vertebrae between the two groups were compared to assess clinical effect.Results: The amount of bone cement injected was significantly higher in the K group than in the O group (P=0.025). The cement distribution pattern of local solid lump was dominant in the K group (65.71%), while intercalation with trabeculae was dominant in the O group (74.29%) (P<0.001). VAS and ODI were significantly lower both in the two groups at the 1st day, 1st year and 2nd years after surgery than before surgery (all P<0.05), but significantly lower in the K group than in the O group at each time point after surgery (all P<0.05). The correction rates of kyphosis and vertebral compression in both groups were significantly improved (P<0.05, respectively) and gradually lost with time (P<0.05, respectively). The correction rates of kyphosis and vertebral compression were significantly higher in the K group than in the O group at each time point after surgery (all P<0.05).Conclusion: Kümmell's disease has a higher degree of disease progression and osteoporosis than OVCFs. PVP can better restore partial vertebral height and correct kyphosis in the treatment of Kümmell's disease, while can better alleviate pain and improve ODI in the treatment of OVCFs.

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The therapeutic effect of intravertebral vacuum cleft with osteoporotic vertebral compression fractures: A systematic review and meta-analysis

Abstract: The IVCs had an important effect of therapeutic efficacy in PVA for the treatment OVCFs. Therefore, we strongly recommend its strict observation and follow-up for the IVCs patients.

Cited by 31 publications

References 18 publications

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Comparison of the clinical manifestations and cement distribution after percutaneous vertebroplasty between thoracolumbar Kümmell’s disease and OVCFs

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