scholarly journals Postoperative Clinical Outcomes of Balloon Kyphoplasty Treatment: Would Adherence to Indications and Contraindications Prevent Complications?

2020 ◽  
Vol 14 (2) ◽  
pp. 198-203
Author(s):  
Rei Momomura ◽  
Yoshio Shimamura ◽  
Kazuo Kaneko
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Vertebral Body ◽  
Vertebral Fractures ◽  
Disease Duration ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Persistent Pain ◽  
Pedicle Fracture ◽  
Wall Injury

Study Design: We retrospectively assessed the postoperative clinical outcomes of balloon kyphoplasty (BKP).Purpose: To evaluate the risk factors for complications and to reconfirm the indications and contraindications for BKP.Overview of Literature: In Japan, BKP is indicated for cases of osteoporotic vertebral fractures when pain is not improved even after an adequate period of conservative treatment. Contraindications to BKP include pedicle fracture, fracture of a flat vertebra, or fracture of the posterior wall of the vertebral body diagnosed on computed tomography.Methods: Seventy-five patients who underwent BKP in our institution participated in this study; 49 provided follow-up data. Those with complications and persistent pain were assigned to the “eventful” group; the others, to the “uneventful” group. We evaluated risk factors for complications and persistent pain, including the presence or absence of severe posterior wall injury/pedicle fracture, the shape of the vertebral body, and the time period from onset of pain to BKP.Results: The incidences of severe posterior wall injury, pedicle fracture, and flattened vertebral body did not differ significantly between the uneventful and eventful groups. However, there was a significant difference in disease duration between those with and those without adjacent vertebral fractures (AVFs): The incidence of AVF was lower among patients with disease of less than 8 weeks’ duration.Conclusions: Disease duration is a possible risk factor for developing AVF, whereas other characteristics were not risk factors for complications after BKP. Although it has been suggested that BKP treatment in the early phase after injury results in a good outcome, the indications should be determined according to prognosis that is based on findings obtained with tools such as imaging examinations.

scholarly journals Endplate Deficits And Posterior Wall Injury Are Predictive Of Prolonged Back Pain After Osteoporotic Vertebral Body Fracture

2021 ◽  
Author(s):  
Masatoshi Teraguchi ◽  
Mamoru Kawakami ◽  
Yoshio Enyo ◽  
Ryohei Kagotani ◽  
Yoshimasa Mera ◽  
...  
Keyword(s):  
Back Pain ◽  
Vertebral Body ◽  
Posterior Wall ◽  
Vertebral Body Fracture ◽  
Body Fracture ◽  
Wall Injury

scholarly journals Mechanical Cavity Creation with Curettage and Vacuum Suction (Q-VAC) in Lytic Vertebral Body Lesions with Posterior Wall Dehiscence and Epidural Mass before Cement Augmentation

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 633
Author(s):  
Piechowiak ◽  
Isalberti ◽  
Pileggi ◽  
Distefano ◽  
Hirsch ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Vertebral Body ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Cement Leakage ◽  
Cement Augmentation ◽  
Tissue Mass ◽  
Vacuum Suction ◽  
Tumor Debulking ◽  
Vertebral Body Stenting

Background and Objectives: We describe a novel technique for percutaneous tumor debulking and cavity creation in patients with extensive lytic lesions of the vertebral body including posterior wall dehiscence prior to vertebral augmentation (VA) procedures. The mechanical cavity is created with a combination of curettage and vacuum suction (Q-VAC). Balloon kyphoplasty and vertebral body stenting are used to treat neoplastic vertebral lesions and might reduce the rate of cement leakage, especially in presence of posterior wall dehiscence. However, these techniques could theoretically lead to increased intravertebral pressure during balloon inflation with possible mobilization of soft tissue tumor through the posterior wall, aggravation of spinal stenosis, and resultant complications. Creation of a void or cavity prior to balloon expansion and/or cement injection would potentially reduce these risks. Materials and Methods: A curette is coaxially inserted in the vertebral body via transpedicular access trocars. The intravertebral neoplastic soft tissue is fragmented by multiple rotational and translational movements. Subsequently, vacuum aspiration is applied via one of two 10 G cannulas that had been introduced directly into the fragmented lesion, while saline is passively flushed via the contralateral cannula, with lavage of the fragmented solid and fluid-necrotic tumor parts. Results: We applied the Q-VAC technique to 35 cases of thoracic and lumbar extreme osteolysis with epidural mass before vertebral body stenting (VBS) cement augmentation. We observed extravertebral cement leakage on postoperative CT in 34% of cases, but with no clinical consequences. No patients experienced periprocedural respiratory problems or new or worsening neurological deficit. Conclusion: The Q-VAC technique, combining mechanical curettage and vacuum suction, is a safe, inexpensive, and reliable method for percutaneous intravertebral tumor debulking and cavitation prior to VA. We propose the Q-VAC technique for cases with extensive neoplastic osteolysis, especially if cortical boundaries of the posterior wall are dehiscent and an epidural soft tissue mass is present.

Kyphoplasty for osteoporotic vertebral fractures with posterior wall injury

2018 ◽  
Vol 18 (7) ◽  
pp. 1143-1148 ◽  
Author(s):  
Ahmed Shawky Abdelgawaad ◽  
Ali Ezzati ◽  
Ramachandran Govindasamy ◽  
Branko Krajnovic ◽  
Belal Elnady ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Posterior Wall ◽  
Osteoporotic Vertebral Fractures ◽  
Wall Injury

scholarly journals Evaluation of risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis

2020 ◽  
Author(s):  
Yu Mori ◽  
Takuya Izumiyama ◽  
Kazuyoshi Baba ◽  
Naoko Mori ◽  
Hiroshi Fujii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Treatment Duration ◽  
Disease Duration ◽  
Clinical Parameters ◽  
Glucocorticoid Treatment ◽  
Japanese Female ◽  
Hip Bmd ◽  
Rheumatological Diseases

Abstract Background Glucocorticoid-induced osteoporosis and vertebral fracture are common complications in patients on glucocorticoid treatment for rheumatological diseases. The present study aimed to identify the risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis.Methods This study included 225 Japanese women with glucocorticoid-induced osteoporosis and 72 patients with postmenopausal osteoporosis. All participants were treated with bisphosphonate or denosumab for osteoporosis with active form of vitamin D for at least 3 years. The differences of clinical parameters, including age, disease duration, body mass index (BMI), bone mineral density (BMD), and the dose and treatment duration of glucocorticoid were assessed between patients with and without vertebral fracture. Multivariate logistic regression analysis was also performed to evaluate the association of vertebral fracture with clinical parameters.Results The significant differences related to age, BMD of the hip, disease duration, glucocorticoid treatment duration between patients with and without vertebral fractures were demonstrated. The present study indicated that disease duration, BMI, and the total hip BMD were independent risk factors for vertebral fractures in patients with glucocorticoid-induced osteoporosis.Conclusions Prolonged disease duration, low BMI, and low total hip BMD could be risk factors of vertebral fracture in patients on glucocorticoid treatment for rheumatological diseases.

scholarly journals Characteristic radiological findings for revision surgery after balloon kyphoplasty

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shinji Takahashi ◽  
Masatoshi Hoshino ◽  
Hiroyuki Yasuda ◽  
Yusuke Hori ◽  
Shoichiro Ohyama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Revision Surgery ◽  
Treatment Strategies ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Angular Motion ◽  
Radiological Findings ◽  
Osteoporotic Vertebral Fractures ◽  
Flexion Extension ◽  
Type Fracture

AbstractBalloon kyphoplasty (BKP) sometimes fails to improve patients’ outcomes, with revision surgery, using anterior or posterior reconstruction, being required. The purpose of this study was to investigate the radiological risk factors of failure after BKP in the treatment of osteoporotic vertebral fractures (OVFs). This case-control study included 105 patients treated with single BKP and 14 patients  who required revision BKP. We evaluated radiological findings differentiating both groups, using plain radiography and computed tomography, before BKP. Angular flexion-extension motion was significantly greater in the revision than BKP group. While the frequency of pedicle fracture and posterior wall injury was not different between the groups, a split type fracture was more frequent in the revision group. Split type fracture had the highest adjusted odds ratio (OR) for revision (16.5, p = 0.018). Angular motion ≥14° increased the risk for revision surgery by 6-fold (p = 0.013), with endplate deficit having an OR of revision of 5.0 (p = 0.032). The revision rate after BKP was 3.8%, with split type fracture, greater angular motion and large endplate deficit being risk factors for revision. Treatment strategies for patients with these risk factors should be carefully evaluated, considering the inherent difficulties in performing revision surgery after BKP.

scholarly journals Safety and Efficacy of Balloon Kyphoplasty for Vertebral Fractures With Posterior Wall Disruption

10.14444/8046 ◽  
2021 ◽  
pp. 8046
Author(s):  
Jennifer L. Perez ◽  
Alp Ozpinar ◽  
Nitin Agarwal ◽  
Emily Hacker ◽  
Nima Alan ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Safety And Efficacy

Incidence and risk factors for early adjacent vertebral fractures after balloon kyphoplasty for osteoporotic fractures: analysis of the SWISSspine registry

2013 ◽  
Vol 23 (6) ◽  
pp. 1332-1338 ◽  
Author(s):  
Christian Spross ◽  
Emin Aghayev ◽  
Rouven Kocher ◽  
Christoph Röder ◽  
Thomas Forster ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Fractures ◽  
Osteoporotic Fractures ◽  
Balloon Kyphoplasty

Percutaneous balloon kyphoplasty in the treatment of pathological vertebral body fracture and deformity in multiple myeloma: a one-year follow-up

2006 ◽  
Vol 47 (4) ◽  
pp. 369-376 ◽  
Author(s):  
R. Pflugmacher ◽  
F. Kandziora ◽  
R. -J. Schroeder ◽  
I. Melcher ◽  
N. P. Haas ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Vertebral Body ◽  
Vertebral Fractures ◽  
Body Height ◽  
Balloon Kyphoplasty ◽  
Disability Score ◽  
Pain Status ◽  
Body Fracture ◽  
Percutaneous Balloon

Purpose: To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by multiple myeloma. Material and Methods: Vertebral fractures due to multiple myeloma were treated by balloon kyphoplasty (20 patients, 48 vertebral bodies). Symptomatic levels were identified by clinical presentation, magnetic resonance imaging (MRI), radiographs, and computed tomography (CT). During the following year, visual analog scale (VAS) and Oswestry disability score were documented. Radiographs were taken pre- and postoperatively at 3, 6, and 12 months. Vertebral height and kyphotic deformity were measured to assess restoration of the sagittal alignment. Results: The median pain scores (VAS) decreased significantly from pre- to post-treatment, as did the Oswestry disability score ( p<0.05). Clinically asymptomatic cement leakage occurred at 5 fracture levels (10.4%). During 1-year follow-up, this surgical technique demonstrated restoration and stabilization of the height of the vertebral body. Conclusion: Balloon kyphoplasty is an effective minimally invasive procedure for stabilizing pathological vertebral fractures caused by multiple myeloma and leading to a statistically significant reduction of pain status. Balloon kyphoplasty stabilizes the vertebral body height, but is only partially able to prevent further kyphotic deformities.

scholarly journals Evaluation of risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis

2020 ◽  
Author(s):  
Yu Mori ◽  
Takuya Izumiyama ◽  
Kazuyoshi Baba ◽  
Naoko Mori ◽  
Hiroshi Fujii ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Fracture ◽  
Vertebral Fractures ◽  
Treatment Duration ◽  
Disease Duration ◽  
Clinical Parameters ◽  
Glucocorticoid Treatment ◽  
Japanese Female ◽  
Hip Bmd ◽  
Rheumatological Diseases

Abstract Background Glucocorticoid-induced osteoporosis and vertebral fracture are common complications in patients on glucocorticoid treatment for rheumatological diseases. The present study aimed to identify the risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis.Methods This study included 225 Japanese women with glucocorticoid-induced osteoporosis and 72 patients with postmenopausal osteoporosis. All participants were treated with bisphosphonate or denosumab for osteoporosis with active form of vitamin D for at least 3 years. The differences of clinical parameters, including age, disease duration, body mass index (BMI), bone mineral density (BMD), and the dose and treatment duration of glucocorticoid were assessed between patients with and without vertebral fracture. Multivariate logistic regression analysis was also performed to evaluate the association of vertebral fracture with clinical parameters.Results The significant differences related to age, BMD of the hip, disease duration, glucocorticoid treatment duration between patients with and without vertebral fractures were demonstrated. The present study indicated that disease duration, BMI, and the total hip BMD were independent risk factors for vertebral fractures in patients with glucocorticoid-induced osteoporosis.Conclusions Prolonged disease duration, low BMI, and low total hip BMD could be risk factors of vertebral fracture in patients on glucocorticoid treatment for rheumatological diseases.

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