New Vertebral Compression Fractures After Prophylactic Vertebroplasty in Osteoporotic Patients

Kamano, Hironori; Hiwatashi, Akio; Kobayashi, Nobuo; Fuwa, Sokun; Takahashi, Osamu; Saida, Yukihisa; Honda, Hiroshi; Numaguchi, Yuji

doi:10.2214/ajr.10.5937

Cited by 22 publications

(16 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[18,19] PVP can also increase the risk of fractures of adjacent vertebrae. [14,20–23] The incidence of postoperative infections is low. [24] Systemic complications are rare, [25,26] but can produce serious diseases—fat embolism, [27] PMMA pulmonary embolism, [25,28–30] cardiac damage, [31,32] or arterial [33] or renal embolization.…”

Section: Introductionmentioning

confidence: 99%

Complications of percutaneous vertebroplasty

Saracen

Kotwica

2016

Medicine

View full text Add to dashboard Cite

Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins—osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation. One thousand one hundred PVP were analyzed, performed in 616 patients. There were 468 (76%) women and 148 men (24%), 24 to 94-year old, mean age 68 years. From 1100 procedures, 794 treated osteporotic and 137 fractures due to malignant disease, 69 PVP were made in traumatic fractures. One hundred patients had painful vertebral hemangiomas. Seven hundred twenty-six (66%) lesions were in thoracic, and 374 (34%) in lumbar area. Results of treatment were assessed using 10 cm Visual Analogue Scale (VAS) 12 hours after surgery, 7 days, 30 days, and then each 6 months, up to 3 years. Before surgery all patients had significant pain 7 to 10 in VAS scale, mean 8.9 cm. Twelve hours after surgery 602 (97.7%) reported significant relief of pain, with mean VAS of 2,3 cm. Local complications occurred in 50% of osteoporotic, 34% of neoplastic, 16% of traumatic fractures, and 2% of vertebral hemangiomas. The most common was PMMA leakage into surrounding tissues—20%; paravertebral vein embolism—13%; intradiscal leakage—8%; and PMMA leakage into the spinal canal—0.8%. Results of treatment did not differ between patients with and without any complications. From 104 patients who had chest X-ray or CT study performed after surgery, pulmonary embolism was noted in 2 patients, but without any clinical symptoms. Only 1 patient—with PMMA leakage into the spinal canal required surgical decompression In conclusion, PVP is effective in decreasing the level of pain in compression vertebral fractures. Complications occur in almost half of the patients but in more than 95% of them do not produce any clinical symptoms.

show abstract

Section: Introductionmentioning

confidence: 99%

Complications of percutaneous vertebroplasty

Saracen

Kotwica

2016

Medicine

View full text Add to dashboard Cite

show abstract

“…However, some patients may suffer subsequent fractures in the untreated vertebrae following vertebroplasty, which usually requires further treatment . Previous studies found that the incidence of subsequent VCFs ranged from 6.16 to 37% .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for new vertebral compression fractures after vertebroplasty: a meta‐analysis

Cao

Kong

Meng

et al. 2016

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…The osteoporotic vertebral compression fractures (OVCF) have attracted more and more attention due to increase in life span globally and aging population 12345. Vertebroplasty has gained popularity during the past few years for the treatment of osteoporotic compression fractures 6789.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous kyphoplasty combined with the posterior screw-rod system in treatment of osteoporotic thoracolumbar fractures

Chen

et al. 2013

IJOO

View full text Add to dashboard Cite

Background:The osteoporotic vertebral compression fractures (OVCF) have attracted more and more attention due to increase in life span globally and aging population. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) have been popularized rapidly by virtue of their unique advantage in minimal invasiveness. We analysed our results in osteoporotic thoracolumbar fractures using percutaneous kyphoplasty and posterior screw rod system. To investigate the possibility of treatment of rupture of the posterior vertebral osteoporotic fractures by means of kyphoplasty combined with the posterior screw-rod system.Materials and Methods:Twenty six patients (65 years of age or older) with the single spine fractures included in study. The preoperative bone mineral density was measured by dual-energy X-ray. The PKP was done in all the cases. Decompression was done if neurological symptoms were present.Results:The results demonstrated osteoporosis with BMD T value ≤ −2.5; injured posterior vertebral body (3 cases) had shown the whole damage accompanied by neurological symptoms through X-ray or CT. After 2 days, the remaining patients of back pain symptoms were relieved or disappeared except for three cases of patients with decompression incision. VAS score and Cobb angle changed from preoperative 8.23 ± 0.17 and 28.7 ± 0.33° respectively to postoperative 3.77 ± 0.44 and 3.8 ± 0.2° respectively.Conclusion:Treatment of rupture of the posterior vertebral osteoporotic thoracolumbar fractures by means of kyphoplasty combined with posterior screw-rod system is a safe, effective procedure.

show abstract

New Vertebral Compression Fractures After Prophylactic Vertebroplasty in Osteoporotic Patients

Abstract: Patients with three or more fractures tended to have subsequent fractures, despite undergoing prophylactic percutaneous vertebroplasty. However, there was no increased risk of subsequent fractures related to prophylactic percutaneous vertebroplasty.

Cited by 22 publications

References 21 publications

Complications of percutaneous vertebroplasty

Complications of percutaneous vertebroplasty

Risk factors for new vertebral compression fractures after vertebroplasty: a meta‐analysis

Percutaneous kyphoplasty combined with the posterior screw-rod system in treatment of osteoporotic thoracolumbar fractures

Contact Info

Product

Resources

About