Effects of cement augmentation on the mechanical stability of multilevel spine after vertebral compression fracture

Tan, Eelin; Wang, Tian; Pelletier, Matthew H.; Walsh, William R.

doi:10.21037/jss.2016.06.05

Cited by 8 publications

(4 citation statements)

References 49 publications

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“…Vertebral bodies treating with PVP will increase their mobility in all directions due to their limited height recovery. Tan E et al (34)found in a goat lumbar spine PVP model test that postoperative range of motion (ROM) and neutral zone (NZ) increased in all directions of motion after fracture, and cement augmentation could not restore the normal biomechanics of the spine. Jhong GH et al (35)found that AVHR increased ROM in extension in a lumbar spine model test.…”

Section: Discussionmentioning

confidence: 99%

Safety and prognosis of repeated vertebroplasty in the treatment of osteoporotic vertebral fractures

Zou

Qiu

Jin

et al. 2022

Preprint

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Purpose The number of patients with re-fracture after vertebral augmentation has gradually increased. Usually, these patients are re-treated with vertebral augmentation, but less attention has been paid to the safety and prognosis of repeated and multi-level treatment with percutaneous vertebroplasty(PVP). This study aims to retrospectively analyze the safety and prognosis of repeated PVP in the treatment of patients with osteoporotic vertebral fractures (OVFs), and to further analyze the factors affecting their prognosis. Methods A retrospective analysis of 61 patients with re-fractures after vertebral augmentation who received PVP treatment again from January 2019 to December 2021. The patients were divided into pain group and pain-free group according to their back pain status at last follow-up. The following covariates were reviewed: Age, bone mineral density(BMD), bone cement dosage, bone cement leakage, body mass index (BMI); and the rate of anterior vertebral height(AVH) loss in the target before surgery, 1 week after surgery and at last follow-up. The patients were assessed using Visual analogue scale score (VAS), Oswestry Disability Index (ODI). Results A total of 61 patients were included, 17 in the pain group and 44 in the pain-free group. Binary logistic regression analysis revealed the rate of AVH loss at 1 week postoperatively and last follow-up was associated with postoperative back pain. According to the ROC curve analysis, the area under the curvature(AUC) of the AVH loss rate at 1 week after operation was 0.6845, and the cut-off value was 0.18; the AUC of the AVH loss rate at the last follow-up was 0.7306, and the cut-off value was 0.2815. Further Kaplan-Meier survival analysis showed that patients with lower AVH loss rates had lower incidence of postoperative back pain and better prognosis. Conclusion PVP is safe and effective in the short term for patients with re-fracture after vertebral augmentation. Postoperative back pain was strongly associated with AVH loss at 1 week postoperatively and at last follow-up. Patients with a lower rate of AVH loss had a lower incidence of postoperative back pain and a better prognosis.

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Section: Discussionmentioning

confidence: 99%

Safety and prognosis of repeated vertebroplasty in the treatment of osteoporotic vertebral fractures

Zou

Qiu

Jin

et al. 2022

Preprint

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“…For animal models, the lumbar vertebrae of goats are considered anatomically and biomechanically similar to humans [24]. Many related studies have utilized goats as experimental subjects, including the development of a vertebral bone defect model [25], an experimental model for PV procedures [26], and the spinal mechanical stability after cement augmentation [27]. Accordingly, we choose goats as an ex vivo animal model for the evaluation of the efficacy of APV.…”

Section: Introductionmentioning

confidence: 99%

Impact of Aspiration Percutaneous Vertebroplasty in Reducing Bone Cement Leakage and Enhancing Distribution—An Ex Vivo Study in Goat Vertebrae

Lin

Tsuei

et al. 2023

Bioengineering

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Osteoporosis-induced vertebral compression fracture (OVCF) occurs commonly in people over the age of 50, especially among menopausal women. Besides conservative therapy, minimally invasive percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used in clinical treatment and achieved good efficacy. However, the leakage of bone cement (CL) during vertebroplasty (PV) is a major risk that can cause (serious) complications such as compression of the spinal cord, pulmonary embolism, or even paraplegia. In this study, we introduced a new aspiration technique with standard PV procedures (APV) to ameliorate the risk of leakage with quantitative verifications of its effectiveness. APV intends to create a differential pressure to guide the direction of cement flow within the vertebrae. To test this technique, Nubian goats’ ex vivo vertebral bodies (VBs) were used to simulate the PV surgical process in humans. Results show that the proposed APV has a lower leakage rate of 13% compared to the 53% of conventional PV. Additionally, the APV approach achieves more uniform cement distribution via the 9-score method with a value of 7 ± 1.30 in contrast to 4 ± 1.78 by conventional PV.

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“…The main factors associated with OLVF are a decrease in bone density, bone quality deterioration, and bone microstructure degeneration caused by osteoporosis [ 1 , 2 ]. Since the risk of osteoporosis increases with age, the number of patients with osteoporosis and those who develop OLVF will continue to increase as life expectancy increases [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

A Deep Learning-Based Model for Classifying Osteoporotic Lumbar Vertebral Fractures on Radiographs: A Retrospective Model Development and Validation Study

Ono,

Suzuki,

Sakano

et al. 2023

J. Imaging

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Early diagnosis and initiation of treatment for fresh osteoporotic lumbar vertebral fractures (OLVF) are crucial. Magnetic resonance imaging (MRI) is generally performed to differentiate between fresh and old OLVF. However, MRIs can be intolerable for patients with severe back pain. Furthermore, it is difficult to perform in an emergency. MRI should therefore only be performed in appropriately selected patients with a high suspicion of fresh fractures. As radiography is the first-choice imaging examination for the diagnosis of OLVF, improving screening accuracy with radiographs will optimize the decision of whether an MRI is necessary. This study aimed to develop a method to automatically classify lumbar vertebrae (LV) conditions such as normal, old, or fresh OLVF using deep learning methods with radiography. A total of 3481 LV images for training, validation, and testing and 662 LV images for external validation were collected. Visual evaluation by two radiologists determined the ground truth of LV diagnoses. Three convolutional neural networks were ensembled. The accuracy, sensitivity, and specificity were 0.89, 0.83, and 0.92 in the test and 0.84, 0.76, and 0.89 in the external validation, respectively. The results suggest that the proposed method can contribute to the accurate automatic classification of LV conditions on radiography.

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Effects of cement augmentation on the mechanical stability of multilevel spine after vertebral compression fracture

Cited by 8 publications

References 49 publications

Safety and prognosis of repeated vertebroplasty in the treatment of osteoporotic vertebral fractures

Safety and prognosis of repeated vertebroplasty in the treatment of osteoporotic vertebral fractures

Impact of Aspiration Percutaneous Vertebroplasty in Reducing Bone Cement Leakage and Enhancing Distribution—An Ex Vivo Study in Goat Vertebrae

A Deep Learning-Based Model for Classifying Osteoporotic Lumbar Vertebral Fractures on Radiographs: A Retrospective Model Development and Validation Study

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