ABSTRACT
Objective To evaluate the influencing factors of recurrence of fracture after percutaneous vertebral augmentation.Methods From January 2007 to December 2013,256 cases patients with percutaneous vertebral augmentation in treatment of osteoporotic vertebral compression fractures in the Central Hospital of Chaoyang were retrospectively reviewed.After operation,the patients were divided into recurrent fracture group (59 cases) and no recurrence group (197 cases) according to whether postoperative recurrence of vertebral fracture.The age,sex,body mass index (BMI),bone mineral density,operation mode,bone cement injection volume,the existence of bone cement leakage and vertebral body height recovery rate were compared between the two groups respectively.Multi factor Logistic regression analysis was performed to analyze the correlation between the factors and the recurrence of vertebral body fractures.Results The age((75.9±4.6) years old vs.(69.9±5.0) years old),BMI((23.5±0.6) kg/m2 vs.(25.4±0.7) kg/m2),bone mineral density((-3.67±0.68)vs.(-2.75 ±0.98)),the existence of bone cement leakage rate(22.0％ vs.5.1％) and vertebral body height recovery rate ((24.1±2.9) ％ vs.(14.9±3.0)％) between recurrent fracture group and no recurrence group had statistically significant differences (P=0.046,0.047,0.046,0.026,0.023).Multi factor Logistic regression analysis showed that age,BMI were not related to postoperative recurrence of fracture(P=0.140,0.137),and bone density,bone cement leakage and vertebral body height recovery rate were related to recurrence of fracture (P=0.018,0.000,0.000).Conclusion Low bone mineral density,existence of bone cement leakage and high body height recovery rate are the risk factors of recurrence of fracture after percutaneous vertebral augmentation.
ABSTRACT
Objective To evaluate the efficacy of medical therapy in the patients with osteoporotic vertebrae fracture. Methods The patients suffered from vertebrae fracture and had undergone percutaneous vertebroplasty operation were reviewed from May, 2006 to December, 2009. Informations were collected via case evaluation and telephone interview, regarding dual-energy X-ray absorptiometry(DXA), calcium and vitamin D supplementation,and anti-osteoporosis drugs treatment. Patients with fracture induced by trauma and tumor metastasis were excluded. Results Among 253 patients, DXA was performed only in 3.6% of patients. Calcium and vitamin D supplements were prescribed in 9.5% and 6.7% of patients, respectively. Anti-osteoporosis drugs were prescribed in 36% of patients, of them 27.5%, 29.7%, 2.2%, and 3.3% received bisphosphonate, calcitonin, ossotide, and traditional Chinese drugs respectively. 37. 4% of patients could not recall the name of the drug they had received. Conclusions Most patients with osteoporotic vertebrae fracture do not receive adequate anti-osteoporosis drugs or appropriate evaluation. More care should be given to the patients with vertebrae fracture, with regard to adequate drug treatment and appropriate evaluation in order to prevent future fractures.
ABSTRACT
To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A (n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B (n=50) did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B (group A: 6.4 degree; group B: 5.4 degree)/At the end of follow-up, kyphosis correction was maintained in group A but lost in group B (P=0.0001). Postoperatively, greater anterior height was achieved in group A than in group B (P<0.01). During follow-up study, anterior vertebral height was maintained only in Group A (P<0.001). Both group A and group B showed good Denis pain scores (P1 and P2) but group A outdid group B in terms of control of severe and constant pain (P4 and P5). By Frankel criteria, the changes in neurological functions in group A was better than those of group B (P<0.001). It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.
ABSTRACT
[Objective] To discuss the opportunity and method of the posterior route operation in the upper-middle thoracic fracture to resume the thoracic vertebral normal sequence、decompression completely and reconstruction immediate stability as soon as possible,so as to relieve pressure to spinal cord and nerve and avoid the secondary trauma of spinal cord and nerve and blood vessel and patients can do rehabilitation.[Method]Seventeen cases of the patients with upper-middle thoracic vertebral fracture were operated on with posterior route early decompression、fusion、internal fixation under general anaesthesia.There were 17 cases including male 11 and female 6 with the ages from 18 to 53 years(average 33.8 years).The injury reason: 7 cases as traffic accident,10 cases as falling from high altitude.The time from trauma to hospital were 1 hr.to 72 hrs.(average 15.4 hrs.).The injured segment of vertebral: T5～T10 segment,T5 2 cases,T6 6 cases,T7 5 cases,T9 4 cases,T10 2 cases.The function evaluation of spinal cord: 10 cases with incompletely neurological defect,7 cases with completely neurological defect.[Result]All patients were followed for 6~27 months(average 13.5months).The thoracic vertebra restoration were contentment and bone fuse were obtained in 12 weeks after operation.10 cases with incompletely neurological defect got improved postoperatively and 5 cases activity normolly.7 cases with completely neurological defect got improved of numbness and pain.[Conclusion]The upper-middle thoracic vertebral fracture can be operated early and the outcome are contentment.
ABSTRACT
[Objective] To evaluate the efficacy of reinforcing short-segment pedicle screw fixation with posterior morselized bone grafting in vertebrae for spinal fusion in patients with thoracolumbar vertebrae fractures.[Method]Seventy patients with thoracolumbar vertebrae fractures were treated with short-segment pedicle screw fixation.Fractures in Group A(n =20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion.Group B patients(n =50) were not treated with morselized bone grafting.Kyphotic deformity,anterior vertebral height,instrument failure rates,and neurological function outcomes were compared between the two groups.[Result]Kyphosis correction was achieved in Group A(morselized bone grafting) and Group B(Group A,6.4 degrees,Group B,5.4 degrees).At the end of the follow-up period,kyphosis correction was maintained in Group A but lost in Group B(Group A,0.33-degree loss,Group B,6.20-degree loss)(P=0.0001).After surgery,greater anterior vertebral height was achieved in Group A than in Group B(Group A,12.9%,Group B,2.3%)(P
ABSTRACT
Objective To study a simple?minimally invasive?safe?effective and economical therapy for osteoportic vertebrae compression fracture. Methods 9 patients with 14 vertebrae (13 lumbar, 1 thoracic) suffered from osteoportic compression fractures were treated with percutaneous vertebrolasty from March to September in 2001. The patients included 8 women and 1 man aged from 33 to 85 years with a mean of 72 years. Results All patients had marked to complete pain relief at 1～2 postoperative days, and could get up to move at 2～3 postoperative days. During 1-6 months follow-up period, no pain reoccurred. No severe comlication occurred. Conclusions Percutaneous vertebroplasty provided significant pain relief in the patients with osteoportic vertebrae compression fractures. It is a promising therapy for patients with osteoportic vertebrae compression fracture.