ABSTRACT
Objective@#To compare the curative effects between our self-designed flexible vertebroplasty device and the conventional straight bone cement injector in the treatment of osteoporotic thoracic compression fractures.@*Methods@#A retrospective case-control study was conducted to analyze the clinical data of 140 patients with osteoporotic thoracic compression fracture who had been admitted to Department of Spine Surgery, Xi’an Honghui Hospital from June 2016 to January 2017. They were 61 males and 79 females, aged from 55 to 88 years (average, 70.3 years). Their fractured vertebrae distributed from T5 to T12. Our self-designed flexible vertebroplasty device was used in 67 of them (group A) while the conventional straight bone cement injector in the other 73 patients (group B). The 2 groups were compared in terms of operative time, amount of bone cement injected, distribution ratio of bone cement on the contralateral side, bone cement leakage, and visual analogue scale (VAS), anterior height ratio of the fractured vertebra and kyphosis cobb angle at 1 d, 1 and 2 years after operation.@*Results@#The 2 groups were comparable due to their insignificant differences in preoperative general data (P>0.05). All the patients were followed up for more than 2 years, with an average of 26.7 months. There were no significant differences between the 2 groups in operation time (28.1±4.2 min versus 26.3±3.2 min) or in bone cement leakage [34.3%(23/67) versus 17.8%(13/73)] (P>0.05). However, group A was significantly higher than group B in amount of bone cement injection (5.6±1.2 mL versus 4.9±1.1 mL) and in distribution ratio of bone cement on the contralateral side (71.5%±11.3% versus 65.7%±12.9%), significantly lower than group B in VAS at 1 and 2 years after operation (2.8±0.7 and 3.0±0.9 versus 3.1±0.8 and 3.4±0.8) and in kyphosis cobb angle at 1 and 2 years after operation (25.2°±5.2° and 26.8°±5.5° versus 27.7°±4.9° and 29.1°±1.6°), and significantly higher than group B in anterior height ratio of the fractured vertebra at 1 and 2 years after operation (39.2%±8.1% and 37.1%±7.2% versus 35.4%±7.8% and 33.2%±8.4%) (all P< 0.05). There were no significant differences between the 2 groups in VAS, anterior height ratio of the fractured vertebra or kyphosis cobb angle at one day after operation (P>0.05).@*Conclusions@#Compared with the conventional straight bone cement injector, our self-designed flexible vertebroplasty device can lead to better contralateral distribution of bone cement, more effective maintenance of the height of injured vertebra, and better long-term analgesic effect in the treatment of osteoporotic thoracic compression fractures.
ABSTRACT
Objective To compare the curative effects between our self-designed flexible vertebroplasty device and the conventional straight bone cement injector in the treatment of osteoporotic thoracic compression fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 140 patients with osteoporotic thoracic compression fracture who had been admitted to Department of Spine Surgery,Xi'an Honghui Hospital from June 2016 to January 2017.They were 61 males and 79 females,aged from 55 to 88 years (average,70.3 years).Their fractured vertebrae distributed from T5 to T12.Our self-designed flexible vertebroplasty device was used in 67 of them (group A) while the conventional straight bone cement injector in the other 73 patients (group B).The 2 groups were compared in terms of operative time,amount of bone cement injected,distribution ratio of bone cement on the contralateral side,bone cement leakage,and visual analogue scale (VAS),anterior height ratio of the fractured vertebra and kyphosis cobb angle at 1 d,1 and 2 years after operation.Results The 2 groups were comparable due to their insignificant differences in preoperative general data (P ＞ 0.05).All the patients were followed up for more than 2 years,with an average of 26.7 months.There were no significant differences between the 2 groups in operation time (28.1 ±4.2 min versus 26.3 ±3.2 min) or in bone cement leakage [34.3％ (23/67) versus 17.8％ (13/73)] (P ＞ 0.05).However,group A was significantly higher than group B in amount of bone cement injection (5.6 ± 1.2 mL versus 4.9 ± 1.1 mL) and in distribution ratio of bone cement on the contralateral side (71.5％ ± 11.3％ versus 65.7％ ± 12.9％),significantly lower than group B in VAS at 1 and 2 years after operation (2.8±0.7 and 3.0±0.9 versus 3.1 ±0.8 and 3.4±0.8) and in kyphosis cobb angle at 1and 2 years after operation (25.2°±5.2° and 26.8°±5.5° versus 27.7°±4.9° and 29.1°±1.6°),and significantly higher than group B in anterior height ratio of the fractured vertebra at 1 and 2 years after operation (39.2％ ± 8.1％ and 37.1％ ± 7.2％ versus 35.4％ ± 7.8％ and 33.2％ ± 8.4％) (all P ＜0.05).There were no significant differences between the 2 groups in VAS,anterior height ratio of the fractured vertebra or kyphosis cobb angle at one day after operation (P ＞ 0.05).Conclusions Compared with the conventional straight bone cement injector,our self-designed flexible vertebroplasty device can lead to better contralateral distribution of bone cement,more effective maintenance of the height of injured vertebra,and better long-term analgesic effect in the treatment of osteoporotic thoracic compression fractures.
ABSTRACT
Thoracic fracture-dislocations reportedly lead to an 80% incidence of complete paraplegia. Thus, thoracic fracture-dislocations without cord injury are uncommon. There are a few cases of thoracic fracture-dislocations in which the neural sparing status was associated with separation of the posterior spinal structures, such as the pedicles and laminae. The authors experienced two cases of thoracic fracture-dislocations without spinal cord injury: one was a 50-year-old man who fell from the fourth floor of a building and sustained a T6-7 fracture-dislocation; and the other was a 43-year-old man who was involved in motorcycle accident and sustained a T12 fracture-dislocation. Segmental spinal instrumentation and fusion without open reduction was performed in each of the two cases and there has not been any abnormality detected on neurological examination at a minimum follow-up period of 2 years.