Unilateral versus bilateral percutaneous vertebroplasty for osteoporotic vertebral compression fractures in elderly patients

Chen, Ying‐Chun; Zhang, Lin; Li, Er-Nan; Ding, Lei; Zhang, Genai; Hou, Yu; Yuan, Wei

doi:10.1097/md.0000000000014317

Cited by 20 publications

(34 citation statements)

References 21 publications

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“…However, this classification method was mostly applicable for unilateral puncture cases, because bilateral puncture injection of bone cement can often achieve a uniform distribution on both sides of the vertebral body, effectively avoiding the uneven stress caused by asymmetric distribution on the coronal plane. Many previous literatures have also confirmed that bilateral puncture does not significantly increase the risk of complications such as cement leakage and nerve injury as long as the puncture route is strictly followed [9,10]. Therefore, studying the distribution of bone cement in the sagittal plane on lateral radiographs may be more meaningful for the analysis of surgical efficacy.…”

Section: Discussionmentioning

confidence: 92%

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The effect of bone cement distribution on the outcome of percutaneous Vertebroplasty: a case cohort study

Tan

Wen

Guo

et al. 2020

BMC Musculoskelet Disord

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Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: One hundred thirty seven patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 h post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results: 24 h post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6-24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. Analysis in subgroup B revealed no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.

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Section: Discussionmentioning

confidence: 92%

“…There were 26 males and 111 females, with an average age of 69 ± 7.0 years old. The average follow-up time was 15.3 ± 6.3 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) months.…”

Section: General Datamentioning

confidence: 99%

The effect of bone cement distribution on the outcome of percutaneous Vertebroplasty: a case cohort study

Tan

Wen

Guo

et al. 2020

BMC Musculoskelet Disord

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show abstract

“…However, this classi cation method was mostly applicable for unilateral puncture cases, because bilateral puncture injection of bone cement can often achieve a uniform distribution on both sides of the vertebral body, effectively avoiding the uneven stress caused by asymmetric distribution on the coronal plane. Many previous literatures have also con rmed that bilateral puncture does not signi cantly increase the risk of complications such as cement leakage and nerve injury as long as the puncture route is strictly followed [9,10]. Therefore, studying the distribution of bone cement in the sagittal plane on lateral radiographs may be more meaningful for the analysis of surgical e cacy.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

Tan

Wen²,

Guo

et al. 2020

Preprint

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Background: To analyze the effect of different types of bone cement distribution after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture (OVCF). Methods: 137 patients with single level OVCF who underwent PVP were retrospectively analyzed. The patients were divided into two groups according to bone cement distribution. Group A: bone cement contacted both upper and lower endplates; Group B: bone cement missed at least one endplate. Group B was divided into 3 subgroups. Group B1: bone cement only contacted the upper endplates; Group B2: bone cement only contacted the lower endplates; Group B3: bone cement only located in the middle of vertebral body. The visual analogue scale (VAS) score at 24 hours post operation and last follow-up, anterior vertebral height restoration ratio (AVHRR), anterior vertebral height loss ratio (AVHLR), local kyphotic angle change and vertebral body recompression rate were compared. Results: 24 hours post operation, the pain of all groups were significantly improved. The average follow-up time was 15.3 ± 6.3 (6-24) months. At last follow-up, the VAS score of group A was lower than that of group B. There were 14 cases (10.2%) of adjacent vertebral fracture, 5 cases (8.6%) in group A and 9 cases (11.4%) in group B. There were 9 cases (6.6%) of cement leakage, 4 cases (6.9%) in group A and 5 cases (6.3%) in group B. At last follow-up, there were 16 cases (11.7%) of vertebral body recompression, including 3 cases (5.2%) in group A and 13 cases (16.5%) in group B. There was no significant difference in AVHRR between two groups. Local kyphotic angle change was significant larger in group B. At last follow-up, AVHLR in group B was higher than that in group A. In subgroup analysis, there was no significant difference in VAS score, local kyphotic angle change, vertebral recompression rate, AVHRR or AVHLR. Conclusions: If the bone cement fully contacted both the upper and lower endplates, it can better restore the strength of the vertebral body and maintain the height of the vertebral body, reduce the risk of the vertebral body recompression and long-term pain.

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“…We have reviewed thoroughly literatures on several aspects on the relationship between surgical operation and residual pain. As many meta-analyses shown, PKP and PVP have no difference in pain improvement and function recovery [19,20]. 10 studies, from a meta-analysis with 16 studies [19], indicated no difference by comparing the pain improvement in PKP group and PVP group.…”

Section: Operation Related Factorsmentioning

confidence: 99%

Factors and Strategies for Post-Vertebroplasty Residual Pain from Thoracolumbar Osteoporotic Vertebral Compression Fractures (OVCF): a systematic review.

Tang

Liu

et al. 2021

Preprint

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Purpose Insignificant pain relief (IPR) in short period after vertebroplasty is common, which often disturb doctors and affect patients Therefore, we reviewed systematically relative articles and attempted to get meaningful evidence on factors and strategies for IPR.Methods PubMed, Web of Science, Embase, CNKI, WanFang, and VIP were searched for literatures treating the osteoporotic vertebral compression fractures (OVCFs) with vertebroplasty and assessing the clinical efficacy.Results 817 references were electronically retrieved, 81 full-text papers were screened and 41 studies were included. Twenty-two trials presented factors on IPR, mainly including bone cement related, operation related and patient-related factors. Nineteen studies showed strategies on residual pain, including improving osteoporosis, reforming surgical operation and add other therapies. 16 prospective, 20 retrospective and 5 meta-analyses consisted the systematic review. The date from included studies point to different results, with less risk of bias, were needed to clarify the factors and strategies for residual pain.Conclusions Bone cement distribution and operation error are highly related to the post-vertebroplasty residual pain. Many therapeutic methods could improve pain and rehabilitate function but lacking more high-level evidence due to the insufficient trails.

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Unilateral versus bilateral percutaneous vertebroplasty for osteoporotic vertebral compression fractures in elderly patients

Cited by 20 publications

References 21 publications

The effect of bone cement distribution on the outcome of percutaneous Vertebroplasty: a case cohort study

The effect of bone cement distribution on the outcome of percutaneous Vertebroplasty: a case cohort study

The Effect of Bone Cement Distribution on the Outcome of Percutaneous Vertebroplasty: A Case cohort study

Factors and Strategies for Post-Vertebroplasty Residual Pain from Thoracolumbar Osteoporotic Vertebral Compression Fractures (OVCF): a systematic review.

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