Osteoporotic vertebral fractures without compression: key factors of diagnosis and initial outcome of treatment with cement augmentation

Mao, Haiqing; Zou, Jun; Geng, Dechun; Zhu, Xuesong; Zhu, Mo; Jiang, Weimin; Yang, Huilin

doi:10.1007/s00234-012-1018-8

Cited by 16 publications

(14 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…MSCT was also performed to study the vertebral structures before the PKP procedure. MRI was the most confirmative screening examination used to determine the presence of painful OOVFs; STIR sequences of MRI images show hyperintensity signal because of bone edema in the affected vertebra [18]. Patients with local infections, non-correctable coagulation disorders, and other systemic diseases were excluded from the treatment.…”

Section: Methodsmentioning

confidence: 99%

“…Patients highly suspected to have a fresh occult vertebral fracture, who have persistent pain and normal X-ray and CT images, should undergo additional radiologic tests, especially MRI. MRI is the most confirmative screening examination used to determine the presence of painful OOVFs; T2 and STIR sequences of MRI images show hyperintensity signal because of bone edema in the affected vertebra [18]. OOVFs are disabling causes of severe low back pain, requiring bed rest and increasing the risk of comorbidities [15].…”

Section: Introductionmentioning

confidence: 99%

“…Pham et al [17] and Mao et al [18] reported that 79% of patients with OOVF developed a “classic” vertebral collapse within 3 months after the first radiograph. Thus, it is essential and necessary to enhance the vertebral body with occult fracture to prevent further vertebral collapse.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Sun

Zhao

et al. 2017

Med Sci Monit

View full text Add to dashboard Cite

BackgroundThe definition of a vertebral fracture is usually based on the presence of a deformation of the vertebral body and this can be misleading in the presence of a fracture without radiologic collapse with the definition of occult osteoporotic vertebral fractures (OOVFs). STIR sequence of MRI images showing hyperintensity signal was the most confirmative screening examination used to determine the presence of painful OOVFs. To date, clinical management of OOVFs has been rarely discussed.Material/MethodsBetween 2011 and 2013, 89 patients suffering from painful OOVFs underwent 142 percutaneous balloon kyphoplasty (PKP) procedures. Outcome data (mean variation of anterior and middle vertebral body height, visual analog scale [VAS] scores, Oswestry Disability Index [ODI] scores, and SF-36 scores) were recorded preoperatively, postoperatively, and at 1 month, 6 months, and 2 year after treatment, to evaluate the results.ResultsWe successfully treated 89 patients (142 vertebral bodies) with PKP. Cement leakages were observed in 12 (8.45%) treated vertebral bodies and there were 5 new adjacent vertebral fractures during the follow-up period. The mean variation of anterior and middle vertebral body height changed from 96.5±3.4% preoperatively to 97.2±2.5% postoperatively (p>0.05) and from 96.3±2.8% preoperatively to 97.9±3.1% postoperatively (p>0.05), respectively. The mean VAS scores were reduced significantly from pre-surgery to post-surgery (8.3±1.2 to 2.9±0.7; p<0.05), as was the ODI score (76.4±12.5 to 26.7±5.6; p<0.05). The SF-36 scores, including Bodily Pain (BF), Vitality (VT), Physical Function (PF), and Social Functioning (SF), all showed notable improvement (P<0.05). These variations were maintained during the 2-year follow-up period.ConclusionsPKP is a safe and effective method in the treatment of painful OOVFs.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Sun

Zhao

et al. 2017

Med Sci Monit

View full text Add to dashboard Cite

show abstract

“…The most well recognized risk factor for adjacent fractures is cement leak into the disk space [69–72]; osteoporosis [25, 69, 72] and kyphotic angle/degree of correction [25, 69] are also being implicated. In our practice, as suggested in the literature, to reduce the possibility of further fractures (especially when bony edema is found on the MRI at adjacent levels), we perform prophylactic augmentation [73, 74]. …”

Section: Subsequent Fracturesmentioning

confidence: 99%

Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

Papanastassiou

Filis

Gerochristou

et al. 2014

BioMed Research International

View full text Add to dashboard Cite

Kyphoplasty (KP) and vertebroplasty (VP) have been successfully employed for many years for the treatment of osteoporotic vertebral fractures. The purpose of this review is to resolve the controversial issues raised by the two randomized trials that claimed no difference between VP and SHAM procedure. In particular we compare nonsurgical management (NSM) and KP and VP, in terms of clinical parameters (pain, disability, quality of life, and new fractures), cost-effectiveness, radiological variables (kyphosis correction and vertebral height restoration), and VP versus KP for cement extravasation and complications profile. Cement types and optimal filling are analyzed and technological innovations are presented. Finally unipedicular/bipedicular techniques are compared. Conclusion. VP and KP are superior to NSM in clinical and radiological parameters and probably more cost-effective. KP is superior to VP in sagittal balance improvement and cement leaking. Complications are rare but serious adverse events have been described, so caution should be exerted. Unilateral procedures should be pursued whenever feasible. Upcoming randomized trials (CEEP, OSTEO-6, STIC-2, and VERTOS IV) will provide the missing link.

show abstract

“…Based on clinical practice, OVFs can be divided into three categories according to fracture symptoms and presence of vertebral deformation on plain radiographs: 1) painful OVFs, also known as fresh OVFs, refer to symptomatic fractures with loss of the vertebral height; 2) painless OVFs, also known as old OVFs, are asymptomatic fractures with vertebral collapse; and 3) occult OVFs, which imply painful vertebral fractures without radiographic measurable compression. [13] The diagnosis of painful occult OVFs is difficult due to the unapparent radiographic finding. Pham et al[11] reported that 21 cases of vertebral fractures in 16 patients were presented with a typical history of acute back pain in a setting of osteoporosis; however, there was no substantial deformation of the vertebral body at the initial plain radiographs.…”

Section: Discussionmentioning

confidence: 99%

Radiographic Detection of Osteoporotic Vertebral Fracture without Collapse

et al. 2013

View full text Add to dashboard Cite

BackgroundOn retrospective basis, we investigated the detection of osteoporotic vertebral fractures (OVFs) without radiologic collapse using a modified Yoshida's classification, which was designed by the authors.MethodsWe observed 82 cases in 76 patients with confirmed OVFs without collapse at the thoracolumbar junction. The following factors were measured: age, gender, body mass index (BMI, kg/m2), bone mineral density (BMD, mg/cm3), type of a modified Yoshida's classification. The correct diagnosis rate for the presence and location of OVFs and the correct diagnosis rate according to the morphological type by a modified Yoshida's classification of the OVFs were analyzed.ResultsThe mean BMI was 21.2; mean BMD, 44.1; and T-score, -4.4. As for the four subtypes of anterior cortical morphological change, there were 14 cases of the protruding type, 12 cases of the indented type, 5 cases of the disrupted type and 8 cases of the prow type. As for the three subtypes of endplate depression, there were 20 cases of upper endplate depression, 12 cases of lower endplate depression and 11 cases of endplate slippage type. According to the examiners, there was a significant difference between being informed before and after the modified Yoshida's classification. For the relationship of examiners and the type of fracture, there was a significant difference between being informed before and after the modified Yoshida's classification, particularly in the protruding type and the upper plate type.ConclusionsA modified Yoshida's classification can be helpful for the diagnosis of OVFs without radiologic collapse in a simple radiograph.

show abstract

Osteoporotic vertebral fractures without compression: key factors of diagnosis and initial outcome of treatment with cement augmentation

Cited by 16 publications

References 24 publications

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases

Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

Radiographic Detection of Osteoporotic Vertebral Fracture without Collapse

Contact Info

Product

Resources

About