Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly

Shi, Chen; Zhang, Mi; Cheng, An-yuan; Huang, Zifeng

doi:10.2147/cia.s146871

Cited by 21 publications

(13 citation statements)

References 31 publications

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“…Besides, no sufficient diagnosis of osteoporosis was performed and no anti-osteoporotic therapy was started in the majority of the patients despite the clear recommendation for it in the discharge report. The low number of patients who received sufficient antiosteoporotic therapy might be partially responsible for the high rate of sequential vertebral fractures and might negatively affect clinical outcomes [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Midterm outcome after posterior stabilization of unstable Midthoracic spine fractures in the elderly

Spiegl¹,

Hölbing²,

Jarvers³

et al. 2021

BMC Musculoskelet Disord

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Background The evidence for the treatment of midthoracic fractures in elderly patients is weak. The aim of this study was to evaluate midterm results after posterior stabilization of unstable midthoracic fractures in the elderly. Methods Retrospectively, all patients aged ≥65 suffering from an acute unstable midthoracic fracture treated with posterior stabilization were included. Trauma mechanism, ASA score, concomitant injuries, ODI score and radiographic loss of reduction were evaluated. Posterior stabilization strategy was divided into short-segmental stabilization and long-segmental stabilization. Results Fifty-nine patients (76.9 ± 6.3 years; 51% female) were included. The fracture was caused by a low-energy trauma mechanism in 22 patients (35.6%). Twenty-one patients died during the follow-up period (35.6%). Remaining patients (n = 38) were followed up after a mean of 60 months. Patients who died were significantly older (p = 0.01) and had significantly higher ASA scores (p = 0.02). Adjacent thoracic cage fractures had no effect on mortality or outcome scores. A total of 12 sequential vertebral fractures occurred (35.3%). The mean ODI at the latest follow up was 31.3 ± 24.7, the mean regional sagittal loss of reduction was 5.1° (± 4.0). Patients treated with long segmental stabilization had a significantly lower rate of sequential vertebral fractures during follow-up (p = 0.03). Conclusion Unstable fractures of the midthoracic spine are associated with high rates of thoracic cage injuries. The mortality rate was rather high. The majority of the survivors had minimal to moderate disabilities. Thereby, patients treated with long segmental stabilization had a significantly lower rate of sequential vertebral body fractures during follow-up.

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Section: Discussionmentioning

confidence: 99%

Midterm outcome after posterior stabilization of unstable Midthoracic spine fractures in the elderly

Spiegl¹,

Hölbing²,

Jarvers³

et al. 2021

BMC Musculoskelet Disord

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“…advised for treating OTFs in clinical routine practice, and we are unable to determine whether PV causes new symptomatic vertebral fractures and/or serious adverse events as well as an increased risk of PV in acute OTFs [9][10][11][12] . There are no severe complications due to treatment, and although PMMA leakage frequently occurs, it is always asymptomatic [13][14][15] .…”

Section: Discussionmentioning

confidence: 99%

Risk factors of adjacent segmental fractures when percutaneous vertebroplasty is performed for the treatment of osteoporotic thoracolumbar fractures

Liang

Zhong

Luο

et al. 2020

Sci Rep

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The study aimed to analyze the radiographic and magnetic resonance imaging (MRI) findings that might predict the risk for adjacent segmental fractures (ASfs) when percutaneous vertebroplasty (PV) is used for the treatment of osteoporotic thoracolumbar fractures (OTFs). A total of 92 OTFs patients who underwent PV between January 2013 and January 2015 were retrospectively reviewed. the visual analog scale (VAS), oswestry-Disability index (oDi) and radiolographic measurements were assessed. The VAS and ODI scores improved significantly at the final follow-up (FU) compared with the preoperation scores. compared with the preoperative values, the fractured body alignment (FBA) significantly improved at the 3-month FU and the final FU, but the adjacent segment alignment (ASA) and thoracolumbar alignment (tLA) did not improve. According to the correlation analysis, the final FU TLA and the final FU ASA were correlated with the preoperative FBA, ASA, and TLA on plain radiography and were highly correlated on MRI. However, the final FU FBA was not correlated with the preoperative fBA, ASA, or tLA on plain radiography or MRi (p > 0.05). The ASFs were correlated with the 3-month FU TLA (r = 0.6044, P = 0.0037) and the final FU TLA (r = 0.5699, P = 0.007) on plain radiography, and the final TLA was more correlated with the preoperative FBA, ASA, and TLA on MRi than on plain radiography. in conclusion, the preoperative ASA and tLA on MRi were risk factors associated with ASfs in otfs treated with pV.

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“…Besides, no su cient diagnosis of osteoporosis was performed and no anti-osteoporotic therapy was started in the majority of the patients despite the clear recommendation for it in the discharge report. The low number of patients who received su cient antiosteoporotic therapy might be partially responsible for the high rate of sequential vertebral fractures and might negatively affect clinical outcomes [43].…”

Section: Discussionmentioning

confidence: 99%

Midterm Outcome after Posterior Stabilization of Unstable Midthoracic Spine Fractures in the Elderly

Spiegl

Hölbing

Jarvers

et al. 2020

Preprint

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Background: The evidence for the treatment of midthoracic fractures in elderly patients is weak. The aim of this study was to evaluate midterm results after posterior stabilization of unstable midthoracic fractures in the elderly.Methods: Retrospectively, all patients aged ≥65 suffering from an acute unstable midthoracic fracture treated with posterior stabilization were included. Trauma mechanism, ASA score, concomitant injuries, ODI score and radiographic loss of reduction were evaluated. Posterior stabilization strategy was divided into short-segmental stabilization (SSS) and long-segmental stabilization (LSS). Results: Fifty-nine patients (76.9 ± 6.3 years; 51% female) were included. The fracture was caused by a low-energy trauma mechanism in 22 patients (35.6%). Twenty-one patients died during the follow-up period (35.6%). Remaining patients (n=38) were followed up after a mean of 60 months. Patients who died were significantly older (p = 0.01) and had significantly higher ASA scores (p = 0.02). Adjacent thoracic cage fractures had no effect on mortality or outcome scores. A total of 12 sequential vertebral fractures occurred (35.3%). The mean ODI at the latest follow up was 31.3 ± 24.7, the mean regional sagittal loss of reduction was 5.1° (± 4.0). Patients treated with LSS had a significantly lower rate of sequential vertebral fractures during follow-up (p = 0.03). Conclusion: Unstable fractures of the midthoracic are associated with high rates of thoracic cage injuries. The mortality rate was rather high. The majority of the survivors had minimal to moderate disabilities. Thereby, patients treated with LSS had a significantly lower rate of sequential vertebral body fractures during follow-up.

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Percutaneous kyphoplasty combined with zoledronic acid infusion in the treatment of osteoporotic thoracolumbar fractures in the elderly

Cited by 21 publications

References 31 publications

Midterm outcome after posterior stabilization of unstable Midthoracic spine fractures in the elderly

Midterm outcome after posterior stabilization of unstable Midthoracic spine fractures in the elderly

Risk factors of adjacent segmental fractures when percutaneous vertebroplasty is performed for the treatment of osteoporotic thoracolumbar fractures

Midterm Outcome after Posterior Stabilization of Unstable Midthoracic Spine Fractures in the Elderly

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