Top

Journal of Orthopaedic Surgery and Research

Published in:

Open Access 01-12-2020 | Research article

Comparison of targeted percutaneous vertebroplasty and traditional percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures in the elderly

Authors: Lingli Yuan, Jianzhong Bai, Chunhui Geng, Guansheng Han, Wendi Xu, Zhongchuan Zhang, Hong Luo, Xunbing Zhu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2020

Abstract

Objective

To investigate the clinical effect of precise puncture and low-dose bone cement in percutaneous vertebroplasty (PVP).

Methods

Sixty patients with osteoporotic vertebral compression fracture (OVCFs) who were treated with PVP in our hospital from July 2018 to June 2019. These included patients were divided into group A (N = 30) and group B (N = 30). Group A has punctured to the fracture area accurately and injected with a small dose of bone cement, the group B was injected with a conventional dose of bone cement. The operation time, the amount of bone cement injection, the number of X-rays, the VAS scores, the leakage rate of bone cement, and the incidence of adjacent vertebral fractures were compared between the two groups.

Result

The operation time, fluoroscopic times, and bone cement volume in group A are less than that in group B (P < 0.05). Patients in group A had a lower incidence of cement leakage and adjacent vertebral fracture than that in patients in group B. There was no significant difference in postoperative pain relief between the two groups.

Conclusions

Precise puncture and injection of small doses of bone cement can reduce the number of X-ray fluoroscopy, operation time, amount of bone cement injection, reduce the rate of bone cement leakage and the incidence of adjacent vertebral fractures, which is a safe and effective surgical approach for the treatment for the aged with OVCFs.

Lou S, Shi X, Zhang X, Lyu H, Li Z, Wang Y. Percutaneous vertebroplasty versus non-operative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials. Osteoporos Int. 2019;30(12):2369–80.PubMedCrossRef

van Schoor NM, Smit JH, Twisk JW, Lips P. Impact of vertebral deformities, osteoarthritis, and other chronic diseases on quality of life: a population-based study. Osteoporos Int. 2005;16(7):749–56.PubMedCrossRef

Rostom S, Allali F, Bennani L, Abouqal R, Hajjaj-Hassouni N. The prevalence of vertebral fractures and health-related quality of life in postmenopausal women. Rheumatol Int. 2012;32(4):971–80.PubMedCrossRef

Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neuro-Chirurgie. 1987;33(2):166–8.PubMed

Liu T, Li Z, Su Q, Hai Y. Cement leakage in osteoporotic vertebral compression fractures with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty surgery. Medicine. 2017;96(25):e7216.PubMedPubMedCentralCrossRef

Zhu SY, Zhong ZM, Wu Q, Chen JT. Risk factors for bone cement leakage in percutaneous vertebroplasty: a retrospective study of four hundred and eighty five patients. Int Orthop. 2016;40(6):1205–10.PubMedCrossRef

Kaufmann TJ, Trout AT, Kallmes DF. The effects of cement volume on clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol. 2006;27(9):1933–7.PubMed

Wenger M, Markwalder TM. Re: Percutaneous vertebroplasty for pain relief and spinal stabilization (Spine 2000; 25: 923-8). Spine. 2000;25(22):2968–9.PubMedCrossRef

Itshayek E, Miller P, Barzilay Y, Hasharoni A, Kaplan L, Fraifeld S, Cohen JE. Vertebral augmentation in the treatment of vertebral compression fractures: review and new insights from recent studies. J Clin Neurosci. 2012;19(6):786–91.PubMedCrossRef

10.

Furtado N, Oakland RJ, Wilcox RK, Hall RM. A biomechanical investigation of vertebroplasty in osteoporotic compression fractures and in prophylactic vertebral reinforcement. Spine. 2007;32(17):E480–7.PubMedCrossRef

11.

Afzal S, Dhar S, Vasavada NB, Akbar S. Percutaneous vertebroplasty for osteoporotic fractures. Pain Physician. 2007;10(4):559–63.PubMed

12.

Lu CH, Liu ZJ, Zhang HP, Chang Z, Wang Y, Zhou WP. Effect of the volume and distribution of bone cement on the adjacent vertebrae after vertebroplasty: a finite analysis. Chin J Osteopor. 2015;1:29–33.

13.

Belkoff SM, Mathis JM, Erbe EM, Fenton DC. Biomechanical evaluation of a new bone cement for use in vertebroplasty. Spine. 2000;25(9):1061–4.PubMedCrossRef

14.

Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, Chastanet P, Duquesnoy B, Deramond H. Percutaneous vertebroplasty: state of the art. Radiographics. 1998;18(2):311–20 discussion 320-313.PubMedCrossRef

15.

Reidy D, Ahn H, Mousavi P, Finkelstein J, Whyne CM. A biomechanical analysis of intravertebral pressures during vertebroplasty of cadaveric spines with and without simulated metastases. Spine. 2003;28(14):1534–9.PubMed

16.

Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures: identification of risk factors. Spine J. 2011;11(9):839–48.PubMedCrossRef

17.

Sun G, Tang H, Li M, Liu X, Jin P, Li L. Analysis of risk factors of subsequent fractures after vertebroplasty. Eur Spine J. 2014;23(6):1339–45.PubMedCrossRef

18.

Lu K, Liang CL, Hsieh CH, Tsai YD, Chen HJ, Liliang PC. Risk factors of subsequent vertebral compression fractures after vertebroplasty. Pain Med. 2012;13(3):376–82.PubMedCrossRef

19.

Berlemann U, Ferguson SJ, Nolte LP, Heini PF. Adjacent vertebral failure after vertebroplasty. A biomechanical investigation. J Bone Joint Surg (Br). 2002;84(5):748–52.CrossRef

20.

Huang TJ, Kou YH, Yin XF, Xiong J, Zhang PX, Zhang DY, Fu ZG, Xue F, Jiang BG. Clinical characteristics and risk factors of newly developed vertebral fractures after vertebral augmentation. Beijing Da Xue Xue Bao. 2015;47(2):237–41.PubMed

21.

Ning L, Wan S, Liu C, Huang Z, Cai H, Fan S. New levels of vertebral compression fractures after percutaneous kyphoplasty: retrospective analysis of styles and risk factors. Pain Physician. 2015;18(6):565–72.PubMed

22.

Schulte TL, Keiler A, Riechelmann F, Lange T, Schmoelz W. Biomechanical comparison of vertebral augmentation with silicone and PMMA cement and two filling grades. Eur Spine J. 2013;22(12):2695–701.PubMedPubMedCentralCrossRef

23.

Gilula L, Persenaire M. Subsequent fractures post-vertebral augmentation: analysis of a prospective randomized trial in osteoporotic vertebral compression fractures. AJNR Am J Neuroradiol. 2013;34(1):221–7.PubMedCrossRef

24.

Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine. 2001;26(14):1547–54.PubMedCrossRef

25.

Han S, Jang IT. Analysis of adjacent fractures after two-level percutaneous vertebroplasty: is the intervening vertebral body prone to re-fracture? Asian Spine J. 2018;12(3):524–32.PubMedPubMedCentralCrossRef

26.

Deibert CP, Gandhoke GS, Paschel EE, Gerszten PC. A longitudinal cohort investigation of the development of symptomatic adjacent level compression fractures following balloon-assisted kyphoplasty in a series of 726 patients. Pain Physician. 2016;19(8):E1167–e1172.PubMed

27.

Takahara K, Kamimura M, Moriya H, Ashizawa R, Koike T, Hidai Y, Ikegami S, Nakamura Y, Kato H. Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women. BMC Musculoskelet Disord. 2016;17:12.PubMedPubMedCentralCrossRef

28.

Cui W, Liu B, Wang L, Kang W, Chen B. The correlation analysis of balloon volume and bone cement volume in percutaneous kyphoplasty. Zhonghua Wai Ke Za Zhi. 2015;53(4):289–93.PubMed

29.

Nieuwenhuijse MJ, Muijs SP, van Erkel AR, Dijkstra SP. A clinical comparative study on low versus medium viscosity polymethylmetacrylate bone cement in percutaneous vertebroplasty: viscosity associated with cement leakage. Spine (Phila Pa 1976). 2010;35(20):E1037–44.CrossRef

30.

Wang CH, Ma JZ, Zhang CC, Nie L. Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Pain Physician. 2015;18(2):E187–94.PubMed

Title: Comparison of targeted percutaneous vertebroplasty and traditional percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures in the elderly
Authors: Lingli Yuan
Jianzhong Bai
Chunhui Geng
Guansheng Han
Wendi Xu
Zhongchuan Zhang
Hong Luo
Xunbing Zhu
Publication date: 01-12-2020
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2020
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-020-01875-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of targeted percutaneous vertebroplasty and traditional percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures in the elderly

Abstract

Objective

Methods

Result

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Result

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2020

RETRACTED ARTICLE: Comparison of bone morphogenetic protein and autologous grafting in the treatment of limb long bone nonunion: a systematic review and meta-analysis

The role of antibiotic-loaded bone cement in complicated knee arthroplasty: relevance of gentamicin allergy and benefit from revision surgery — a case control follow-up study and algorithmic approach

Comparison of concomitant injuries and patient-reported outcome in patients that have undergone both primary and revision ACL reconstruction—a national registry study

An analysis on the effect of the three-incision combined approach for complex fracture of tibial plateau involving the posterolateral tibial plateau

Risk factors for lung metastasis at presentation with malignant primary osseous neoplasms: a population-based study

Treatment of patellar dislocation with arthroscopic medial patellofemoral ligament reconstruction using gracilis tendon autograft and modified double-patellar tunnel technique: minimum 5-year patient-reported outcomes