Clinical Outcomes of Fracture Haemorrhage Aspiration for Percutaneous Vertebroplasty in Treating Osteoporotic Vertebral Compression Fractures

Abstract

Background A retrospective study aimed to introduce a new method for improving the diffusion degree of bone cement and to observe its clinical efficacy in percutaneous vertebroplasty treating osteoporotic vertebral compression fractures (OVCFs). Methods From January 2019 to March 2020, a total of 83 patients were enrolled and reviewed. The patients were divided into two groups according to the operation method. The clinical and radiographic parameters were recorded and compared between these two groups. Those who received percutaneous vertebroplasty with haemorrhage aspiration were recorded as group A (n=42). In group A, the haemorrhage in the vertebral fracture was aspirated compared with conventional percutaneous vertebroplasty. Patients who underwent conventional percutaneous vertebroplasty were classified as group B (n=41). Results Visual analogue scale (VAS) values and Oswestry Disability Index (ODI) scores showed no significant difference between the two groups preoperatively, postoperatively or at the final follow-up (FU) (P>0.05). The intraoperative VAS score (bone cement injection) in group A was significantly lower than that in group B (3.83±0.79 vs 5.44±1.32, P < 0.01). The local kyphotic angle (LKA) (final follow-up), LKA loss, fractured vertebral anterior height loss (FVAHL) and anterior vertebral height loss ratio (AVHLR) were significantly lower in group A than in group B. The anterior vertebral height ratio (AVHR) at the final FU in group A was higher than that in group B (P=0.013). The distribution of bone cement was significantly different (P=0.034). By analysing the distribution pattern of bone cement, it was found that the values of LKA loss, FVAHL and AVHLR were superior in the type A bone cement distribution to those in types B and C. Conclusion Compared with traditional surgical methods, bone haemorrhage aspiration could improve the diffusion degree of bone cement and reduce the height loss and deformity of injured vertebrae. This method provides a feasible new scheme for improving the dispersion of bone cement.

Establishment and Verification of a Predictive Nomogram for New Vertebral Compression Fracture Occurring after Bone Cement Injection in Middle‐Aged and Elderly Patients with Vertebral Compression Fracture

“…Several studies have focused on the degree of diffusion of bone cement, which exerts a significant impact on biomechanical aspects, such as the stability and mechanical properties of the fracture site. Some studies have shown that the asymmetric distribution of the vertebral body and excessive filling of cement volume lead to the transfer and switching of unilateral load, resulting in NVCF 40,41 . The height and strength of the vertebral body recovered well, and the risk of vertebral recompression decreased significantly when the bone cement was in contact with the upper and lower endplates 40,41 .…”

“…Some studies have shown that the asymmetric distribution of the vertebral body and excessive filling of cement volume lead to the transfer and switching of unilateral load, resulting in NVCF 40,41 . The height and strength of the vertebral body recovered well, and the risk of vertebral recompression decreased significantly when the bone cement was in contact with the upper and lower endplates 40,41 . At the same time, some experts believe that when the cement distribution is wide enough (i.e., the area between the midline and contralateral pedicle), unilateral PKP can significantly restore the height of the vertebral body and provide a good therapeutic effect 15 .…”

“…40,41 The height and strength of the vertebral body recovered well, and the risk of vertebral recompression decreased significantly when the bone cement was in contact with the upper and lower endplates. 40,41 At the same time, some experts believe that when the cement distribution is wide enough (i.e., the area between the midline and contralateral pedicle), unilateral PKP can significantly restore the height of the vertebral body and provide a good therapeutic effect. 15 Therefore, good cement diffusion has a positive impact on fracture site stability, mechanical properties, and stress distribution, effectively preventing NVCF in the vertebral body.…”

Risk–benefit ratio of percutaneous kyphoplasty and percutaneous vertebroplasty in patients with newly diagnosed multiple myeloma with vertebral fracture: a single-center retrospective study

“…The results of the study showed that only less than 10% of patients in the surgical group obtained sustained pain relief after surgery, more than half of the patients obtained only short-term pain relief for less than 3 months, and about one-third of the patients had no pain relief after surgery, so the effect of surgical pain relief was not satisfactory. In patients with osteoporosis alone, the effect of PVP/PKP on pain relief has been inconsistently concluded in different studies, with most studies concluding that patients had significant pain relief within 1 year after surgery [ 26 , 27 ]. However, some studies have also concluded that there was no significant improvement in pain in the surgical group compared to the placebo group [ 28 ].…”

Percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar vertebral compression fractures, unilateral OR bilateral？A large retrospective cohort study

“…Steinmann et al [9] found no signi cant difference in stiffness and strength between unilateral and bilateral percutaneous kyphoplasty. Therefore, percutaneous kyphoplasty is becoming a common surgical option for the treatment of osteoporotic vertebral fractures [10][11]. Traditionally, retrobulbar kyphoplasty was performed by injecting polymethylmethacrylate bone cement through the working channel established by the pedicle on both sides.…”