Percutaneous Kyphoplasty

Yılmaz, Atilla; Çakır, Mürteza; Yucetas, Cem; Urfalı, Boran; Üçler, Necati; Altaş, Murat; Aras, Mustafa; Serarslan, Yurdal; Koç, Rahmi Kemal

doi:10.1097/brs.0000000000002531

Cited by 23 publications

(6 citation statements)

References 42 publications

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“…PVP research nowadays focuses mostly on comparing the effects and consequences of unilateral versus bilateral penetration. Yilmaz [ 5 ] found that there was no significant difference between pain alleviation and vertebral height improvement between unilateral and bilateral puncture. However, unilateral puncture takes much less time, has less bone cement injection, and takes longer to puncture.…”

Section: Introductionmentioning

confidence: 99%

A Comparison between Accurate Unilateral Puncture Paths Planned by Preoperative and Conventional Unilateral Puncture Techniques in Percutaneous Vertebroplasty

Xie¹,

Gu²,

Yongcun³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. Comparison of the clinical and radiological effects of precise unilateral puncture pathway prepared by preoperative CT data and traditional unilateral puncture pathway in PVP administration for the treatment of osteoporotic vertebral compression fractures. Summary of background data. PVP is a commonly used vertebral augmentation operation for the treatment of painful spinal compression fractures. A percutaneous unilateral approach is routinely used to get access to the vertebral body. PVP has had positive clinical results in a number of prior investigations. Numerous difficulties and issues, including puncture difficulty, radiation exposure, cement leakage, spinal cord or nerve damage, and intraspinal hematoma, have been described in contrast. Methods. This prospective study included 300 patients with single-level lumbar osteoporotic vertebral compression fractures, 180 females and 120 males, with an average age of 71.5 years. PVP was performed on randomized subjects using two distinct puncture procedures. The patients were separated into two groups: Preoperative planning, in which a precise unilateral puncture path was established using preoperative CT data, and Conventional planning, in which multiple puncture procedures were used. The participants were followed up on after surgery and mostly assessed on clinical and radiological results. The visual analogue scale for pain and the 36-item Short Form Health Survey (SF-36) questionnaire for health status were used to assess clinical outcomes. Radiation dosage, bone cement distribution, vertebral body height, and kyphotic angle were used to evaluate radiological results. Results. Participants remained monitored for 12 to 28 months on average. 151 individuals were treated with accurate unilateral puncture paths planned by preoperative CT data percutaneous vertebroplasty and 149 patients were treated with conventional unilateral paths percutaneous vertebroplasty. The Preoperative planning group’s operation time and radiation dose were significantly lower than the Conventional group’s; nevertheless, the volume of injected cement was significantly higher in the Preoperative steering committee than in the Conventional group. All patients in both groups had much less pain after the operations when compared to their preoperative suffering. There were no statistically significant variations between groups when the visual analogue scale and the 36-Item Short Form Health Survey were compared. Neither group showed a substantial decrease in the kyphotic angle during the follow-ups. In the Preoperative planning group, the kyphotic angle improved much more than in the Conventional group. At 1 month postoperatively, 16 patients in the Conventional group experienced apparent discomfort in the puncture sites because to facet joint violation. At the latest follow-up, all of the patients’ discomfort had vanished after receiving local block therapy. Conclusion. Both preoperatively designed precise unilateral puncture pathways and traditional unilateral puncture procedures PVP are reasonably safe and effective for individuals with painful osteoporotic spinal compression fractures. Unilateral puncture courses planned via preoperative PVP, on the other hand, absorbed less radiation and operation time, as well as a good level of deformity correction and amount of injected cement, and caused less complications than traditional unilateral PVP.

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Section: Introductionmentioning

confidence: 99%

A Comparison between Accurate Unilateral Puncture Paths Planned by Preoperative and Conventional Unilateral Puncture Techniques in Percutaneous Vertebroplasty

Xie¹,

Gu²,

Yongcun³

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Complications of PKP surgery primarily included bone cement leakage, puncture damage to surrounding structures (facet joints, spinal cord, and blood vessels), and pulmonary embolism. 23 The rate of bone cement leakage was not significantly different in the two groups. This supported the fact that the rate of bone cement leakage is not associated with the puncture approach of PKP.…”

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confidence: 78%

Is It Necessary to Approach the Severe Osteoporotic Vertebral Biconcave-Shaped Fracture Bilaterally During the Process of PKP?

Tan

Yang

Fan

et al. 2021

JPR

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Purpose The goal of this study was to explore the outcomes of unilateral and bilateral approach percutaneous kyphoplasty (PKP) using CT-guidance in the treatment of severe osteoporotic single-level vertebral biconcave-shaped fracture. Methods We retrospectively reviewed 89 patients with severe osteoporotic single-level vertebral biconcave-shaped fracture who had undergone unilateral and bilateral PKP surgeries using CT-guidance at our hospital between June 2013 and June 2019, and followed for at least 1 year. All patients were divided into unilateral (the transverse process-pedicle approach, n = 49) and bilateral (the pedicle approach, n = 40) groups. We collected the clinical and radiological evaluation results during postoperative and last follow-up periods. Results Our findings revealed that the surgery time for the unilateral group was significantly shorter than that of the bilateral group at P < 0.05. The amount of bone cement and radiation exposure of the unilateral group were significantly lesser than that of the bilateral group ( P < 0.05). Relative to preoperative data, the values of the VAS score and Oswestry disability index (ODI) were significantly improved at 1 day after surgery and the last follow-up in the two groups ( P < 0.05). Notably, the median height of vertebra at 1 day after surgery and the last follow-up in the unilateral group was significantly restored than that of preoperative data ( P < 0.05). However, the median height of vertebra at the same time intervals in the bilateral group showed no significant change compared with preoperative data ( P > 0.05). Furthermore, the rate of bone cement leakage and incidence of adjacent-level vertebra fracture were not significantly different in the two groups (P > 0.05). Finally, both groups can obtain an asymmetrical distribution of bone cement in the vertebra. Conclusion Compared to the bilateral PKP, unilateral PKP using CT-guidance in the treatment of the sOVBFs exhibits significantly shorter operation time, lesser radiation dose, and complications. Moreover, unilateral PKP can restore the median height of the vertebral body and eventually obtain a symmetrical distribution of bone cement in the vertebra.

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“…PKP injects bone cement into the injured vertebrae through a working channel, effectively restoring vertebral height in a short period time, relieving symptoms such as low back pain, greatly shortening the patients' bed rest and reducing the occurrence of long-term bed rest complications like deep vein thrombosis, hypostatic pneumonia, decubitus and disuse muscular atrophy[8, 21,22]. PKP works through the pedicle, and most studies have shown that the unilateral approach has similar e cacy compared to the bilateral approach, but the former in quicker, less invasive, less expensive and has a lower risk of cement leakage and displacement [23,24]. In this study, a unilateral approach via the pedicle was adopted.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of cement-augmented pedicle screw fixation combined with vertebroplasty and PKP alone in the treatment of osteoporotic vertebral burst fracture

Zheng,

Wu,

Guo

et al. 2023

Preprint

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To compare the clinical efficacy of cement-augmented pedicle screw fixation combined with vertebroplasty (PS-VP) and PKP alone in the treatment of osteoporotic vertebral burst fracture (OVBF), The clinical data of 41 OVBF patients admitted to our department from January 2017 to December 2022 were retrospectively analyzed, including 18 patients who underwent PS-VP and 23 patients who underwent PKP alone. The age, BMI, LSS, NRS, ODI, KA and AHR were compared between the two groups to assess the efficacy of the two procedures. The differences between the postoperative clinical indicators of the two procedures were statistically significant compared with the preoperative ones (P＜0.05). The NRS, ODI, KA and AHR showed great difference between the two groups at 6 months postoperatively(P＜0.05). The KA and AHR in the PS-VP group at 6 months postoperatively were close to those at 3 days (P＞0.05), whereas the KA in the PKP alone group at 6 months postoperatively was larger and AHR was lower than that at 3 days postoperatively with statistical significance (P＜0.05). To conclude, there is no significant difference in the near-term efficacy between PS-VP and PKP alone for OVBF, but the former has advantages in improving clinical symptoms and dysfunction, restoring height of the injured vertebra and maintaining spinal loading capacity in the medium and long term.

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Percutaneous Kyphoplasty

Abstract: 3.

Cited by 23 publications

References 42 publications

A Comparison between Accurate Unilateral Puncture Paths Planned by Preoperative and Conventional Unilateral Puncture Techniques in Percutaneous Vertebroplasty

A Comparison between Accurate Unilateral Puncture Paths Planned by Preoperative and Conventional Unilateral Puncture Techniques in Percutaneous Vertebroplasty

Is It Necessary to Approach the Severe Osteoporotic Vertebral Biconcave-Shaped Fracture Bilaterally During the Process of PKP?

A comparative study of cement-augmented pedicle screw fixation combined with vertebroplasty and PKP alone in the treatment of osteoporotic vertebral burst fracture

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