Treatment of severe vertebral body compression fractures with percutaneous vertebroplasty

Young, Clint; Munk, Peter L.; Heran, Manraj K.S.; Lane, Michael; Le, Huy; Lee, Steven; Badii, Maziar; Clarkson, Paul W.; Hugue, Ouellette C.

doi:10.1007/s00256-011-1138-y

Cited by 27 publications

(20 citation statements)

References 19 publications

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“…Many methods exist for the management of thoracolumbar fractures, and there is no consensus or guidelines regarding treatment. 10 Depending on the severity of injury, treatment methods include percutaneous vertebroplasty, 14 percutaneous internal fi xation combined with kyphoplasty, 15 external fi xation with percutaneous bone grafting, 16 long-segmental instrumentation, 17 and pedicle screw fi xation with screws placed at various levels. Modi et al 18 retrospectively analyzed 31 thoracolumbar fractures treated with pedicle screws placed 2 levels above and 1 level below the fractured vertebra; they found that at an average follow-up of 34 months, all patients had a full recovery and that the technique was useful for the…”

Section: Discussionmentioning

confidence: 99%

Posterior Short-segmental Fixation Combined With Intermediate Screws vs Conventional Intersegmental Fixation for Monosegmental Thoracolumbar Fractures

Tian

Wang²,

Xia³

et al. 2011

Orthopedics

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Posterior short-segmental fixation is reliable for the management of thoracolumbar fractures; however, it is associated with recurrence of kyphosis and failure of fixation. This study compared the short-term results of short-segmental fixation combined with intermediate screws with those of conventional intersegmental fixation in the treatment of monosegmental thoracolumbar fractures. The records of 62 consecutive patients with thoracolumbar monosegmental fractures who underwent conventional 4-screw intersegmental fixation (35 patients) or short-segmental fixation combined with intermediate screws (27 patients) were reviewed. The study population included 43 men and 19 women (mean age, 44.1±13.6 years). The majority of fractures were L1 (28 [45.1%]) and T12 (21 [33.9%]) fractures. There were no significant differences between the 2 groups with respect to the preoperative relative height of the fractured vertebra or the segmental kyphotic angle. There was a significant difference in the restoration rate between the conventional and short-segmental fixation groups (62.6±38.7% vs 100.4±25.4%, respectively; P<.001). However, a statistically significant decrease in postoperative segmental kyphotic angle was noted in both groups (P<.001). The mean change of segmental kyphotic angle in the short-segmental fixation group was greater than in the conventional fixation group (14.4±6.8° vs 8.3±7.9°, respectively; P<.002). Patients in the short-segmental fixation group ambulated an average of 10 days earlier than those in the conventional fixation group. These findings indicate that compared to conventional intersegmental fixation, short-segmental fixation combined with intermediate screws more effectively restores fractured vertebral height, is associated with a decrease in the segmental kyphotic angle, and allows earlier ambulation.

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Section: Discussionmentioning

confidence: 99%

Posterior Short-segmental Fixation Combined With Intermediate Screws vs Conventional Intersegmental Fixation for Monosegmental Thoracolumbar Fractures

Tian

Wang²,

Xia³

et al. 2011

Orthopedics

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“…Nevertheless, there is increasing interest in performing vertebroplasty in symptomatic severe compression fractures including vertebra plana; technical feasibility, safety, and efficacy have been seen in small series [1][2][3]. Our technique differs from recent publications in that we used CBCT with navigation guidance to increase the confidence of accurate needle placement.…”

Section: Ct-guided Vertebroplasty For Vertebra Planamentioning

confidence: 77%

“…Va s c u l a r a n d I nt e r ve nt io n a l R a d io l og y • Te c h n ic a l I n nov at io n AJR 2016;207:196-199 0361-803X/16/2071-196 © American Roentgen Ray Society V ertebra plana is traditionally considered a contraindication for vertebroplasty, partly because of the technical difficulty with needle placement. However, recent studies have found that vertebroplasty under conventional fluoroscopic guidance is not only feasible in patients with vertebral plana but could also provide pain relief [1][2][3]. We illustrate the use of cone-beam CT (CBCT) with a navigation guidance system to achieve safe needle trajectory and placement during vertebroplasty in a patient with severe vertebra plana.…”

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confidence: 96%

Cone-Beam CT–Guided Vertebroplasty in a Patient With Vertebra Plana

Pua

Lim

2016

American Journal of Roentgenology

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“…The leakage rate of spinal metastases is often higher than that of osteoporotic vertebral fractures, which may be caused because tumor destructs cortical bone of the vertebral body or that tumor richens blood vessels and blood supply (27). Percutaneous balloon dilatation vertebral kyphoplasty is improved based on PVP, which can reduce the leakage rate to 8.4% (28)(29)(30)(31). In order to further reduce the leakage of bone cement, bone filling mesh bags were made.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Bone-Filling Mesh Container in Treating Vertebral Metastases with Vertebral Body Posterior Marginal Damage

et al. 2019

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Background: In order to reduce the occurrence of bone cement leakage, bone filling mesh container technique can be a prior choice for the treatment of vertebral metastases with damaged posterior margin of the thoracolumbar vertebral body. Objectives: The purpose of this retrospective study was to compare the efficacy and safety of percutaneous balloon kyphoplasty (PKP) and bone filling mesh containers (BFMCS) in the treatment of vertebral metastases with posterior vertebral body damage. Patients and Methods: This is a retrospective study. From October 2016 to January 2018, 40 cases (72 vertebral bodies) of thoracolumbar osteolytic metastases were treated with vertebroplasty. Among them, 20 cases (37 vertebral bodies) were treated with PKP (PKP group), and 20 cases (35 vertebral bodies) were treated with BFMCS (BFMCS group). The operation time of the two groups was recorded, and visual analog scale (VAS), Oswestry disability index (ODI), intraoperative bone cement leakage and complications were observed before operation and 1 day, 1 month and 6 months after operation. Results: All patients underwent successful operation. The operation time of the PKP group was 42.65 ± 7.84 minutes, and 42.95±8.48 minutes in the BFMCS group (P = 0.91). Both groups differed significantly when the results were compared with those measured before treatment. VAS dropped from 7.50 ± 0.95 points before operation to 1.20 ± 0.41 points at 6 months follow up in PKP group (P < 0.001), in the BFMCS group VAS dropped from 7.50 ± 0.94 points before operation to 1.45 ± 0.51 points at 6 months after operation (P < 0.001). The ODI of the PKP group dropped from 75.80±4.76 before operation to 12.05 ± 1.47, 6 months after operation (P < 0.001), ODI dropped from 75.00 ± 4.34 before operation to 11.60 ± 1.39 at 6 months follow up in the BFMCS group (P < 0.001). In the PKP group, 15 vertebral bodies (40.5%, 15/37) occurred bone cement leakage, but the patients had no clinical symptoms of bone cement leakage. Cement leakage occurred in one case in the BFMCS group. There were no complications such as pulmonary embolism, paraplegia or perioperative death. Conclusion: The application of bone-filling mesh container for treating patients with thoracolumbar osseointegrated metastases could significantly reduce the leakage rate of bone cement, and is similar to traditional PKP in pain relief and activity improvement.

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Treatment of severe vertebral body compression fractures with percutaneous vertebroplasty

Abstract: Percutaneous vertebroplasty is safe and effective in the treatment of single level severe vertebral body compression fractures.

Cited by 27 publications

References 19 publications

Posterior Short-segmental Fixation Combined With Intermediate Screws vs Conventional Intersegmental Fixation for Monosegmental Thoracolumbar Fractures

Posterior Short-segmental Fixation Combined With Intermediate Screws vs Conventional Intersegmental Fixation for Monosegmental Thoracolumbar Fractures

Cone-Beam CT–Guided Vertebroplasty in a Patient With Vertebra Plana

Therapeutic Effect of Bone-Filling Mesh Container in Treating Vertebral Metastases with Vertebral Body Posterior Marginal Damage

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