Adjacent-level symptomatic fracture after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a retrospective analysis

Wang, Yuntao; Wu, Xiao‐Tao; Chen, Hui; Wang, Chen; Mao, Zubin

doi:10.1007/s00776-014-0610-7

Cited by 24 publications

(33 citation statements)

References 20 publications

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“…13,15,16 There are, however, studies that indicate excessive correction of kyphotic angle as a risk factor for the development of new OVFs adjacent to the treated segment. 6,16,20 Despite this, in our study we did not find any relationship between the correction of kyphotic angle and the development of new OVFs, either adjacent or not adjacent. Therefore, adding the high correlation between improved quality of life of the patients and correction of their kyphosis to the fact that no significant difference in the appearance of new OVFs was found, balloon kyphoplasty could be recommended over vertebroplasty.…”

Section: Discussioncontrasting

confidence: 86%

“…[6][7][8]20 In our study, we did not observe any relationship between the volume of cement applied and the development of complications with cement leakage or the appearance of new OVFs, or between the volume of cement and both radiographic and clinical improvement. These results are consistent with those reported in the literature, 6,16,20 so we are not able to recommend the ideal volume of cement for obtaining a satisfactory result or minimizing the occurrence of complications.…”

Section: Discussioncontrasting

confidence: 57%

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Kyphoplasty and Vertebroplasty in the Treatment of Osteoporotic Vertebral Fractures

García¹,

Ángel²,

Amado³

et al. 2018

Coluna/Columna

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Objective: To compare these procedures in the treatment of osteoporotic vertebral compression fractures. Methods: Patients who underwent vertebral augmentation procedures between March 2010 and October 2016 were selected for the study. Kyphosis, anterior vertebral height, Oswestry Disability Index (ODI), Visual Analog Scale (VAS), number of portals, cement volume, and complications were recorded. The results were analyzed by difference of the means. Results: Sixty-eight patients were selected, accounting for 105 procedures. A statistically significant improvement was observed in VAS and ODI with both procedures (p<0.001) without statistically significant difference between them, regardless of the number of portals or cement applied. There was a high correlation between kyphosis correction and ODI improvement (p=0.012). Conclusions: Both vertebroplasty and kyphoplasty are effective procedures for the treatment of vertebral compression fractures. We found no significant difference between both procedures. The high correlation between improvement of kyphosis and ODI suggests that these procedures are better than conservative treatment to improve the quality of life of patients, however more studies are required to reach a final conclusion.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussioncontrasting

confidence: 57%

Kyphoplasty and Vertebroplasty in the Treatment of Osteoporotic Vertebral Fractures

García¹,

Ángel²,

Amado³

et al. 2018

Coluna/Columna

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“…Several reports have indicated potential risk factors for the development of AVF, including preoperative local kyphosis, hardness of the cement, low bone density, low body mass index, age, and cement leakage [13,18,[20][21][22][23][24]. Of these, cement leakage was thought to play a role, inasmuch as the incidence of AVF was low among patients with short disease duration.…”

Section: Discussionmentioning

confidence: 99%

Postoperative Clinical Outcomes of Balloon Kyphoplasty Treatment: Would Adherence to Indications and Contraindications Prevent Complications?

Momomura

Shimamura

2020

Asian Spine J

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Study Design: We retrospectively assessed the postoperative clinical outcomes of balloon kyphoplasty (BKP).Purpose: To evaluate the risk factors for complications and to reconfirm the indications and contraindications for BKP.Overview of Literature: In Japan, BKP is indicated for cases of osteoporotic vertebral fractures when pain is not improved even after an adequate period of conservative treatment. Contraindications to BKP include pedicle fracture, fracture of a flat vertebra, or fracture of the posterior wall of the vertebral body diagnosed on computed tomography.Methods: Seventy-five patients who underwent BKP in our institution participated in this study; 49 provided follow-up data. Those with complications and persistent pain were assigned to the “eventful” group; the others, to the “uneventful” group. We evaluated risk factors for complications and persistent pain, including the presence or absence of severe posterior wall injury/pedicle fracture, the shape of the vertebral body, and the time period from onset of pain to BKP.Results: The incidences of severe posterior wall injury, pedicle fracture, and flattened vertebral body did not differ significantly between the uneventful and eventful groups. However, there was a significant difference in disease duration between those with and those without adjacent vertebral fractures (AVFs): The incidence of AVF was lower among patients with disease of less than 8 weeks’ duration.Conclusions: Disease duration is a possible risk factor for developing AVF, whereas other characteristics were not risk factors for complications after BKP. Although it has been suggested that BKP treatment in the early phase after injury results in a good outcome, the indications should be determined according to prognosis that is based on findings obtained with tools such as imaging examinations.

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“…On the basis of different inclusion criteria, studies have reported the risk of an adjacent fracture after PVP may increase with a lower BMD (6,(16)(17)(18), greater age (16,19), female gender, and cement leakage to disc (19,20), intervertebral vacuum (16), lower BMI (21), increased preoperative segmental kyphosis (22), greater anterior height restoration rate (18), the distribution of cement within the fracture (23) and a larger number of fractures (17,(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Earlier Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture May Minimize the Subsequent Development of Adjacent Fractures: A Retrospective Study

Lee

2018

Pain Phys

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Background: Percutaneous vertebroplasty (PVP) is widely used to treat osteoporotic vertebral compression fractures (OVCFs). The influence of timing (early vs. late) of PVP on the development of adjacent vertebral fractures (AVF) has rarely been discussed. Objective: This study aimed to compare the incidence of AVF among patients who received early PVP (≤ 30 days after symptom onset, EPVP) or late PVP (> 30 days after symptom onset, LPVP) in the thoracolumbar region (T10 to L2) after a 1-year follow up. Study Design: A retrospective cohort study. Setting: Department of Orthopedic, an affiliated hospital of a medical university. Methods: Patients who had single-level, T-score ≤ -2.5 of lumbar bone mineral density (BMD), primary OVCF in the thoracolumbar region (T10 to L2) and who received PVP between July 2012 and June 2014 were included in the study. They were divided into early PVP and late PVP groups according to the interval between symptom onset and treatment. The risk factors associated with subsequent AVFs were analyzed. Results: Of the 225 patients reviewed, 124 met the criteria and were followed for a minimum of 1 year. Eleven patients (14.1%) in the EPVP group (n = 78) and 18 patients (39.1%) in the LPVP group (n = 46) experienced an AVF during the first year following vertebroplasty. Outcomes were significantly better in patients with higher bone mineral density, lower cement volume, and without cement leakage (P < 0.01). Cox regression indicated an increase risk for AVF for LPVP, with an adjusted hazard ratio of 6.08 (95% confidence interval: 2.50–14.81). Limitation: The incidence of AVFs could be over estimated due to this being a retrospective study with a small case number and lack of either biomechanical study of intra-vertebral cement distribution by times to support the result. Conclusions: Compared with later interventions, PVP performed within 30 days after fracture development may be associated with a lower risk of adjacent fractures in the thoracolumbar region. Key words: Percutaneous vertebroplasty, osteoporosis, osteoporotic vertebral compression fracture, adjacent vertebral fracture

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Adjacent-level symptomatic fracture after percutaneous vertebral augmentation of osteoporotic vertebral compression fracture: a retrospective analysis

Cited by 24 publications

References 20 publications

Kyphoplasty and Vertebroplasty in the Treatment of Osteoporotic Vertebral Fractures

Kyphoplasty and Vertebroplasty in the Treatment of Osteoporotic Vertebral Fractures

Postoperative Clinical Outcomes of Balloon Kyphoplasty Treatment: Would Adherence to Indications and Contraindications Prevent Complications?

Earlier Vertebroplasty for Osteoporotic Thoracolumbar Compression Fracture May Minimize the Subsequent Development of Adjacent Fractures: A Retrospective Study

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