Therapeutic effect of percutaneous kyphoplasty combined with anti-osteoporosis drug on postmenopausal women with osteoporotic vertebral compression fracture and analysis of postoperative bone cement leakage risk factors: a retrospective cohort study

Abstract

BackgroundThe purpose of this study is to explore the therapeutic effect of percutaneous kyphoplasty (PKP) combined with anti-osteoporosis drug, zoledronic acid, on postmenopausal women with osteoporotic vertebral compression fracture (OVCF) and to perform an analysis of postoperative bone cement leakage risk factors.MethodsA total of 112 OVCF patients, according to therapeutic regimens, were divided into control group (n = 52, treated with PKP) and observation group (n = 60, treated with PKP and zoledronic acid injection).ResultsPostoperative tumor necrosis factor-α and interleukin-6 levels were significantly decreased in the two groups, compared with those before treatment (both P < 0.05); bone mineral density (BMD), serum bone gla protein (BGP), and vertebral height ratio of injured vertebrae were significantly increased, and procollagen type I N-terminal propeptide (PINP), Cobb angle, visual analogue scale/score (VAS), and Oswestry disability index (ODI) were significantly decreased compared with those before treatment (all P < 0.05). There were significantly higher changes in difference value of BMD, PINP, BGP, vertebral height ratio of injured vertebrae, Cobb angle, VAS, and ODI levels and significantly better therapeutic effect in the observation group than those in the control group (all P < 0.05). Multivariate logistic regression analysis showed that the use of zoledronic acid, vertebral height ratio of injured vertebrae, and ODI were independent factors affecting the therapeutic effect, and that the dosage of bone cement, and peripheral vertebrae wall damage were independent risk factors causing postoperative bone cement leakage. There were no significant differences in postoperative bone cement leakage rate between the two groups.ConclusionsPeripheral vertebrae wall damage and the dosage of bone cement are independent risk factors causing bone cement leakage in OVCF patients treated with PKP. PKP combined with zoledronic acid has an improvement effect on the condition of postmenopausal women with OVCF and reduces the inflammation and pain in patients, which is beneficial to clinical treatment.

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

“…We found that the rates of vertebral compression and kyphosis correction in the two groups gradually decreased significantly with time, suggesting that vertebral height and kyphosis angle gradually lost after surgery, which was consistent with previous findings [7,14]. In the treatment of OVCF without IVC by PVP and PKP, the injected bone cement of the former is mainly embedded in cancellous bone, while the bone cement of the latter is mainly filled with clumps, so stress occlusion is more likely to occur after PKP and lead to recollapse [32].…”

“…Since 1984, Galiber et al [12] applied PVP in the treatment of 1 case of C 2 vertebra invasive hemangioma to find its advantages of simple operation and definite effect. PVP and PKP have gradually become one of the effective methods to treat vertebral tumor and OVCF [8,13,14].…”

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

“…We found that the rates of vertebral compression and kyphosis correction in the two groups gradually decreased significantly with time, suggesting that vertebral height and kyphosis angle gradually lost after surgery, which was consistent with previous findings [7,14]. In the treatment of OVCF without IVC by PVP and PKP, the injected bone cement of the former is mainly embedded in cancellous bone, while the bone cement of the latter is mainly filled with clumps, so stress occlusion is more likely to occur after PKP and lead to recollapse [33].…”

“…Since 1984, Galiber et al [12] applied PVP in the treatment of 1 case of C 2 vertebra invasive hemangioma to find its advantages of simple operation and definite effect. PVP and PKP have gradually become one of the effective methods to treat vertebral tumor and OVCF [8,13,14]. Kümmell's disease is a rare type in OVCF after minor trauma, which is progressive occurrence of vertebral collapse and kyphosis due to vertebral ischemia and necrosis.…”

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

“…The correction rates of vertebral compression rate and kyphosis both in the two groups gradually lost with time, which was consistent with previous ndings [30,31]. In the vertebral intensive treatment of OVCFs, bone cement in the PVP group was mainly embedded in cancellous bone, while bone cement in the PKP group was mainly distributed in clumps, so stress blocking is more likely to occur after PKP surgery, resulting in recollapse [32].…”