scholarly journals UNILATERAL PERCUTANEOUS VERTEBROPLASTY FOR SYMPTOMATIC OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES -EVALUATION OF RADIOLOGICAL AND CLINICAL OUTCOMES

2021 ◽  
pp. 1-2
Author(s):  
Sandeep Kumar ◽  
Kumari Rashmi ◽  
Kumar Anshuman ◽  
Debarshi Jana
Keyword(s):  
Vertebral Fractures ◽  
Local Anaesthesia ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Osteoporotic Fractures ◽  
Early Mobilization ◽  
Vertebral Compression Fractures ◽  
Vas Score ◽  
Osteoporotic Vertebral Fractures

Background: Vertebral fractures are the most common type of osteoporotic fractures. These are developing into a significant health problem worldwide as about 30% of the patients above 50 years suffer from a fracture secondary to osteoporosis. Osteoporotic vertebral fractures may be treated with rest and analgesics. Some fractures may also require surgery. Percutaneous procedure like vertebroplasty and kyphoplasty done under local anaesthesia can reduce the pain and restore height of vertebral body without need for an open surgery. The aim of the study was to assess the clinical and radiological outcomes following unilateral percutaneous vertebroplasty under local anaesthesia. Methods: 21 patients who underwent unilateral vertebroplasty for symptomatic osteoporotic compression fracture between August 2019 and July 2020 were included in the study. Unilateral vertebroplasty using an 11-gauge trocar through transpedicular technique was performed under c-arm guidance. Patient was mobilized as soon as tolerated. Oswestry disability index and visual analogue scale were assessed pre-operatively, in the immediate post-op and at 1-year follow up. Results: There were 15 females and 6 males. The mean age was 70.04±6.07 years. The pre-op ODI score was 76.8±7.6. The pre-op VAS score was 7.66±0.71. The average time period from fracture to vertebroplasty is 4.19±3.19 days. The immediate post-operative VAS score was 5.76±0.8 and the ODI score was 62.85±7.17. The VAS at final follow up was 1.23±1.19. ODI at final follow up was 9.04±3.19. There was a showed a significant improvement when preoperative, immediate post-operative ODI and VAS scores and final follow up (p<0.001). Conclusions: In our study unilateral percutaneous vertebroplasty has provided pain relief, early mobilization of the patient with less complication without the requirement of general anaesthesia.

scholarly journals Unilateral percutaneous vertebroplasty for symptomatic osteoporotic vertebral compression fractures -evaluation of radiological and clinical outcomes

2018 ◽  
Vol 5 (1) ◽  
pp. 19
Author(s):  
Shanmuga Sundaram Pooswamy ◽  
Niranjanan Raghavn Muralidharagopalan
Keyword(s):  
Vertebral Fractures ◽  
Local Anaesthesia ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Osteoporotic Fractures ◽  
Early Mobilization ◽  
Vertebral Compression Fractures ◽  
Vas Score ◽  
Osteoporotic Vertebral Fractures

<p class="abstract"><strong>Background:</strong> Vertebral fractures are the most common type of osteoporotic fractures. These are developing into a significant health problem worldwide as about 30% of the patients above 50 years suffer from a fracture secondary to osteoporosis. Osteoporotic vertebral fractures may be treated with rest and analgesics. Some fractures may also require surgery. Percutaneous procedure like vertebroplasty and kyphoplasty done under local anaesthesia can reduce the pain and restore height of vertebral body without need for an open surgery. The aim of the study was to assess the clinical and radiological outcomes following unilateral percutaneous vertebroplasty under local anaesthesia.</p><p class="abstract"><strong>Methods:</strong> 21 patients who underwent unilateral vertebroplasty for symptomatic osteoporotic compression fracture between 2012 and 2015 were included in the study. Unilateral vertebroplasty using an 11-gauge trocar through transpedicular technique was performed under c-arm guidance. Patient was mobilized as soon as tolerated. Oswestry disability index and visual analogue scale were assessed pre-operatively, in the immediate post-op and at 1-year follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 15 females and 6 males. The mean age was 70.04±6.07 years. The pre-op ODI score was 76.8±7.6. The pre-op VAS score was 7.66±0.71. The average time period from fracture to vertebroplasty is 4.19±3.19 days. The immediate post-operative VAS score was 5.76±0.8 and the ODI score was 62.85±7.17.  The VAS at final follow up was 1.23±1.19. ODI at final follow up was 9.04±3.19. There was a showed a significant improvement when preoperative, immediate post-operative ODI and VAS scores and final follow up (p&lt;0.001).</p><p class="abstract"><strong>Conclusions:</strong> In our study unilateral percutaneous vertebroplasty has provided pain relief, early mobilization of the patient with less complication without the requirement of general anaesthesia.</p>

scholarly journals Percutaneous Vertebroplasty for Osteoporotic Fractures

2007 ◽  
Vol 4;10 (7;4) ◽  
pp. 559-663
Author(s):  
Suhail Afzal
Keyword(s):  
Back Pain ◽  
Pain Relief ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Osteoporotic Fractures ◽  
Percutaneous Injection ◽  
Compression Fractures ◽  
Vas Score

Background: Vertebral augmentation has been widely used to treat vertebral body compression fractures caused by varied pathologies. The lifetime risk of a vertebral body compression fracture is 16% for women and 5% for men, and exponential increase of osteoporotic fractures worldwide. Purpose: To determine the efficacy and durability of percutaneous vertebroplasty for the treatment of back pain associated with osteoporotic vertebral fractures. Design: A prospective study. Materials and Methods: A prospective evaluation of pain relief in 30 patients, with mean age of 73.7 years, who underwent percutaneous injection of polymethyl methacrylate into 54 vertebrae under fluoroscopic guidance over a period of 35 months was done. Before the procedure and at follow up, patients were asked to quantify their pain on a visual analogue scale. Results: The procedure was technically successful in all the patients. Mean duration of follow up was 21.5 months (6-44months). Ninety-seven percent of the patients reported a significant relief 24 hours after the procedure. Ninety-two percent reported significant improvement in back pain, previously associated with a compression fracture, as well as improved ambulatory ability. Before vertebroplasty, the VAS score was 8.91+/- 1.82 compared to a score of 2.02+/- 1.95 at follow up. The mean difference in VAS score was significant (p<.0001). One patient had an asymptomatic epidural leak of PMMA, however did not require any further intervention. Conclusion: Percutaneous vertebroplasty of symptomatic osteoporotic vertebral compression fractures is a minimally invasive procedure that provides immediate and sustained pain relief in patients with refractory pain. Key words: Compression fracture, osteoporosis; pain, vertebroplasty, polymethylmethacrylate

Twelve-Months Follow-up in Forty-Nine Patients With Acute/Semiacute Osteoporotic Vertebral Fractures Treated Conservatively or With Percutaneous Vertebroplasty

Spine ◽  
2010 ◽  
Vol 35 (5) ◽  
pp. 478-482 ◽  
Author(s):  
Rikke Rousing ◽  
Karina L. Hansen ◽  
Mikkel O. Andersen ◽  
Stig M. Jespersen ◽  
Karsten Thomsen ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Percutaneous Vertebroplasty ◽  
Osteoporotic Vertebral Fractures

scholarly journals Are Non-Contrast MR Images Enough for Detection of Fracture Levels Prior to Percutaneous Vertebroplasty in Patients with Osteoporosis?

2008 ◽  
Vol 14 (2_suppl) ◽  
pp. 79-84
Author(s):  
Wei-Hsin Yuan ◽  
Michael Mu-Huo Teng ◽  
Hui-Chen Hsu ◽  
Ying — Chou Sun ◽  
Cheng-Yen Chang
Keyword(s):  
Vertebral Fractures ◽  
Predictive Value ◽  
Percutaneous Vertebroplasty ◽  
Lumbar Vertebrae ◽  
Vertebral Compression Fractures ◽  
Mr Images ◽  
Contrast Enhanced ◽  
Osteoporotic Vertebral Fractures ◽  
Sensitivity Specificity ◽  
Rule Out

We evaluated the detectability of painful vertebral compression fractures (VCFs) on different MRI protocols in 40 osteoporotic patients with thoraco-lumbar osteoporotic vertebral fractures. Five hundred and ten thoracic and lumbar vertebrae in 40 patients were evaluated. All patients underwent percutaneous vertebroplasty. Vertebral fractures were found in 126 (24.7%) of 510 vertebrae. Healed vertebral fractures were found in 33 (26.2%) of 126 vertebral fractures. Painful osteoporotic VCFs was found in 93 (73.8%) of 126 fractures. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of contrast-enhanced MR images, and the non-contrasted combined protocol (including T1-weighted, T2-weighted and STIR images) for the detection of painful osteoporotic VCFs were all more than 90%. Therefore, the non-contrasted combined protocol can be used for detection of painful osteoporotic VCFs prior to percutaneous vertebroplasty, unless there are conditions where contrast-enhanced MR is needed to rule out other causes of VCFs.

MRI PATTERN OF VERTEBRAL FRACTURES DUE TO OSTEOPOROSIS, INFECTION, AND MALIGNANT TUMORS

2010 ◽  
Vol 13 (02) ◽  
pp. 57-63
Author(s):  
Mohamed El-Sayed Abdel-Wanis ◽  
Mohamed Tharwat Mahmoud Solyman ◽  
Nahla Mohamed Ali Hasan
Keyword(s):  
Vertebral Body ◽  
Vertebral Fractures ◽  
Malignant Tumors ◽  
Compression Fracture ◽  
Osteoporotic Fractures ◽  
Spinal Infection ◽  
Vertebral Compression Fractures ◽  
Vertebral Collapse ◽  
Compression Fractures ◽  
Vertebral Wedging

No previous studies discussed the significance of the MRI pattern of vertebral collapse in differentiation between vertebral compression fractures due to malignancy, osteoporosis, and infections. MRI was used in the evaluation of 152 atraumatic vertebral compression fractures in 80 patients: 85 malignant, 34 osteoporotic, and 33 infective. Central collapse of the fractured vertebral body was the commonest pattern in malignant fractures (57 vertebrae, 67%), followed by uniform collapse (21 vertebrae, 24.7%), then anterior wedging (5 vertebrae, 5.9%), and finally posterior wedging (2 vertebrae, 2.4%). In osteoporotic fractures, anterior wedging was the commonest pattern (18 vertebrae, 53%), followed by central collapse (11 vertebrae, 32.3%), then uniform collapse (4 vertebrae, 11.8%), and finally posterior wedging (1 vertebra, 2.9%). In vertebral compression fractures due to spinal infection, anterior wedging was the commonest pattern (20 vertebrae, 60.6%), followed by uniform collapse (12 vertebrae, 36.4%), while only one vertebra (3%) was centrally collapsed. Central collapse of the vertebral body is highly suggestive of malignant compression fracture while anterior vertebral wedging is highly suggestive of a benign compression fracture.

scholarly journals A second puncture and injection technique for treating osteoporotic vertebral compression fractures

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhaofei Zhang ◽  
Feng Jiao ◽  
He Huang ◽  
Yonghui Feng ◽  
Chunliang Xie ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Cement Leakage ◽  
Vertebral Compression Fractures ◽  
Injection Technique ◽  
Vertebral Height ◽  
Vas Score ◽  
Injection Group ◽  
Group A ◽  
Group B

Abstract Objective To evaluate the clinical effect of the second puncture and injection technique during a percutaneous vertebroplasty (PVP) procedure. Methods Patients treated with a second puncture and injection (group A) or a single puncture and injection (group B) during PVP at our institution during 2010–2017 were reviewed. Vertebral height loss, visual analogue scale (VAS) score, Oswestry disability index (ODI), adjacent vertebral fractures, and cement leakage were compared between the groups. Results A total of 193 patients were enrolled (86 cases in group A, 107 cases in group B). The follow-up period was 15.64 (12–20) months. The loss of anterior (group A 0.01 ± 0.03; group B 0.14 ± 0.17) and middle (group A 0.13 ± 0.12; group B 0.16 ± 0.11) vertebral height in group B was significantly higher than that in group A (P < 0.05). The VAS score and ODI were also significantly higher in group B than in group A at the final follow-up; the VAS score and ODI in group B were 1.65 ± 0.70 and 14.50 ± 4.16, respectively, and those in group A were 1.00 ± 0.74 and 12.81 ± 4.02, respectively (P < 0.05). Three patients in group A and two in group B experienced adjacent vertebral fractures. Regarding mild, moderate, and severe cement leakage, there were 25 (29%), 5 (5%), and 0 cases, respectively, in group A and 28 (26%), 3 (2.8%), and 1 (0.009%) case, respectively, in group B (P > 0.05). Conclusions The second puncture and injection technique may effectively increase the dispersion of cement, thus preventing recompression of the cemented vertebral body, and it does not increase the risk of cement leakage or adjacent vertebral fracture.

Percutaneous Transpedicular Vertebroplasty versus Conservative Management in Osteoporotic Vertebral Fractures

2016 ◽  
Vol 695 ◽  
pp. 205-211
Author(s):  
Iulian Popa ◽  
Petre Matusz ◽  
Diana Andrei ◽  
Mihai Mardare ◽  
Dan V. Poenaru
Keyword(s):  
Conservative Management ◽  
Vertebral Fractures ◽  
Percutaneous Vertebroplasty ◽  
Osteoporotic Fractures ◽  
Control Group ◽  
First Year ◽  
Lung Capacity ◽  
Osteoporotic Vertebral Fractures ◽  
Group 2 ◽  
Group 1

Osteoporotic vertebral fractures can lead to late collapse which often cause kyphotic spinal deformity, persistent back pain, decreased lung capacity, increased fracture risk and increased mortality. The purpose of our study is to compare the efficacy and safety of vertebroplasty against conservative management of osteoporotic vertebral fractures without neurologic symptoms. A total of 66 patients with recent OVF on MRI examination were included in the study. All patients were admitted from September 2009 to September 2012. The cohort was divided in two groups: first study group consisted of 33 prospectively followed consecutive patients who suffered 40 vertebral osteoporotic fractures treated by percutaneous vertebroplasty (Group 1), and the control group consisted of 33 patients who suffered 41 vertebral osteoporotic fractures treated conservatory because they reffused vertebroplasty (Group 2). Vertebroplasty with PMMA was performed in 30 patients on 39 VBs, including four thoracic vertebras, 27 vertebras of the thoracolumbar jonction and 8 lumbar vertebras. In the Group 2 were included 30 patients with 39 OVFs (four thoracic vertebras, 23 vertebras of the thoracolumbar junction and 11 lumbar vertebras). In our study on OVF, vertebroplasty delivered superior clinical and radiological outcomes over the first year from intervention when compared to consevative treatment of patients with osteoporotic compression fractures without neurological deficit.

Efficacy of Postural Reduction in Osteoporotic Vertebral Compression Fractures Followed by Percutaneous Vertebroplasty

Neurosurgery ◽  
2006 ◽  
Vol 58 (4) ◽  
pp. 695-700 ◽  
Author(s):  
Dong-Kyu Chin ◽  
Young-Soo Kim ◽  
Yong-Eun Cho ◽  
Jun-Jae Shin
Keyword(s):  
Cobb Angle ◽  
Compression Ratio ◽  
Vertebral Compression Fracture ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Vertebral Compression Fractures ◽  
Significant Relation ◽  
Osteoporotic Vertebral Fractures ◽  
The Mean ◽  
Postural Reduction

Abstract OBJECTIVE: Vertebroplasty in the symptomatic osteoporotic vertebral fracture has become increasingly popular. However, there have been some limitations in restoring the height of the collapsed vertebrae and in preventing the leaking of cement. In the severely collapsed vertebrae of more than two thirds of their original height, vertebroplasty is regarded as a contraindication. We tried postural reduction using a soft pillow under the compressed level. This study was undertaken to investigate the effectiveness of the combination of postural reduction and vertebroplasty for re-expansion and stabilization of the osteoporotic vertebral fractures. METHODS: A total of 75 patients with single level vertebral compression fracture were treated with postural reduction followed by vertebroplasty. In 30 patients, the vertebral body was severely collapsed more than two-thirds of its original height. We calculated the compression ratio (anterior height/posterior height) and measured the Cobb angle. We analyzed the degree of re-expansion according to the onset duration. RESULTS: The mean compression ratio was 0.60 ± 0.15 initially and increased to 0.75 ± 0.17 after vertebroplasty. The mean Cobb angle was 16.14 ± 11.29° and corrected to 10.71 ± 12.08°. The degree of re-expansion showed significant relation with the onset duration. Twenty-eight of 30 (93%) severely collapsed vertebrae re-expanded after postural reduction, which made vertebroplasty possible. CONCLUSION: This new method of vertebroplasty leads to significant restoration of height and correction of kyphosis. The re-expansion was closely related with onset duration. In cases of severely collapsed vertebrae which is able to be re-expanded by postural reduction, vertebroplasty could be applied safely.

scholarly journals Does Percutaneous Vertebroplasty or Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures Increase the Incidence of New Vertebral Fractures? A Meta-Analysis

2017 ◽  
Vol 1 (21;1) ◽  
pp. E13-E28 ◽  
Author(s):  
Tao Zhang
Keyword(s):  
Vertebral Fractures ◽  
Percutaneous Vertebroplasty ◽  
Meta Analysis ◽  
Balloon Kyphoplasty ◽  
Vertebral Compression Fractures ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Inclusion Criteria ◽  
Compression Fractures ◽  
Osteoporotic Vertebral Fractures ◽  
Significant Difference

Background: Because of an aging population,osteoporotic vertebral fractures are becoming more frequent. Conservative therapy was considered the gold standard for treating osteoporotic vertebral compression fractures (OVCFs) in the past. Percutaneous vertebroplasty (PVP) or balloon kyphoplasty (BKP) as minimally invasive techniques are new treatments that arewidely used for painful OVCFs. However, an increase in new vertebral compression fractures at non-treated levels following augmentation is of concern. There is no convincing evidence that new fractures are inevitable after augmentation compared to after conservative treatment, and it is still unclear whether further fractures are the consequence of augmentation ora result of the natural progression of osteoporosis. Objective: The objective of this study was to evaluate the new-level fracture risk after PVP or BKP compared with conservative (non-operative) treatment and to determine the dominant risk factor associated with new OVCFs. Study Design: A meta-analysis of comparative studies was performed to evaluate the incidence of new vertebral fractures between vertebral augmentation, such as vertebroplasty and kyphoplasty, and no operation. Setting: The PubMed,ISI Web of Science, ELSEVIER ScienceDirect, and Cochrane Library databases and abstracts published in annual proceedings were systematically searched.In addition, we also retrieved data from references when titles met our inclusion criteria. Methods: Detailed searches of a number of online databases comparing operative and non-operative groups were performed. We included randomized controlled trials,clinical controlled trials,and prospective clinical studies to provide available data. All studies were reviewed by 2 reviewers independently, and all the references that met our inclusion criteria were searched for additional trials, using the guidelines set by the QUOROM (Quality of Reporting of Meta-analysis) statement. Results: We evaluated 12 studies encompassing 1,328 patients in total,including 768 who underwent operation with polymethylmethacrylateand 560 who received non-operative treatments. For new-level vertebral fractures, our meta-analysis found no significant difference between the 2 methods, including total new fractures (P = 0.55) and adjacent fractures (P = 0.5).For pre-existing vertebral fractures, there was no significant difference between the 2 groups (operative and non-operative groups) (P = 0.24). Additionally,there was no significant difference in bone mineral density, both in the lumbar (P = 0 .13) and femoral neck regions (P = 0.37), between the 2 interventions. Limitation: All studies we screened were published online except for unpublished articles. Moreover, only a few data sources could be extracted from the published studies. There were only 5 randomized clinical trials and 7 prospective studies that met our inclusion criteria. Conclusion: Vertebral augmentation techniques, such as vertebroplasty and kyphoplasty, have been widely used to treat osteoporotic vertebral fractures in order to alleviate back pain and correct the deformity, and it has been frequently reported that many new vertebral fractures occurred after this operation. Our analysis did not reveal evidence of an increased risk of fracture of vertebral bodies, especially those adjacent to the treated vertebrae, following augmentation with either method compared with conservative treatment. Key words: Vertebroplasty, kyphoplasty, new osteoporotic compression vertebral fracture, meta-analysis

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