ABSTRACT
Objective To analysis risk factor and to construct a line graph prediction model for bone cement leakage after percutaneous transluminal vertebroplasty treatment in patients with osteoporotic spinal compression fractures. Methods A total of 236 patients with osteoporotic spinal compression fractures who came to our hospital from December 2019 to December 2021 were selected for the stud)', and they were divided into a leakage group (n = 58) and a non-leakage group (n = 178) according to whether bone cement leakage occurred after percutaneous transluminal vertebroplasty treatment. The clinical data were collected to analyze the factors associated with bone cement leakage; The work receiver operating characteristic
ABSTRACT
STUDY DESIGN: The comparison was based on the radiographc and clinically differences of 96 vertebroplasty cases. PURPOSE: This study evaluated the clinical and radiological results of performing percutaneous vertebroplasty for acute or subacute osteoporotic vertebral compression fracture (group A) and for posttraumatic vertebral collapse (Kummell's disease) (group B). SUMMARY OF LITERATURE REVIEW: Percutaneous vertebroplasty is a minimal invasive procedure for the treatment of a painful collapsed vertebral body MATERIALS AND METHODS: We experienced 67 cases of group A and 29 cases of group B, and we followed these patients for 2 years or more. We evaluated the clinical results by using the serial visual analogue scale (VAS) and the radiological results were evaluated by measuring the restoration of the anterior vertebral height and the change of the kyphotic angle. We also compared both groups for their bone mineral density (BMD) and new fracture rate. RESULTS: Statistically significant pain relief was obtained by both groups in the perioperative period. The average VAS change was 6.5 (from 8.7 preoperatively to 2.2 postoperatively) in group A, and 7.1 (from 9.1 preoperatively to 2.0 postoperatively) in group B on a 10 point pain scale. The anterior vertebral height increased an average of 4.9mm (16.5%), (from 16.8mm preoperatively to 21.7 mm postoperatively) in group A, and 6.5 mm (21%) (from 12.8 mm preoperatively to 19.3 mm postoperatively) in group B on the perioperative period. But the height was minimally decreased more that it was measured at the immediate postoperative period: 18.7 mm in group A, and 16.2 mm in group B on the last follow up. The kyphotic angle was restored an average of 5.2 degrees (from 32.4 degrees preoperatively to 27.2 degrees postoperatively) in group A, and 4.9 degrees (from 39.5 degrees preoperatively to 34.6 degrees postoperatively) in group B on the perioperative period. But the angle was increased more than that measured preoperatively: about 1.7 degree in group A and group B on the last follow up. There's no significant difference in the BMD between the groups. New fracture developed in 17.9% (12) of group A, and 20.7% (6) of group B. We did this procedure for 15 cases of new fracture, and then the VAS change was an average 5.0 immediately after the operation. CONCLUSIONS: Percutaneous vertebroplasty was an effective treatment method for both groups and there were no statistically significant differences in the clinical and radiological results. Care must be taken due to the relatively high rate of new fracture and this can be resolved by repeat vertebroplasty
Subject(s)
Humans , Bone Density , Follow-Up Studies , Fractures, Compression , Osteoporosis , Perioperative Period , Postoperative Period , VertebroplastyABSTRACT
PURPOSE: To determine the clinical efficacy of percutaneous vertebroplasty in cases of painful and medically intractable osteoporotic vertebral compression fracture. MATERIALS AND METHODS: Ninety-eight patients (20 men and 78 women; mean age, 69 years) underwent 122 per-cutaneous vertebroplasty procedures for the treatment of osteoporotic vertical compression fracture. For the evaluation of bone mass, bone densitometry was performed in 45 patients, and to assess the recent evolution of the fracture, all 98 underwent MRI. Percutaneous vertebroplasty involves percutaneous transpedicular puncture of the involved vertebrae followed by the injection of a Polymethylmethacrylate(PMMA)-Barium mixture into the vertebral body. To assess leakage of the mixture into the epidural tissue, neural foramina, venous plexus and paravertebral tissue, we then immediately obtained a computerized tomographic (CT) scan, assessing the clinical efficacy of the procedure on the basis of time required for pain relief (defined as more than 60% reduction of initial pain), and time required for ambulation without significant pain. RESULTS: Percutaneous vertebroplasty was successful in all patients. Pain relief was accomplished within 1-5(mean, 1.8) days and early ambulation without significant pain was possible within 2 -15 (mean, 3.3) days. Post-procedural CT scanning revealed leakage of the PMMA-barium mixture into Paravertebral tissue(n=41), the paravertebral venous plexus (n=34) and epidural tissue (n=4). No neural foraminal leakage was identified, and no procedure-related complication requiring surgical treatment occurred. CONCLUSION: Percutaneous vertebroplasty is an effective new interventional procedure for the treatment of osteoporotic vertebral compression fracture. It relieves pain, provides early mobilization, and strengthens involved vertebral bodies.