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Objective: To explore the effect of percutaneous kyphoplasty (PKP) on lumbar-pelvic correlation in osteoporotic vertebral compressive fracture (OVCF). Methods: According to the inclusion criteria, 63 patients with primary osteoporosis between January 2012 and June 2017 were selected as the control group and 67 patients with single-segment lumbar OVCF receiving PKP and complete clinical data were included as the observation group. There was no significant difference in gender, age, and lumbar spine bone density between the two groups ( P>0.05). The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) score were used to assess lumbar pain and function before operation and at 3 days after operation in the observation group; lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured in lumbar lateral X-ray films which were taken before PKP and at 1 month after PKP. The same parameters were measured in the lumbar lateral X-ray films which were taken at the time of initial diagnosis in the control group. Results: All patients were followed up 3-24 months with an average of 5.8 months in the observation group. The VAS score decreased from 5.6±1.8 before PKP to 2.8±1.3 at 3 days after PKP ( t=14.082, P=0.000); ODI decreased from 50.1%±5.0% before PKP to 18.2%±1.8% ( t=47.011, P=0.000). Compared with the control group, the LL, PI, and SS decreased and the PT increased in the observation group, and only the difference in LL between the two groups was significant ( P0.05). In the control group, LL was positively correlated with PI and SS ( P<0.05); PI was positively correlated with PT and SS ( P<0.05). In the observation group, PI was positively correlated with SS ( P<0.05) before and after PKP. Conclusion: OVCF patients lost the specific lumbar-pelvic correlation. PKP can restore lumbar lordosis, but it still can not restore the normal physiological fitting.
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Objective To explore the correlation between spinal sagittal balance and quality of life after the treatment of percutaneous kyphoplasty in osteoporotic vertebral compressive fractures. Methods We retrospec-tively enrolled and screened 85 patients with osteoporotic vertebral compression fractures(OVCF),treated by per-cutaneous kyphoplasty(PKP)in spinal surgery department of Shanghai East Hospital from January 2012 to Decem-ber 2016. The full length of the spine X-ray examinations had been taken preoperatively,pre-discharge and during the follow-up and spine-pelvis sagittal parameters included C7 sagittal vertical axis(C7SVA),thoracic kyphosis (TK),lumber lordosis(LL),pelvic incidence(PT)and sacral slope(SS). Shot Form 36 Health Survey Question-naire(SF-36)was used for the scoring. Results In the last follow-up,C7SVA decreased from(35.9 ± 17.1)mm to(30.8 ± 12.8)mm(P=0.002)and SF-36 scores varied significantly(P<0.01). Before the surgery,follow-up 3 days,6 months and 12 months after the surgery,C7SVA was negatively correlated with the general health status in each period of SF-36(r=-0.343,-0.264,-0.272,-0.258;P=0.001,0.015,0.012,0.017). Conclusions PKP has a significant effect on OVCFs and changes the spine-pelvic sagittal balance in patients with OVCF. Spinal-pel-vic sagittal balance is closely related to the quality of life of these patients.
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Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
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Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
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Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region,which are the earliest signs of OP deterioration in elderly patients.Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength.To OP patients,preventing the occurrence of OP fracture is the primary goal for preventative measures,treatment and research of OP.This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF),and advocates early prevention of OVCF in OP patients,who should avoid activities that might exceed the security scope of the vertebral body load in daily life,so as to prevent subsequent fractures of the vertebral fracture cascade.
ABSTRACT
Osteoporosis (OP)-related vertebral fractures often occur in the transitional thoracolumbar region, which are the earliest signs of OP deterioration in elderly patients. Such fractures can be regarded as a physical incident that occurs when the vertebral stress load exceeds the mechanical structural strength. To OP patients, preventing the occurrence of OP fracture is the primary goal for preventative measures, treatment and research of OP. This paper reviews the biomechanical research progress of osteoporotic vertebra compressive fracture (OVCF), and advocates early prevention of OVCF in OP patients, who should avoid activities that might exceed the security scope of the vertebral body load in daily life, so as to prevent subsequent fractures of the vertebral fracture cascade.
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10.3969/j.issn.2095-4344.2013.26.006
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[Objective]To analyze the therapeutic effects of percutaneous kyphoplasty for acute versus chronic osteoporotic vertebral compressive fracture.[Method]Percutaneous kyphoplasty was performed in 56 patients(137 vertebraes) with osteoporotic vertebral compression fracture (VCF).Based on the changes on MRI,all compression fractures were divided into 3 types:acute VCF,repairing VCF and chronic VCF.Types were examined for differences in treatment efficacy,according to the anterior/middle vertebral body height,Cobb's angle and visual analogue scale(VAS) at pre-and post-operation.[Result]All patients with the VCFs had rapid and significant improvement in back pain following percutaneous kyphoplasty.VAS was from 8.09?1.12 preoperatively to 2.31?0.91 postoperatively,and 2.26?0.88 at final follow-up.The results showed that 41 cases were Type Ⅰ on MRI,69 were Type Ⅱ and 27 were Type Ⅲ.Significant improvement was observed at the post-operative versus pre-operative assessments in Type Ⅰ and Type Ⅱ.No significant differences were observed between post-and pre-operative assessments in Type Ⅲ.[Conclusion]The curative effect of percutaneous kyphoplasty for the treatment of acute VCFs appears superior to that of chronic VCFs.After a definite diagnosis of VCFs,percutaneous kyphoplasty should be performed as early as possible in order to obtain a better therapeutic effect.
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[Objective]To compare the difference between single and double balloon kyphoplasty to treat osteoporotic vertebral body.[Method]Twenty osteoporotic vertebral bodies were harvested from 10 embalmed cadavers,alternatingly assigned to either the single and double group.All vertebraes were compressed by 25% of their initial height using materials testing machine to create vertebral compression fractures and determine their augmented strength and stiffness before and after injecting the cement.Precompression,postcompression and posttreatment height of vertebrae were measured.[Result]Both treatments resulted in significantly stronger vertebral bodies relative to their initial state(P
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STUDY DESIGN: Retrospective study OBJECTIVES: To determine MR findings that affect the bone cement leakage in patients with osteoporotic compressive fractures who are receiving percutaneous vertebroplasties and kyphoplasties. MATERIALS AND METHODS: A retrospective review was conducted on 105 patients with 131 vertebrae treated by percutaneous vertebroplasties (group 1: 66 patients and 78 cases) and kyphoplasties (group 2: 39 patients and 53 cases) from October 2001 to October 2005. The study was performed to determine whether cement leakage was related to any of the following MR findings: level of injured vertebra, severity of anterior height loss, posterior cortical disruption, endplate disruption, presence of either vacuum or cystic portions, linear sclerosis that was low in signal intensity in T1 and T2-weighted images. RESULTS: Bone cement leakage was detected in 51 (65.3%) of 78 treated vertebrae in group 1 and 18 (33.9%) of 53 treated vertebrae in group 2. There was a statistically significant difference between the incidences (p<0.05). Vertebral endplate disruption had a positive correlation in both groups (p<0.05). There was more cement leakage in group 1 (48.5%) than in group 2 (18.1%) in cases of endplate disruption (p<0.05). Vacuum or cystic change had negative correlations to bone cement leakage in group 1 (p<0.05). No other MR findings demonstrated a statistically significant correlation with bone cement leakage. CONCLUSION: On the MR findings, vertebral endplate disruption and vacuum or cystic change in fractured vertebrae demonstrated a significant correlation with bone cement leakage in group 1. There was relatively less cement leakage into the intervertebral spaces with kyphoplasties than with vertebroplasties in the cases of vertebral endplate disruption.