Comparison of the Amounts of Canal Encroachment Between Semisitting and Supine Position of Computed Tomography-Myelography for Vertebral Fractures of the Elderly Involving the Posterior Vertebral Wall

Hayashi, Tetsuo; Maeda, Takeshi; Ueta, Takayoshi; Shiba, Keiichiro; Iwamoto, Yukihide

doi:10.1097/brs.0b013e31825e71a4

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Basic data of all patients included age, sex, injury mechanism of fracture, bone density, and spinal canal occupational ratio. The spinal canal occupational ratio was assessed by computed tomography (CT) of the spine using the following equation:

[1 - A / (B + C) / 2] \times 100

where A is the diameter of the spinal canal at the fractured level, B is the diameter of the spinal canal at the superior nonfractured level, and C is the diameter of the spinal canal at the inferior nonfractured level 23 . According to Schnake's morphological osteoporotic fracture classification, all patients in our study met the criteria for type II of osteoporotic fracture: Deformation without or with only minor involvement of the posterior wall (<1/5) 24 .…”

Section: Methodsmentioning

confidence: 99%

“…where A is the diameter of the spinal canal at the fractured level, B is the diameter of the spinal canal at the superior nonfractured level, and C is the diameter of the spinal canal at the inferior nonfractured level 23 . According to Schnake's morphological osteoporotic fracture classification, all patients in our study met the criteria for type II of osteoporotic fracture: Deformation without or with only minor involvement of the posterior wall (<1/5) 24 .…”

Section: Patientsmentioning

confidence: 99%

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Lateral‐Opening Injection Tool Used in Percutaneous Vertebroplasty to Treat Asymptomatic Osteoporotic Vertebral Burst Fractures: A Retrospective Study

Sun

Wang

Liu

et al. 2022

Orthopaedic Surgery

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Objective The adequate management of asymptomatic osteoporotic vertebral burst fractures (OVBFs) was still controversial. Percutaneous vertebroplasty (PVP) could achieve quick recovery with minor trauma, but there were certain safety problems by traditional bone cement injection method. Thus, the aim of this study was to assess the efficacy of lateral‐opening injection tool used in PVP treating patients with asymptomatic OVBFs. Methods This was a retrospective study of OVBFs treated in our institute from March 2016 to March 2020. A total of 66 patients (mean age 72.10 ± 7.98 years, with 21 men and 45 women) who were diagnosed with acute asymptomatic OVBFs with mild spinal canal compromise were treated with PVP by using a lateral‐opening injection tool. Two puncture needles were simultaneously placed transpedicularly in the fractured vertebra, and the inner core was removed, and the lateral‐opening injection tool was inserted. The adjustment of lateral hole was to improve the distribution height of bone cement and avoid the entry of bone cement into the posterior wall of vertebral body. Related clinical outcomes and images were assessed, including back pain (visual analog scale [VAS]), vertebral height ratio (fractured vertebral height/average adjacent nonfractured vertebral height), kyphosis Cobb angle, union of the fractured vertebral posterior wall, distribution of bone cement, surgical data, and complications. Results The average follow‐up time of all cases was 21.23 ± 9.35 months. The mean amount of bone cement was 3.28 ± 0.35 ml in the vertebrae and the mean operative time was 34.02 ± 5.23 min. There were 60 cases of bone cement that contacted the upper and lower endplates on at least one side. There was no cement leakage into the spinal canal or fracture displacement of the posterior wall of the vertebral body in all cases. The VAS scores were 3.78 ± 0.42 at 1 day postoperatively and 0.53 ± 0.40 at the last follow‐up, significantly lower than 8.40 ± 0.48 preoperatively (p < 0.05). The average height ratio of anterior, middle, and posterior vertebral body after operation increased compared with that pre‐operation (p < 0.05), and the postoperative kyphosis angle decreased (p < 0.05). At 6 months follow‐up, there was no significant height loss of the vertebral body. Computed tomography examination 3 months postoperatively showed that the fracture of posterior vertebral wall healed well in all cases. There were seven cases of bone cement leakage without clinical symptoms and two adjacent vertebral fractures caused by falling. There were no cases of deep vein embolism, lower limb muscle atrophy, pneumonia, decubitus. Conclusion The lateral opening tool can be safely and effectively used in the PVP treatment on asymptomatic OVBFs with mild spinal canal compromise.

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[1 - A / (B + C) / 2] \times 100

Section: Methodsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Lateral‐Opening Injection Tool Used in Percutaneous Vertebroplasty to Treat Asymptomatic Osteoporotic Vertebral Burst Fractures: A Retrospective Study

Sun

Wang

Liu

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

“…[1-A/(B+C)/2] * 100 where A is the diameter of the spinal canal at the fractured level; B is the diameter of the spinal canal at the superior nonfractured level; and C is the diameter of the spinal canal at the inferior nonfractured level [19].…”

Section: Study Design and Patientsmentioning

confidence: 99%

A Lateral Opening Injection Tool Used In Percutaneous Vertebroplasty To Treat Asymptomatic Osteoporotic Vertebral Burst Fractures: A Retrospective Study In 66 Cases

Sun

Jia

Liu

et al. 2021

Preprint

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Background: This study aimed to assess the results of percutaneous vertebroplasty (PVP) with a lateral opening injection tool for treating asymptomatic osteoporotic vertebral burst fractures (OVBFs) patients.Methods: 66 patients diagnosed with acute asymptomatic OVBFs with a spinal canal occupational ratio under 20% were treated with bilateral PVP using a lateral opening injection tool in our study. The related clinical outcomes and images were assessed, including Visual Analogue Scale (VAS), vertebral height (VH) ratio (=fractured VH/ adjacent nonfractured VH), the bone union of the fractured vertebral posterior wall, bone cement distribution, and complications.Results: The VAS scores were 3.80±0.40 at postoperative one day and 0.59±0.41 at last follow-up, significantly lower than 8.37±0.49 at pre-operation (P<0.05). The vertical distribution of bone cement in 60 cases contacted the upper and lower endplates of fractured vertebras. There was no leakage of bone cement in the spinal canal or displacement of posterior wall fracture to the spinal canal in all cases. There was asymptomatic cement leakage in 7 cases. The mean anterior, middle and posterior vertebral height ratios were significantly increased after PVP compared with preoperative values in all patients (P<0.05). At 6 months follow-up, there was no significant height loss of the vertebral body. Three months postoperatively, the posterior wall of fractured vertebral bodies was healed in all cases according to CT images. Conclusions: PVP using a lateral opening injection tool was effective and safe for treating asymptomatic OVBF patients.

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Morphology of the injured posterior wall causing spinal canal encroachment in osteoporotic vertebral fractures

et al. 2016

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Comparison of the Amounts of Canal Encroachment Between Semisitting and Supine Position of Computed Tomography-Myelography for Vertebral Fractures of the Elderly Involving the Posterior Vertebral Wall

Cited by 3 publications

References 13 publications

Lateral‐Opening Injection Tool Used in Percutaneous Vertebroplasty to Treat Asymptomatic Osteoporotic Vertebral Burst Fractures: A Retrospective Study

Lateral‐Opening Injection Tool Used in Percutaneous Vertebroplasty to Treat Asymptomatic Osteoporotic Vertebral Burst Fractures: A Retrospective Study

A Lateral Opening Injection Tool Used In Percutaneous Vertebroplasty To Treat Asymptomatic Osteoporotic Vertebral Burst Fractures: A Retrospective Study In 66 Cases

Morphology of the injured posterior wall causing spinal canal encroachment in osteoporotic vertebral fractures

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