What are the predictors of clinical success after percutaneous vertebroplasty for osteoporotic vertebral fractures?

Denoix, Elsa; Viry, Flore; Ostertag, Agnès; Parlier‐Cuau, Caroline; Laredo, Jean‐Denis; Cohen‐Solal, Martine; Bousson, Valérie; Funck‐Brentano, Thomas

doi:10.1007/s00330-017-5274-1

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…Predictive factors of a favorable outcome included an early procedure (performed within 2 months after fracture) and the absence of intravertebral cleft on preintervention imaging. 32 The results of the various randomized trials are apparently contradictory. However, these trials differ in many methodological aspects.…”

Section: Efficacy Of Vertebral Augmentation Techniques On Pain In Ostmentioning

confidence: 99%

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Bousson

Hamzé

Odri

et al. 2018

Semin intervent Radiol

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Percutaneous vertebral augmentation/consolidation techniques are varied. These are vertebroplasty, kyphoplasty, and several methods with percutaneous introduction of an implant (associated or not with cement injection). They are proposed in painful osteoporotic vertebral fractures and traumatic fractures. The objectives are to consolidate the fracture and, if possible, to restore the height of the vertebral body to reduce vertebral and regional kyphosis. Stabilization of the fracture leads to a reduction in pain and thus restores the spinal support function as quickly as possible, which is particularly important in the elderly. The effectiveness of these interventions on fracture pain was challenged once by two randomized trials comparing vertebroplasty to a sham intervention. Since then, many other randomized studies in support of vertebroplasty efficacy have been published. International recommendations reserve vertebroplasty for medical treatment failures on pain, but earlier positioning may be debatable if the objective is to limit kyphotic deformity or even reexpand the vertebral body. Recent data suggest that in osteoporotic fracture, the degree of kyphosis reduction achieved by kyphoplasty and percutaneous implant techniques, compared with vertebroplasty, is not sufficient to justify the additional cost and the use of a somewhat longer and traumatic procedure. In young patients with acute traumatic fractures and a significant kyphotic angle, kyphoplasty and percutaneous implant techniques are preferred to vertebroplasty, as in these cases a deformity reduction has a significant positive impact on the clinical outcome.

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Section: Efficacy Of Vertebral Augmentation Techniques On Pain In Ostmentioning

confidence: 99%

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Bousson

Hamzé

Odri

et al. 2018

Semin intervent Radiol

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“…Despite controversies about the efficacy of routine percutaneous vertebroplasty (PVP) [6][7][8] in symptomatic OVCFs, PVP remains a commonly used tool in this indication, allegedly providing vertebral stability and thus potentially improving the clinical outcomes [9], especially when performed at the acute phase [10,11]. However PVP appears insufficient to correct the structural deformities (vertebral height loss and kyphotic angulations) and, in unstable OVCFs (grade A3 in Magerl's classification [12]), might cause bony fragments bulging into the spinal canal.…”

Section: Introductionmentioning

confidence: 99%

Vertebral augmentation with the SpineJack® in chronic vertebral compression fractures with major kyphosis

et al. 2018

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“…In fact, previous studies found twenty-one percent of vertebrae had new areas of marrow edema on follow-up. Twenty-two percent of vertebrae imaged 6 months after vertebroplasty had moderate or severe edema, progressive and persistent edema and interval height loss after successful vertebroplasty are common 39 . The models were designed to simulate physiological movements such as flexion, extension, lateral bending, and twisting with different loads, in order to explore the stresses of adjacent and distal non-treated vertebrae.…”

Section: Discussionmentioning

confidence: 99%

Intradiscal cement leakage (ICL) increases the stress on adjacent vertebrae after kyphoplasty for osteoporotic vertebra compression fracture (OVCF): a finite-element study

Meng,

Li,

Lin

et al. 2023

Sci Rep

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This study aimed to explore the biomechanical effects on adjacent vertebra of thoracolumbar Osteoporotic Vertebra Compression Fracture (OVCF) after Percutaneous Kyphoplasty (PKP) with intraoperative intradiscal cement leakage (ICL) by applying a Finite-Element Analysis. We collected pre- and post-operative computer tomography (CT) images of a 71-year-old female patient with single T12 OVCF, who underwent an intraoperative cement leakage into the T12–L1 disc. Three-dimensional finite element models of thoracolumbar spine (T10–L2) were built with the support of Materialise Interactive Medical Image Control System (MIMICS) and ABAQUS software. The stress on adjacent vertebrae and endplates under the uniform compressive pressure (0.3 MPa) and during different loading moments were analyzed. The three-dimensional finite element models reveal an asymmetrical distribution of von Mises stresses on the adjacent endplate unaffected by the surgical intervention. The maximum von Mises stress on adjacent vertebral bodies increased during different loading conditions, especially for lateral bending and rotation loading conditions, whereas the maximum von Mises stress on distal non-treated vertebrae decreased on anteflexion and backward extension loading conditions. Post-operative adjacent vertebra compression fractures after PKP with intraoperative intradiscal cement leakage (ICL) may be closely related to the biomechanical changes of adjacent vertebrae of thoracolumbar OVCF, and it may increase the risk of postoperative fracture.

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What are the predictors of clinical success after percutaneous vertebroplasty for osteoporotic vertebral fractures?

Abstract: • Performing vertebroplasty within 2 months following a fragility fracture increases success rate. • Presence of an intravertebral cleft at baseline is a predictor of poor mid-term outcome. • A pre-intervention MRI should be performed to ascertain the indication of vertebroplasty.

Cited by 9 publications

References 26 publications

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures

Vertebral augmentation with the SpineJack® in chronic vertebral compression fractures with major kyphosis

Intradiscal cement leakage (ICL) increases the stress on adjacent vertebrae after kyphoplasty for osteoporotic vertebra compression fracture (OVCF): a finite-element study

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