Effects of high viscosity bone cement percutaneous vertebroplasty on pain, bone specific alkaline phosphatase, Type-I collage cross-linked-telopeptide and Boneglaprotein levels in patients with osteoporotic vertebral compression fractures.

Objectives: To investigate the effects of percutaneous vertebroplasty with high viscosity bone cement on pain and the levels of bone specific alkaline phosphatase (BALP), Type-I collagen cross-linked telopeptide (CTX) and serum osteocalcin (BGP) in patients with osteoporotic vertebral compression fractures. Methods: The medical records of patients with osteoporotic vertebral compression fractures treated in our hospital from February 2020 to February 2021 were selected after retrospective analysis. Patients (43) who received low viscosity bone cement percutaneous vertebroplasty comprised Group-I, and patients (56) who received high viscosity bone cement percutaneous vertebroplasty, comprised Group-II of the study. The occurrence of bone cement leakage, pain (VAS scores), BALP, CTX and BGP were compared and analyzed between the two groups. Results: The incidence of bone cement leakage in Group-II was 16.28%, lower than 3.57% in Group-I (P<0.05). The visual analogue scale (VAS) scores of patients in Group-II were lower than those in Group-I at one and three months after the surgery (P<0.05). The levels of BALP and BGP in Group-II were higher than those in Group-I three months after the surgery (P<0.05), and CTX was lower than those in Group-I (P<0.05). Conclusions: Percutaneous vertebroplasty with high viscosity bone cement in the treatment of osteoporotic vertebral compression fractures can reduce the incidence of bone cement leakage and help to further reduce pain and improve bone metabolism.

Selections of Bone Cement Viscosity and Volume in Percutaneous Vertebroplasty: A Retrospective Cohort Study.

OBJECTIVE: We sought to evaluate the efficacy and complications of percutaneous vertebroplasty with different viscosities and volumes of bone cement in treating osteoporotic vertebral compression fractures (OVCFs). METHOD: We conducted a retrospective cohort study of 307 patients treated for a single thoracolumbar level (T12-L2) OVCF in our hospital between January 2014 and December 2019. The patients were divided into 6 groups according to different viscosities (I: low-viscosity bone cement, II: high-viscosity bone cement) and injection volumes (A, 2-4 mL; B, 4-6 mL; C, 6-8 mL) of bone cement. Clinical and radiologic characteristics including visual analog scale, local kyphotic angle, anterior vertebral height ratio, cement leakage, and vertebral body recollapse rate were collected preoperatively, 2 days postoperation, and at the last follow-up to assess the efficacy and complications of each group. RESULTS: Regarding efficacy, there was no significant difference between the 2 kinds of bone cement. Injecting >4 mL of cement can provide patients with good improvements of clinical indicators and a low vertebral body recollapse rate. Injecting 6-8 mL of bone cement slightly improved the radiologic indicators. However, the leakage rate of low-viscosity bone cement increased significantly when the volume exceeded 6 mL. The leakage rate of high-viscosity bone cement did not increase significantly at the volume of 6-8 mL. CONCLUSIONS: In summary, when treating single thoracolumbar level OVCFs, the recommended volume of low-viscosity bone cement is 4-6 mL while the optimal volume of high-viscosity bone cement is 6-8 mL.

Tibial Component Migration After Total Knee Arthroplasty With High-Viscosity Bone Cement.

BACKGROUND: High-viscosity (HV) bone cements have been formulated to offer potentially advantageous handling characteristics. However, alteration in the handling characteristics could influence implant fixation and survival. The primary objective of this study was to use radiostereometric analysis after total knee arthroplasty to assess the migration of the Triathlon tibial component fixed with HV cement (Simplex HV). METHODS: Twenty-three patients were followed for two years with radiostereometric analysis examinations at 6 visits. Migration was compared with published thresholds and with a control group from a previously published study from the same center using the same implants fixed with a medium viscosity cement. Inducible displacement was assessed, and Oxford 12 Knee Scores and satisfaction were recorded. RESULTS: Mean maximum total point motion migration reaching 0.40 mm (SD 0.16) at one year, and 0.41mm (SD 0.17) at two years, demonstrating a pattern of stable fixation, below published thresholds of acceptable migration, and not significantly different from the control group. One implant had continuous migration between 1 and 2 years but was clinically asymptomatic. Mean maximum total point motion inducible displacement measured at least one year postoperatively was 0.3 mm (SD 0.12). Mean Oxford 12 Knee Scores improved from 19 (SD 7) preoperatively to 42 (SD 8) 2 years postoperatively. CONCLUSIONS: The use of HV cement demonstrated an acceptable pattern of migration at 2 years, indicating low risk for aseptic loosening.

Efficacy and complications of different viscosities of high-dose bone cement applied in percutaneous vertebroplasty / 中国组织工程研究

BACKGROUND: Percutaneous vertebroplasty has been extensively applied In the treatment of senile osteoporotic vertebral compression fracture with pain. However, the appropriate dose of bone cement remains controversial. OBJECTIVE: To compare the efficacy and complications of different viscosities of high-dose bone cement applied In the treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty. METHODS: One hundred and sixty-nine patients with single-segment osteoporotic fractures at thoracolumbar level (T12-L2) admitted at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from February 2014 to December 2018 were Included. All patients were treated by percutaneous vertebroplasty with high-dose (> 4 mL) bone cement at low viscosity (n=85, control group) and high viscosity (n=84, observation group). The Visual Analogue Scale score, anterior vertebral height, Cobb angle and bone cement leakage were recorded before and 2 days after surgery. The study was approved by the Medical Ethics Committee of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, China (approval No. SH9H-2019-T90-1). RESULTS AND CONCLUSION: (1) The Visual Analogue Scale score at postoperative 2 days in both groups were significantly lower than that at baseline (P 0.05). (2) The anterior vertebral height at postoperative 2 days in both groups was significantly higher than that at baseline (P 0.05). (3) Compared with the baseline level, the Cobb angle at postoperative 2 days in both groups was significantly decreased (P 0.05). (4) The incidence of bone cement leakage in the observation group (36/84,42.9%) was significantly lower than that in the control group (57/85, 67.1 %) (P < 0.05). The incidence of leakage In paravertebral vessels and spinal canal in the observation group was significantly lower than that in the control group (P < 0.05). (5) Peri-Implant Infection, allergic reaction, Immune and rejection reactions occurred in neither groups. (6) These results Indicate that treatment of senile osteoporotic vertebral compression fractures with high dose of low- and high-viscosity bone cement can result In good clinical outcomes. However, the Incidence of leakage is higher in the low-viscosity bone cement, and high-viscosity bone cement can significantly reduce the risk of leakage, especially the leakage of paravertebral blood vessels and spinal canal.

The research of clinical efficacy of high-viscosity bone cement in percutaneous vertebral plasty for treatment of osteoporotic vertebral compression fractures / 临床外科杂志

Objective To compare the clinical efficacy of high-viscosity and ordinary bone ce-ment in percutaneous vertebral plasty for treatment of osteoporotic vertebral compression fractures.Meth-ods Collected 80 osteoporotic vertebral compression fractures(OVCF)cases treated by percutaneous ver-tebroplasty(PVP). The patients were randomized into the high-viscosity group(high-viscosity bone ce-ment,50 patients)and the control group(ordinary bone cement,50 patients).Record the basic information of patients,visual analogue scale(VAS)and oswestry disability index(ODI)were used to evaluate the pain and lumbar function;through measuring the Cobb of X ray,film to compare the recovery of Cobb in two groups.Calculate and compare the incidence of leakage of bone cement and adjacent vertebral fracture in two groups. Results There were no statistically significant difference of VAS,ODI and Cobb in two groups compared with preoperative's(P>0.05).Immediately,3 days and 6 months after PVP,VAS,ODI and Cobb were reduced compared with baseline,the difference was statistically significant(P<0.05),the corresponding time point after operation,VAS,ODI and Cobb of high-viscosity group were lower than the control group,the difference was statistically significant(P<0.05).After PVP,the bone cement leakage rate were 18%(9/50)and 32%(16/50)in high-viscosity group and control group respectively(P <0.05).After PVP,the incidence of adjacent vertebral body fracturewere were 2%(1/50)and 6%(3/50) in high-viscosity group and control group respectively(P<0.05).Conclusion There are better clinical curative effect and less postoperative complications of OVCF patients treated with high-viscosity bone ce-ment in PVP.

Perioperative nursing for patients with osteoporotic vertebral compression fractures receiving vertebroplasty by using high viscosity bone cement / 介入放射学杂志

Objective To discuss the perioperative nursing measures for patients with osteoporotic vertebral compression fractures who are receiving percutaneous vertebroplasty (PVP) treatment by using high viscosity bone cement.Methods A total of 30 patients with osteoporotic vertebral compression fractures were included in this study.All patients were treated with PVP by using high viscosity bone cement.Preoperative routine nursing,psychological intervention,dietary intervention,postoperative guidance of rehabilitation exercise of limbs,close observation of bone cement leakage were strictly implemented,and the corresponding nursing measures were promptly taken when needed.Results Through strict implement of the nursing intervention all 30 patients could actively cooperate with PVP treatment,and after PVP the pain was significantly relieved in all patients.Conclusion Adequate preoperative preparation,proper postoperative guidance,careful observation and effective nursing can help the patients resume their daily life activities as soon as possible,relieve the pain,and improve the quality of life as well.(J Intervent Radiol,2017,26:274-276)

The clinical comparative study on high and low viscosity bone cement application in vertebroplasty.

OBJECTIVE: To investigate the clinical effect of high and low viscosity bone cement in vertebroplasty for treatment of osteoporotic vertebral compression fractures. METHODS: 40 cases of patients with osteoporotic thoracolumbar compression fractures admitted into department of orthopeadics in our hospital were reviewed. All patients were divided into high viscosity bone cement group (20 cases) and low viscosity bone cement group (20 cases). Visual Analog Score (VAS), Oswestry Dability Index (ODI), injured vertebral height restoration (Cobb Angle) and bone cement leakage rate, subsequent fracture rate of vertebrae body with or without surgical treatment were measured. RESULTS: Compared with the low viscosity bone cement group, the VAS score, ODI score and Cobb angle of high viscosity bone cement group had a statistical difference (P<0.05). The postoperative complications in high viscosity bone cement group were lower than those in low viscosity bone cement group (P<0.05). CONCLUSION: Compared with low viscosity bone cement, bone cement leakage rate reduced obviously in high viscosity bone cement with good clinical effect and prognosis in vertebroplasty for treatment of osteoporotic thoracolumbar compression fractures.

The application of high viscosity bone cement in treating severe osteoporotic vertebral body compression fractures / 介入放射学杂志

Objective To discuss the short-term curative effect and the safety of percutaneous vertebroplasty using high viscosity bone cement for the treatment of severe osteoporotic vertebral body compression fractures. Methods The clinical data of 100 patients with severe osteoporotic vertebral body compression fractures (compression degree>70%), who received percutaneous vertebroplasty by using high viscosity bone cement during the period from December 2010 to May 2013, were retrospectively analyzed. All the patients were followed up for at least one month. Both preoperative and postoperative visual analogue scale (VAS) and quality of life (QOL) scores, as well as the incidence of bone cement leakage, were recorded and the results were used to evaluate the curative effect and the safety of percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Results One week after the treatment, significant pain relief was obtained in 92 patients (92%), VAS scores decreased from preoperative (7.0 ±1.2) to postoperative (2.0±1.5), and QOL scores increased from preoperative (30±5.0) to postoperative (80±18.0);the differences were statistically significant (P0.05). Leakage of bone cement was observed in 40 patients (40%), resulting no severe neurological symptoms; among the 40 patients, intervertebral disc leakage at above and below the vertebral body was detected in 28 patients (70%), vertebral anterior edge leakage was observed in 11 patients (27.5%) and vertebral posterior edge leakage was seen in one patient (2.5%). Conclusion For the treatment of severe osteoporotic vertebral body compression fractures, percutaneous vertebroplasty by using high viscosity bone cement is safe and effective.