scholarly journals Risk Factors for Refracture following Primary Osteoporotic Vertebral Compression Fractures

2021 ◽  
pp. E335-E340
Author(s):  
Weihua Cai
Keyword(s):  
Risk Factors ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Hounsfield Units ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Fracture History ◽  
Primary Fracture

Background: In the aging population, osteoporosis and related complications have become a global public health problem. Osteoporotic vertebral compression fractures are among the most common type of osteoporotic fractures and patients are at risk of secondary vertebral compression fracture. Objectives: To identify risk factors for secondary vertebral compression fracture following primary osteoporotic vertebral compression fractures. Study Design: Retrospective study. Setting: Department of Orthopedic, an affiliated hospital of a medical university. Methods: This retrospective cohort study evaluated the risk factors for secondary vertebral compression fracture in 317 consecutive patients with systematic osteoporotic vertebral compression fractures who received percutaneous vertebroplasty and kyphoplasty or conservative treatment. Patients were divided into secondary vertebral compression fracture (n = 43) and non- secondary vertebral compression fracture (n = 274) groups. We retrospectively analyzed clinical characteristics and radiographic parameters, including gender, age, body mass index, number of primary fractures, primary treatment (percutaneous vertebroplasty and kyphoplasty or conservative treatment), nonspinal fracture history before primary fracture, primary fracture at the thoracolumbar junction, steroid use, bisphosphonate therapy, and Hounsfield units value of L1. Results: Comparison between the groups showed significant differences in age (P = 0.001), nonspinal fracture history (P < 0.001), and Hounsfield units value of L1 (P < 0.001). The receiver operating characteristic curves demonstrated that the optimal thresholds for age and Hounsfield units value of L1 were 75 (sensitivity: 55.8%; specificity: 67.5%) and 50 (sensitivity: 88.3%; specificity: 67.4%), respectively. In multivariate logistic regression analysis, nonspinal fracture history (OR = 6.639, 95% CI = 1.809 – 24.371, P = 0.004) and Hounsfield units value of L1 < 50 (OR = 15.260, 95% CI = 6.957 – 33.473, P < 0.001) were independent risk factors for secondary vertebral compression fracture. Limitations: The main limitation is the retrospective nature of this study. Conclusion: Patients with low Hounsfield units value of L1 or non-spinal fracture history are an important population to target for secondary fracture prevention. Key words: Risk factor, vertebral, secondary fracture, osteoporosis

scholarly journals Risk factors for secondary fractures to percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wei Mao ◽  
Fei Dong ◽  
Guowei Huang ◽  
Peiliang He ◽  
Huan Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Mineral Density ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Secondary Fractures ◽  
At Home

Abstract Background Osteoporotic vertebral compression fracture (OVCF) is one of the most common fragile fractures, and percutaneous vertebroplasty provides considerable long-term benefits. At the same time, there are many reports of postoperative complications, among which fracture after percutaneous vertebroplasty is one of the complications after vertebroplasty (PVP). Although there are many reports on the risk factors of secondary fracture after PVP at home and abroad, there is no systematic analysis on the related factors of secondary fracture after PVP. Methods The databases, such as CNKI, Wan Fang Database and PubMed, were searched for documents on secondary fractures after percutaneous vertebroplasty published at home and abroad from January 2011 to March 2021. After strictly evaluating the quality of the included studies and extracting data, a meta-analysis was conducted by using Revman 5.3 software. Results A total of 9 articles were included, involving a total of 1882 patients, 340 of them diagnosed as secondary fractures after percutaneous vertebroplasty. Conclusion The additional history of fracture, age, bone mineral density (BMD), bone cement leakage, intravertebral fracture clefts and Cobb Angle might be risk factors related to secondary fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures. The height of vertebral anterior and body mass index (BMI) were not correlated.

scholarly journals Risk Factors for the Occurrence of Insufficient Cement Distribution in the Fractured Area after Percutaneous Vertebroplasty in Osteoporotic Vertebral Compression Fractures

2018 ◽  
Vol 1 (21;1) ◽  
pp. E33-E42
Author(s):  
Xiaobing Jiang
Keyword(s):  
Risk Factors ◽  
Pain Relief ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Bone Mass Density ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Cement Distribution ◽  
Superior Portion

Background: Insufficient cement distribution (ICD) in the fractured area has been advocated to be responsible for unsatisfied pain relief after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs). However, little is known about risk factors for the occurrence of ICD. Objective: The present study aimed to identify independent risk factors of the emergence of ICD. Study Design: A retrospective cohort study. Setting: Department of spinal surgery, an affiliated hospital of a medical university. Methods: Patients who underwent PVP for single-level OVCF from January 2012 to September 2014 and met this study’s inclusion criteria were retrospectively reviewed. Associations of ICD with co-variates (age, gender, bone mass density with a T-score, amount of injected cement, cement leakage, fracture level, fracture age, fracture severity grade, and location of the fractured area) and the influence of ICD on pain relief were analyzed. Results: A total of 225 patients were included. ICD was found in 26 (11.6%) patients. Fractured area located in the superior portion of the index vertebra was significantly associated with occurrence of ICD. No further significant associations between the studied co-variates and emergence of ICD were seen in the adjusted analysis. In addition, patients with ICD had significantly higher immediate postoperative visual analog scale scores of back pain compared with those with sufficient cement distribution in the fractured area. Limitation: Location of the fractured area and cement distribution in the fractured area could not be evaluated quantitatively. Conclusions: The incidence of ICD is higher in patients with the fractured area located in the superior portion of the index vertebra and ICD might be responsible for unsatisfied pain relief after PVP for OVCFs. Key words: Percutaneous vertebroplasty, insufficient cement distribution, fractured area, risk factor, osteoporosis, vertebral compression fracture, spine, unsatisfied pain relief, cement augmentation

scholarly journals Risk factors of the Secondary Fractures for Osteoporotic Vertebral Compression Fractures after Percutaneous Vertebroplasty

2020 ◽  
Author(s):  
Xiao-kui Kang ◽  
Sheng-fu Guo ◽  
Hui-xin Liu ◽  
Li-li Huang ◽  
Qun-long Jiang
Keyword(s):  
Risk Factors ◽  
Percutaneous Vertebroplasty ◽  
Meta Analysis ◽  
Thoracolumbar Spine ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Secondary Fracture ◽  
Compression Fractures ◽  
Secondary Fractures

Abstract Background Percutaneous vertebroplasty related postoperative secondary fractures risk factors were not consistent in patients with osteoporotic vertebral compression Fractures. The purpose was to identify the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty.Methods Potential academic articles were identified from Cochrane Library, Medline, PubMed, Embase, ScienceDirect and other databases. The time range we retrieved from was that from the inception of electronic databases to August 2019. Gray studies were identified from the references of included literature reports. STATA version 11.0 (Stata Corporation, College Station, Texas, USA) was used to analyze the pooled data.Results Fourteen studies involving 1910 patients, 395 of whom had secondary fracture following the surgery were included in this meta-analysis. The results of meta-analysis showed the risk factors of the secondary fractures for osteoporotic vertebral compression fractures after percutaneous vertebroplasty was related to bone mineral density [WMD= -0.518, 95%CI(-0.784,-0.252), P=0.000], cement leakage [RR=0.596, 95%CI (0.444,0.798), P=0.001] and kyphosis after primary operation [WMD=4.510, 95%CI (3.061,6.004),P=0.000], but not to gender, age, body mass index (BMI), cement volume, thoracolumbar spine, and cement injection approaches.Conclusions BMD, cement leakage and kyphosis after primary operation are the risk factors closely correlative to the secondary fracture after percutaneous vertebroplasty. There has not been enough evidence to support the association between the secondary fracture and gender, age, body mass index, cement volume, thoracolumbar spine, and cement injection approach.

scholarly journals Kyphoplasty for the treatment of an atypical osteoporotic vertebral compression fracture of the lumbar spine: A case report

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774498
Author(s):  
Sanjeev Kumar ◽  
Leon Anijar ◽  
Rishi Agarwal
Keyword(s):  
Older Patients ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Clinical Scenario ◽  
Vertebral Augmentation ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Lumbar Vertebral Body

Vertebral augmentation is a minimally invasive but sometimes technically challenging intervention typically reserved for the treatment of older patients with painful vertebral compression fractures due to osteoporosis or neoplasms. We report the successful treatment of osteoporotic vertebral compression fractures of the first lumbar vertebral body (L1) using kyphoplasty in a paraplegic young patient with multiple comorbidities. Despite the unusual and complicated clinical scenario, kyphoplasty was nonetheless performed with immediate and lasting pain relief.

Treatment of Osteoporotic Vertebral Compression Fracture with Target-Anchored Vertebral Body Plasty

2019 ◽  
Vol 9 (8) ◽  
pp. 1081-1085
Author(s):  
Liu Yang ◽  
Xiangbei Qi ◽  
Tao Lei ◽  
Jingtao Zhang ◽  
Junming Cao
Keyword(s):  
Bone Cement ◽  
Vertebral Body ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Target Group ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Traditional Group ◽  
Compression Fractures ◽  
Fracture Area

Objective: To analyze the clinical effect of target-anchored vertebroplasty and traditional percutaneous vertebroplasty on the treatment of osteoporotic vertebral compression fractures. Methods: 50 female New Zealand rabbits were selected for establishing the osteoporotic vertebral compression fracture model and divided into two groups, traditional group and target group followed by analysis of the anterior, posterior, and posterior vertebral body anterior height of the fracture and the injection volume of the bone cement at full filling, and to compare the ultimate compressive strength and stiffness differences between the two groups of specimens by biomechanical testing. Results: In traditional group, the operative time was significantly shorter than that of target group, and the intraoperative bleeding was significantly lower than that of target group (P < 0.05). The fracture area of target group was filled with sufficient bone cement, in the traditional group, 3 cases (12%) showed that bone cement was not filled in the fracture area (P < 0.05), but the total bone cement filling volume was not significantly different between the two groups, but the traditional group had more complete bone cement filling than the bone cement filling, the difference was statistically significant (P < 0.05). In addition, the anterior vertebral body height of each group was significantly higher than other observation points in the group (P < 0.05). However, the distribution of permeability and osmotic type of bone cement between the two groups was not significantly different (P > 0.05). Conclusion: Target-anchored vertebroplasty can improve the quality of clinical treatment of osteoporotic vertebral compression fractures, indicating that it might be a new surgical method.

Closed reduction vertebroplasty for the treatment of osteoporotic vertebral compression fractures

2004 ◽  
Vol 100 (4) ◽  
pp. 392-396 ◽  
Author(s):  
Shih-Tseng Lee ◽  
Jyi-Feng Chen
Keyword(s):  
Closed Reduction ◽  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Kyphotic Angle ◽  
Content Type ◽  
Compression Fractures ◽  
Fine Print

✓ The purpose of this study was to determine the efficacy and feasibility of closed reduction vertebroplasty for the treatment of osteoporotic vertebral compression fractures. Two hundred consecutive patients (183 women and 17 men) with single-level osteoporotic vertebral compression fracture were included in this study. After induction of general anesthesia, the patient was placed prone on an operating table. Closed reduction of the fractured and kyphotic spine was achieved by extending the table to restore the kyphotic angle and vertebral body (VB) height. Percutaneous vertebroplasty was then performed to treat the fractured vertebra. The results were quantitatively evaluated, according to the concept of estimated VB height. The anterior, middle, and posterior VB heights of the fractured vertebra were measured preoperatively and immediately after surgery by studying plain standing lateral radiographs. In 162 (81%) of the compression fractures the anterior VB height was restored (57.1 ± 24.8% of lost anterior VB height); in 152 (76%) of the compression fractures the middle VB height was restored (61.4 ± 20.6% of lost middle VB height); and in 52 (26%) of the compression fractures the posterior VB height was restored (51.3 ± 23.1% of lost posterior VB height). In 141 (71.5%) of the compression fractures kyphosis was corrected by 12.5 ± 3.8° [mean 61.6 ± 23.7%]). Closed reduction vertebroplasty is an efficacious and simple method in the treatment of osteoporotic vertebral compression fracture and was able to restore the VB height and kyphotic angle in postions of fractured vertebrae. Its associated, long-term effects on treated vertebrae, however, need further evaluation.

BIOMECHANICAL EVALUATION OF LOW-MODULUS BONE CEMENT FOR ENHANCING APPLICABILITY IN VERTEBROPLASTY — AN EXPERIMENTAL STUDY IN PORCINE MODEL

2018 ◽  
Vol 30 (01) ◽  
pp. 1850002
Author(s):  
Mu-Yi Liu ◽  
Po-Liang Lai ◽  
Ching-Lung Tai
Keyword(s):  
Vertebral Compression Fracture ◽  
Compression Fracture ◽  
Cement Augmentation ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Vertebral Height ◽  
Compression Fractures ◽  
Significant Difference ◽  
Compression Stiffness ◽  
Low Modulus

Polymethylmethacrylate (PMMA) bone cement has been widely used in vertebroplasty to treat osteoporotic vertebral compression fracture. However, the high compression stiffness of PMMA is suspected to induce adjacent vertebral fracture following vertebroplasty. In the current study, modified low-modulus cement was prepared by combining PMMA with castor oil to solve this problem. The percentage of height recovery and compression stiffness of vertebral bodies was compared after injection of standard PMMA or low-modulus cement. This study aims to investigate whether low-modulus cement is as effective as standard PMMA for storing the initial vertebral height; while lowering the compression stiffness in treatment of osteoporotic vertebral compression fractures. A total of 20 fresh porcine lumbar vertebrae were assigned into two groups (10 per group): standard and low-modulus. All specimens received a four-week decalcification to mimic human osteoporotic vertebrae. The standard and low-modulus groups received a simulated compression fracture followed by treatment of standard and low-modulus cement augmentation, respectively. The low-modulus cement was prepared by combining standard PMMA with 15% weight fractions of castor oil. For all the 20 specimens, vertebral compression fracture was created by reducing the vertebral height of 25% using a material testing machine. The compression stiffness determined from the creation of compression fracture was defined as the intact group (20 specimens). The fractured vertebrae were then treated with standard and low-modulus cement augmentation. The vertebral height was measured pre- and post-treatment, and the percentage of vertebral height recovery was compared between two cementing groups. Following cement augmentation, axial compression test was conducted to compare compression stiffness among three groups. The results indicated that there is no significant difference in percentage of vertebral height between standard (83.42[Formula: see text][Formula: see text][Formula: see text]11.60%) and low-modulus (88.50[Formula: see text][Formula: see text][Formula: see text]6.15%) groups ([Formula: see text]). Moreover, the compression stiffnesses were 1166.49[Formula: see text][Formula: see text][Formula: see text]392.91 N/mm, 1795.85[Formula: see text][Formula: see text][Formula: see text]247.45[Formula: see text]N/mm and 1362.57[Formula: see text][Formula: see text][Formula: see text]236.92[Formula: see text]N/mm for intact, standard and low-modulus groups, respectively. There is significant difference among three groups ([Formula: see text]). We concluded that the modified low-modulus cement is as effective as standard PMMA for storing the initial vertebral height while lowering the compression stiffness in treatment of osteoporotic vertebral compression fractures. These reduce the risks of adjacent vertebral body fracture following vertebroplasty.

scholarly journals Innovative Spine Implants for Improved Augmentation and Stability in Neoplastic Vertebral Compression Fracture

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 426 ◽  
Author(s):  
Cornelis ◽  
Joly ◽  
Nouri-Neuville ◽  
Ben-Ammar ◽  
Kastler ◽  
...  
Keyword(s):  
Vertebral Compression Fracture ◽  
Clinical Performance ◽  
Compression Fracture ◽  
Treatment Decision ◽  
Definitive Treatment ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Good Pain Relief ◽  
Severe Back Pain ◽  
And Function

Background and objectives: Tumor-related vertebral compression fractures often result in severe back pain as well as progressive neurologic impairment and additional morbidities. The fixation of these fractures is essential to obtain good pain relief and to improve the patients’ quality of life. Thus far, several spine implants have been developed and studied. The aims of this review were to describe the implants and the techniques proposed to treat cancer-related vertebral compression fractures and to compile their safety and efficacy results. Materials and Methods: A systematic MEDLINE/PubMed literature search was performed, time period included articles published between January 2000 and March 2019. Original articles were selected based on their clinical relevance. Results: Four studies of interest and other cited references were analyzed. These studies reported significant pain and function improvement as well as kyphotic angle and vertebral height restoration and maintain for every implant and technique investigated. Conclusions: Although good clinical performance is reported on these devices, the small numbers of studies and patients investigated draw the need for further larger evaluation before drawing a definitive treatment decision tree to guide physicians managing patients presenting with neoplastic vertebral compression fracture.

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