Percutaneous kyphoplasty: Risk Factors for Recollapse of Cemented Vertebrae

Wang, Chongyan; Zhang, Xuyang; Liu, Junhui; Shan, Zhi; Li, Shengyun; Zhao, Fengdong

doi:10.1016/j.wneu.2019.06.071

Cited by 29 publications

(24 citation statements)

References 41 publications

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“…Interestingly, patients treated with SSS had significantly higher rates of further vertebral fractures compared to those treated with LSS. In literature, the majority of studies dealing with osteoporotic non-cervical fractures included the whole thoracolumbar spine [1,4,5,[19][20][21][22][23][24]. Thereby, the majority of fractures occurred at the thoracolumbar Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, Wang et al [5] reported a re-fracture or collaboration rate of the fractured or collapsed vertebral body of 38% 1 year after kyphoplasty. In contrast, we could persistently restore the vertebral morphology with a mean average medial vertebral body height of about 70% after LSS.…”

Section: Discussionmentioning

confidence: 99%

“…Several therapy strategies have been reported in the treatment of these fractures in the elderly, ranging from cement augmented procedures such as kyphoplasty or vertebroplasty, short and long segmental stabilizations and hybrid stabilizations [1][2][3][4][5][6]. The majority of those studies focuses on the thoracolumbar junction and the lumbar spine [2,[4][5][6]. However, the anatomy and biomechanics of the kyphotic mid-thoracic spine differ tremendously from the thoracolumbar junction, and the lordotic lumbar spine.…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Spiegl¹,

Hölbing²,

Jarvers³

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…In literature, the majority of studies dealing with osteoporotic non-cervical fractures included the whole thoracolumbar spine [1,4,5,[19][20][21][22][23][24]. Thereby, the majority of fractures occurred at the thoracolumbar junction.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, Wang et al [5] reported a re-fracture or collaboration rate of the fractured or collapsed vertebral body of 38% one year after kyphoplasty. In contrast, we could persistently restore the vertebral morphology with a mean average medial vertebral body height of about 70% after LSS.…”

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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