Vertebroplasty and vertebroplasty in combination with intermediate bilateral pedicle screw fixation for OF4 in osteoporotic vertebral compression fractures: a retrospective single-Centre cohort study

Abstract

BackgroundAlthough various studies have described the outcomes and complications of each treatment for OF 4 in osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen. This study aimed to investigate the clinical effect of OF 4 in patients with OVCFs treated with percutaneous vertebroplasty (PV) compared with PV in combination with intermediate bilateral pedicle screw fixation (IBPSF).MethodsA total of 110 patients with OF 4 in OVCFs from January 2011 to December 2013 were reviewed retrospectively and divided into two groups (group A: PV, group B: PV + IBPSF). According to the guidelines of the German Society for Orthopaedics and Trauma (DGOU), OF 4 consists of 3 fracture types. The clinical and radiographic assessments were observed preoperatively, postoperatively, and during follow-up.ResultsThe patients were followed for an average of 60.50 ± 15.20 months (group A) and 58.20 ± 17.60 months (group B) without significant differences. No significant differences were found in BMD, BMI and cement volume between the two groups, but differences were found for operation time, blood loss, and hospitalization time. The VAS and ODI scores improved better significantly at the final follow-up in group B but not in group A. Compared with the preoperative values, the postoperative kyphosis angle and loss of fractured segment height significantly improved, but the difference between the groups was significant after 3 months postoperatively. The loss of angular correction and fractured segment height in group A were greater than those in group B. A total of 15 cases of cement leakage were observed in group A and 8 cases in group B, and no complications or revision surgeries were observed in either group. Thirteen new fractures occurred (11 in group A and 2 in group B), which was significant.ConclusionPV with IBPSF could provide effective restoration and maintenance of fractured segment height and segment alignment as well as a lower rate of complications of OF 4 in OVCFs.

The clinical efficacy of three application methods of local anesthesia in percutaneous vertebroplasty: A retrospective single-center cohort study

“…The PV is usually performed under local anesthesia, which facilitates the communication and cooperation between the surgeons and patients during the surgery so that the surgeons can obtain timely and accurate feedback from the patients and ensure the surgery safety of the operation [11][12][13][14]. At present, there is still a consensus on how to reduce or even eliminate the pain during PV [11][12][13][14][15][16][17]. Currently, in the PV, the lidocaine as a routine local anesthetic works fast but doesn't last too long.…”

Effect of bisphosphonates or teriparatide on mechanical complications after posterior instrumented fusion for osteoporotic vertebral fracture: a multi-center retrospective study

“…Surgery is also an effective option for the treatment of kyphosis after fracture [5]. The recent advent of the percutaneous pedicle screw has made it possible to perform minimally invasive surgery in these patients [6]. However, because of the bone fragility in the background, surgically treated patients may experience screw loosening or pseudoarthrosis and revision surgery may be required [7].…”

Effect of Bisphosphonates or Teriparatide on Mechanical Complications after Posterior Instrumented Fusion for Osteoporotic Vertebral Fracture: A Multi-center Retrospective Study

“…Surgery is also an effective option for preventing progressive kyphosis after fracture. The recent advent of the percutaneous pedicle screw has made it possible to perform minimally invasive surgery in these patients [4]. However, because of the bone fragility in the background, surgically treated patients may experience screw loosening or pseudoarthrosis and revision surgery may be required [5].…”