scholarly journals Less PMMA Injection as an Independent Factor for Poor Neurologic Recovery in Malignant Vertebral Compression Fractures With Symptoms of Neurologic Compression Following Percutaneous Vertebroplasty

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 198s-198s
Author(s):  
E.-S. Li ◽  
J.-X. Mu
Keyword(s):  
Multivariate Analysis ◽  
Effective Treatment ◽  
Percutaneous Vertebroplasty ◽  
Independent Predictor ◽  
Spinal Injury ◽  
Univariate Analysis ◽  
Vertebral Compression Fractures ◽  
Intractable Pain ◽  
Compression Fractures ◽  
Group A

Background: Recent years, percutaneous vertebroplasty (PVP) has gained wide clinical acceptance as an effective treatment option for patients with intractable pain related to compression fractures of the spine. But little is known about PVP for spinal malignant lesions with epidural involvement in patients with neurologic deficit. Aim: To evaluate the efficacy of PVP for malignant vertebral compression fractures with symptoms of neurologic compression following percutaneous vertebroplasty (PVP), and evaluate the predictive factors for poor outcomes following PVP. Methods: Forty-three patients with malignant vertebral compression fractures with symptoms of neurologic compression were treated with PVP. Patients were classified into 2 groups according to the American Spinal Injury Association (ASIA) impairment scale at the last follow-up. Data were collected and the patients followed-up at 1, 3, 6 and 12 months and yearly after the procedure. Univariate and multivariate analysis was performed to evaluate factors predictive of poor neurologic compression symptoms recovery. Results: PVP were successful in all patients. Full recovery from (n = 2) or improvement of (n = 16) neurologic compression symptoms were achieved in 18 patients (Group A), and no improvement of neurologic compression symptoms in 25 patients (Group A). Univariate analysis showed more PMMA leakage ( P = 0.038) and less PMMA volume injection ( P < 0.001) was associated with the poor symptoms of neurologic compression recovery, and multivariate analysis showed that less PMMA volume injection ( P = 0.004) was an independent predictor for poor symptom of neurologic compression recovery. Conclusion: Our results indicated PVP should not be served as an effective treatment of malignant compression fractures with symptoms of neurologic compression, and less PMMA volume injection was an independent predictor of poor symptom of neurologic compression recovery.

Comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures

2020 ◽  
Author(s):  
Juan Long ◽  
Chun Jing He ◽  
Zikun Duan ◽  
Xinguo Kang ◽  
Jinfeng Zou
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Needle Position ◽  
Relieve Pain ◽  
Group A ◽  
Group B

Abstract BACKGROUND The purpose of this study was to comparison of unilateral and bilateral percutaneous vertebroplasty in the treatment of severe vertebral compression fractures. METHODS Sixty-four severe vertebral compression fractures patients were treated in our hospital were randomly divided into group A and group B(n = 32). Group A received Percutaneous vertebroplasty (PVP) treatment by unilateral vertebral pedicle approach. Group B received PVP treatment by bilateral vertebralpedicle approach. Visual Analogue scale (VAS) score and Oswesty Disability Index (ODI) were recorded before surgery, and at 1d,1 month, and 6 months after operation. Also, the puncture path, needle position, intraoperative bone cement injection volume, bone cement dispersion, intra-operative and postoperative complications were observed. RESULTS Sixty-four vertebrae were successfully punctured.The postoperative VAS,ODI were lower than preoperative, showed statistical difference compared with the preoperative VAS, ODI, but there are no difference between Group A and Group B.The cement leakage and operation time is lower in group A than that in Group B. CONCLUSION PVP by unilateral vertebral pedicle approach in treating severe vertebral compression fractures can significantly relieve pain and promote functional recovery, which has advantages such as convenient operation and low complication rate.

scholarly journals Precise Puncture Combined With Simplified Percutaneous Vertebroplasty to Treat Osteoporotic Vertebral Compression Fractures: A Comparative Analysis With Conventional Percutaneous Vertebroplasty

2020 ◽  
Author(s):  
Ju-tao Pang ◽  
Hong Chen ◽  
Bin Liu ◽  
Xin-hu Zhang
Keyword(s):  
Bone Cement ◽  
Operative Time ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Intraoperative Fluoroscopy ◽  
Group A ◽  
Group B

Abstract ObjectiveThis study aimed to investigate the feasibility and clinical efficacy of precise puncture combined with simplified percutaneous vertebroplasty (PVP) for treating osteoporotic vertebral compression fractures (OVCF).MethodsA total of 82 patients with single-segment osteoporotic vertebral compression fractures (OVCF) were treated with PVP from Dec. 2016 to Nov. 2018. Among the patients, 45 cases in group A and accepted precise puncture combined with simplified PVP, 37 cases in group B and underwent conventional PVP. The operative time, number of intraoperative fluoroscopy, vertebral height restoration, postoperative bone cement distribution and bone cement leakage were observed and compared. The pain relief and improvement of quality of life (QOL) were assessed by visual analog score (VAS) and Oswestry disability index (ODI).ResultsThere were no difference in injected cement volume and hospital stays in group A versus group B (P > 0.05). The operative time, number of intraoperative fluoroscopy and material cost were lower in group A compared with group B (P < 0.05). After surgery, both of the VAS scores and ODI had a significant decrease (P < 0.05). The average vertebral height and Cobb angle were significantly improved (P < 0.05), there was no statistically significant difference between groups at different time points (P > 0.05). The proportion of patients with bone cement dispersion exceeding the midline of vertebra in group A was significantly higher than that in group B (82.2% vs 62.1%) (P < 0.05), whereas the bone cement leakage rate was lower than group B (8.9% vs 27.0%) (P < 0.05). Patients were followed-up for 12-23 months (mean 17.6 months) after surgery, and 3 cases (6.6%) of adjacent vertebral fractures occurred in group A and 2 cases (5.4%) occurred in group B (P > 0.05).ConclusionPrecise puncture can improve the accuracy of puncture needle through pedicle to vertebral body. It conducive to obtain a better diffusion of bone cement across the midline with lower bone cement leakage rate. Simplified PVP can reduce the surgery procedures, shorten the operatige time, reduces the X-ray frequency, but also saves material cost.

scholarly journals Influence of bone cement distribution on outcomes following percutaneous vertebroplasty: a retrospective matched-cohort study

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110222
Author(s):  
Ling Mo ◽  
Zixian Wu ◽  
De Liang ◽  
Linqiang Y ◽  
Zhuoyan Cai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Cement Distribution ◽  
Group A ◽  
Group B

Objective To evaluate the influence of insufficient bone cement distribution on outcomes following percutaneous vertebroplasty (PVP). Methods This retrospective matched-cohort study included patients 50–90 years of age who had undergone PVP for single level vertebral compression fractures (VCFs) from February 2015 to December 2018. Insufficient (Group A)/sufficient (Group B) distribution of bone cement in the fracture area was assessed from pre- and post-operative computed tomography (CT) images. Assessments were before, 3-days post-procedure, and at the last follow-up visit (≥12 months). Result Of the 270 eligible patients, there were 54 matched pairs. On post-operative day 3 and at the last follow-up visit, significantly greater visual analogue scale (VAS) pain scores and Oswestry Disability Index (ODI) scores were obtained in Group B over Group A, while kyphotic angles (KAs) and vertebral height (VH) loss were significantly larger in Group A compared with Group B. Incidence of asymptomatic cement leakage and re-collapse of cemented vertebrae were also greater in Group A compared with Group B. Conclusions Insufficient cement distribution may relate to less pain relief and result in progressive vertebral collapse and kyphotic deformity post-PVP.

scholarly journals Risk factors for thoracolumbar pain following percutaneous vertebroplasty for osteoporotic vertebral compression fractures

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052198946
Author(s):  
Xiaoguang Fan ◽  
Sha Li ◽  
Xianshang Zeng ◽  
Weiguang Yu ◽  
Xiangzhen Liu
Keyword(s):  
Risk Factors ◽  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Vertebral Compression Fractures ◽  
Mineral Density ◽  
Eligibility Criteria ◽  
Compression Fractures ◽  
Logistic Analysis ◽  
The Difference ◽  
Poor Outcomes

Objective To explore possible risk factors for poor outcomes following percutaneous vertebroplasty (PV) for painful osteoporotic compression fractures of thoracolumbar vertebra. Methods This was a retrospective review of data from patients who underwent PV at our institution over a ten-year period to evaluate the association between possible risk factors and thoracolumbar pain (T11-L2). According to the difference between pre- and post-operative visual analogue scale (VAS) scores for pain, patients were separated into poor relief (PR; <4) and good relief (GR; ≥4) of pain. Results Of the 750 patients identified, 630 (PR group, n =310; GR group, n = 320) fulfilled the eligibility criteria. Multivariate binary logistic analysis showed that bone mineral density (BMD), >2 fractured vertebral bodies, maldistribution of bone cement, <5 ml bone cement injected into a single vertebral body and thoracolumbar fascia injury prior to surgery were independent risk factors associated with thoracolumbar pain following PV. Conclusion Although prospective controlled studies are required to confirm our results, this review suggests that the above factors should be taken into account when selecting patients for PV.

Clinical Application of a 3D-Printed Positioning Module and Navigation Template for Percutaneous Vertebroplasty

2021 ◽  
pp. 155335062110624
Author(s):  
Jing Yang ◽  
Penghui Ni ◽  
Lina Zhang ◽  
Zhanxin Lu ◽  
Dapeng Liu ◽  
...  
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Operation Time ◽  
Vertebral Compression Fractures ◽  
Control Group ◽  
Compression Fractures ◽  
Intraoperative Fluoroscopy ◽  
3D Printed ◽  
Vas Scores ◽  
Experimental Group ◽  
Navigation Template

Background This study aimed to evaluate a personalized 3D-printed percutaneous vertebroplasty positioning module and navigation template based on preoperative CT scan data that was designed to treat patients with vertebral compression fractures caused by osteoporosis. Methods A total of 22 patients with vertebral compression fractures admitted to our hospital were included in the study. Positioning was performed with the new 3D-printed positioning module, and the navigation template was used for patients in the experimental group, and the traditional perspective method was used for patients in the control group. The experimental group consisted of 11 patients, 2 males and 9 females, with a mean age of 67.27 ± 11.86 years (range: 48 to 80 years), and the control group consisted of 11 patients, 3 males and 8 females, with a mean age of 74.27 ± 7.24 years (range: 63 to 89 years). The puncture positioning duration, number of intraoperative fluoroscopy sessions, and preoperative and postoperative visual analog scale (VAS) scores were statistically analyzed in both groups. Results The experimental group had shorter puncture positioning durations and fewer intraoperative fluoroscopy sessions than the control group, and the differences were statistically significant (P < .05). There were no significant differences in age or preoperative or postoperative VAS scores between the two groups (P > .05). Conclusions The new 3D-printed vertebroplasty positioning module and navigation template shortened the operation time and reduced the number of intraoperative fluoroscopy sessions. It also reduced the difficulty in performing percutaneous vertebroplasty and influenced the learning curve of senior doctors learning this operation to a certain degree.

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