Height Restoration after Balloon Kyphoplasty in Rheumatoid Patients with Osteoporotic Vertebral Compression Fracture

Suh, Seung-Pyo; Kim, Chul-Woong; Jo, Young-Hoon; Kang, Chang-Nam

doi:10.4184/asj.2015.9.4.581

Cited by 9 publications

(8 citation statements)

References 19 publications

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“…Therefore, further understanding of the relationship between intraoperative radiographic findings and the therapeutic outcomes may help optimize surgical decision. Several studies have uncovered the effects of bone cement volume on PKP efficacy [ 11 , 12 , 18 ], but few emphasized on bone cement distribution or filling pattern [ 13 ]. In this study, the correlation between bone cement distribution and vertebral reconstruction in unilateral PKP was revealed, shedding light on further improvement of the procedure.…”

Section: Discussionmentioning

confidence: 99%

Bone cement distribution is a potential predictor to the reconstructive effects of unilateral percutaneous kyphoplasty in OVCFs: a retrospective study

et al. 2018

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BackgroundOsteoporotic vertebral compression fracture (OVCF) is a common type of fracture, and percutaneous kyphoplasty (PKP) is an eligible solution to it. Previous studies have revealed that both the volume and filling pattern of bone cement correlate with the clinical outcomes after PKP procedure. However, the role of bone cement distribution remains to be illustrated.MethodsTo retrospectively evaluate the relationship between the bone cement distribution and the clinical outcomes of unilateral PKP, we enrolled 73 OVCF patients receiving unilateral PKP treatment. All the intervened vertebrae were classified into three groups based on the bone cement distribution observed on postoperative X-ray films. Preoperative and postoperative radiographic parameters including the vertebral height and kyphotic Cobb angle were recorded, and anterior vertebral height restoration rate (AVHRR) and Cobb angle correction (CR) were then calculated to assess the vertebral height reconstruction. Preoperative and postoperative Oswestry Disability Index (ODI) and visual analogue scale (VAS) were adopted by interviewing patients to assess the mobility improvement and pain relief. Demographic data, body mass index (BMI), lumbar bone mineral density (evaluated by BMD T-score) of each patient, bone cement volume (BV), and bone cement extravasation (BE) were also recorded. Between- and within-group comparisons and multivariable correlation analysis were carried out to analyze the data.ResultsVAS and ODI scores were both significantly improved in all of the enrolled cases with no significant differences between groups. Among the three groups, the average age, AVHRR, and BV were significantly different. Occurrence of BE was significantly different between two of the three groups. AVHRR was demonstrated to correlate negatively with preoperative anterior vertebral height ratio and positively with preoperative Cobb angle, CR, diffusion score, and ODI changes.ConclusionsBone cement distribution is a potential predictor to the reconstructive effects in unilateral PKP for OVCFs. Bone cement distribution is associated with AVHRR and BV, as well as the risk of BE occurrence. Greater bone cement distribution may indicate better vertebral restoration along with a higher BE risk.

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Section: Discussionmentioning

confidence: 99%

Bone cement distribution is a potential predictor to the reconstructive effects of unilateral percutaneous kyphoplasty in OVCFs: a retrospective study

et al. 2018

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“…However, neither the extent of height restoration nor its loss seems to affect clinical outcomes. Therefore, our data shows that the aspect of reduction seems to be of secondary importance in these elderly patients, as safety and pain reduction might be more important and consistent [ 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Radiological and Clinical Outcomes of Balloon Kyphoplasty versus Radiofrequency Kyphoplasty in the Treatment of Vertebral Compression Fractures

et al. 2018

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Study DesignRetrospective cohort analysisPurposeComparison of balloon kyphoplasty (BKP) and radiofrequency kyphoplasty (RFK) with respect to height restoration of the fractured vertebral bodies and the pain relief experienced after the surgical procedure.Overview of LiteratureBKP and RFK both offer safe, time-saving, and potent treatment options for vertebral compression fractures, but neither of these methods demonstrated any key advantage over the other yet.MethodsWe performed a retrospective analysis of a cohort of 156 patients (mean age, 73±11 years) with 252 fractured vertebral bodies treated with kyphoplasty. Pain intensity was measured using a Visual Analogue Scale. Preoperative and postoperative computed tomography images were analyzed and gauged using modified bisegmental Cobb angle, vertebral angle, as well as anterior (Ha), middle (Hm), and posterior (Hp) vertebral body heights.ResultsThe mean postoperative pain relief was 5.1±1.8, which was maintained over the entire follow-up period. There were no significant differences in the pain relief between BKP and RFK. Postoperative changes in the vertebral angle (−1.3°±3.3°, p<0.001) and Ha, Hm, and Hp vertebral body heights (Ha, 1.5±2.9 mm; Hm, 2.1±2.9 mm; Hp, 0.9±2.1 mm; p<0.001) were significant. However, the initial height restoration could not be maintained by the 6-week and 1-year follow-up. Neither BKP nor RFK could achieve a clinically relevant advantage over each other. There was no correlation between pain relief and height restoration after kyphoplasty.ConclusionsBoth BKP and RFK had comparable beneficial clinical and radiological effects in the treatment of vertebral compression fractures. However, neither the actual extent of height restoration nor its loss seems to affect the marked pain relief.

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“…Early surgical treatment to prevent further collapse of the vertebral body and posterior convex deformity plays a crucial role. Treatment of bone necrosis after osteoporotic vertebral fractures with PMMA achieves good results . Polymethylmethacrylate (PMMA) is often used as filler, but PMAA has disadvantages: no biological activity, causing adjacent vertebral compression fractures by stress, monomer toxicity, and heat production during polymerization .…”

Section: Introductionmentioning

confidence: 99%

“…Treatment of bone necrosis after osteoporotic vertebral fractures with PMMA achieves good results. [7][8][9] Polymethylmethacrylate (PMMA) is often used as filler, but PMAA has disadvantages: no biological activity, causing adjacent vertebral compression fractures by stress, monomer toxicity, and heat production during polymerization. 10 Therefore, researchers are seeking new and more effective filling materials.…”

Section: Introductionmentioning

confidence: 99%

Preparation and characterization of a silk fibroin/calcium sulfate bone cement

et al. 2017

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This study aimed to prepare and characterize a silk fibroin/calcium sulfate (SF/CS) bone cement. SF solutions of the following concentrations 3, 4.5, 6, 7.5, and 9 g/L were used to prepare bone cement samples with SF-to-CS ratios of 0.35, 0.40, 0.45, 0.50, and 0.55 mL of SF solutions (or water as control) per g of CS. Compressive strength, setting time, degradation when immersed in phosphate-buffered saline, X-ray diffraction, Fourier infrared spectroscopy, and scanning electron microscopy were used to characterize the SF/CS bone cement. Biocompatibility was determined using rat bone mesenchymal stem cells (rBMSCs) and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The optimal bone cement was obtained with 0.4 mL of 6 g/L SF solution per g of α-hemihydrate CS powder. Compared with CS bone cement, compressive strength of SF/CS bone cement was 19.7% higher (p = 0.003). Samples prepared with SF had less degradation in phosphate-buffered saline than the ones prepared with deionized water. Using SF solution as the solidifying liquid increases the initial setting and final setting time of CS compared with deionized water. Using extracts from SF/CS bone cement, all cell relative proliferation rates were >100%, showing no cytotoxicity for any sample. In conclusion, using the 6 g/L SF solution at 0.40 mL/g of CS increased the cement compressive strength. SF solution added to CS achieved a bone cement with increased durability compared with CS bone cement. The SF/CS cement had no cytotoxicity on rBMSCs. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 512-519, 2018.

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Height Restoration after Balloon Kyphoplasty in Rheumatoid Patients with Osteoporotic Vertebral Compression Fracture

Cited by 9 publications

References 19 publications

Bone cement distribution is a potential predictor to the reconstructive effects of unilateral percutaneous kyphoplasty in OVCFs: a retrospective study

Bone cement distribution is a potential predictor to the reconstructive effects of unilateral percutaneous kyphoplasty in OVCFs: a retrospective study

Radiological and Clinical Outcomes of Balloon Kyphoplasty versus Radiofrequency Kyphoplasty in the Treatment of Vertebral Compression Fractures

Preparation and characterization of a silk fibroin/calcium sulfate bone cement

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