Improvement in Pulmonary Function of Chronic Obstructive Pulmonary Disease (COPD) Patients With Osteoporotic Vertebral Compression Fractures (OVCFs) After Kyphoplasty Under Local Anesthesia

Abstract

To investigate the changes in respiratory function of COPD patients with osteoporotic vertebral compression fractures (OVCFs) after kyphoplasty (KP). Pain scores, pulmonary function parameters (PFT), and local kyphotic angle (LKA) were measured in 31 older patients (25 women, 6 men) with OVCFs before, 3 days after and 3 months after kyphoplasty. The preoperative and postoperative (3 days, 3 months) PFT parameters were as follows: % pred FVC, 74.33 6 12.35, 85.23.8 6 13.23, and 84.86 6 14.01; % pred FEV1, 60.23 6 11.2, 60.02 6 11.90, and 60.78 6 12.70; FEV1/FVC ratio (%), 68.22 6 16.74, 59.56 6 13.23, and 60.77 612.28, % pred MVV 52.46 6 14.37, 55.23 6 15.68, and 62.12 6 14.48, respectively. The preoperative mean VAS score was 8.01 6 1.41 and significantly decreased to 2.52 6 0.89 and 2.34 6 0.78 at 3 days, 3 months after kyphoplasty, respectively. The preoperative local kyphotic angle degree was 21.96 6 5.758, significantly decreased to 13.48 6 6.128 3 days after KP, and maintained 3 month after KP. The decrease in the VAS scores correlated with the PFT parameters; however, there were no significant correlations between the PFT parameters and the LKA, the VAS scores and the LKA. Kyphoplasty under local anesthesia is a safety treatment for the COPD patients with OVCFS, and is able to improve the lung function impaired by OVCFs.

Hospital admissions and mortality in patients with COPD exacerbations and vertebral body compression fractures

“… 31 Finally, bisphosphonates appear to be effective in preventing fractures, especially if used early in high-risk subjects. 49 It is interesting to consider that surgical treatments such as kyphoplasty can improve lung function in COPD patients with VCF, 50 , 51 although its impact on prognosis and quality care outcomes still remains unexplored.…”

Low back pain and gastroesophageal reflux in patients with COPD: the disease in the breath

“…The percentage of osteoporosis is from two to five times higher in patients with COPD than in patients with osteoporosis, but without limitations of the air flow. 26 , 27 LBP in this population of patients could often be related to vertebral compression due to a fracture (collapse), with a concomitant reduction of the vital capacity and the forced expiratory volume in 1 second. 26 This reduction could be linked to the postural change that follows the vertebral collapse, with hyperkyphosis and reduction of lung volumes, with the progression of the disease and increase in mortality.…”

“… 26 , 27 LBP in this population of patients could often be related to vertebral compression due to a fracture (collapse), with a concomitant reduction of the vital capacity and the forced expiratory volume in 1 second. 26 This reduction could be linked to the postural change that follows the vertebral collapse, with hyperkyphosis and reduction of lung volumes, with the progression of the disease and increase in mortality. 26 , 27 It is not easy to link LBP to COPD.…”

“… 26 This reduction could be linked to the postural change that follows the vertebral collapse, with hyperkyphosis and reduction of lung volumes, with the progression of the disease and increase in mortality. 26 , 27 It is not easy to link LBP to COPD. In fact, even though vertebral compression is common in patients with osteoporosis and worsening respiratory disease, the collapse remains unrecognized in at least half of the patients.…”

Clinical efficacy of PVP and PKP in the treatment of OVCFs after bilateral resection of ovarian cancer

“…The results of this study show that there were no significant differences in preoperative ODI, MPQ and JOA scores between the two groups (P>0.05), and after operation, the scores of ODI, MPQ and JOA in the two groups were significantly improved, which were more obvious in the observation group than those in the control group (P<0.05). This is because patients do not take bed rest, and a sharp pain is felt even when turning over or being touched; when people suffer from OVCFs, spinal kyphosis will occur, which leads to loss of normal curvature and changes in spinal endurance, thus enhancing compression force of injured vertebra and more obvious pain; the nerve involvement of lesions will cause neurological dysfunction, and OP itself can also incur pain in patients ( 17 ). After treatment with PVP and PKP, the concretion of bone cement blocks the blood of the diseased part of the vertebra, thereby reducing the pressure at the fracture site and enhancing the stability of the fracture site; in addition, the chemical reaction during the coagulation process produces heat, which destroys the nerve endings around the fracture and reduces the nerve irritation caused by the movement of the fracture site, thereby achieving analgesic effects ( 18 ).…”