Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures

Abstract

In a prospective study between August 2002 and August 2005, we studied the quantitative clinical and radiological outcome 36 months after percutaneous vertebroplasty for intractable type-II osteoporotic vertebral compression fractures which had been unresponsive to conservative treatment for at least eight weeks. We also examined the quality of life (QoL). The clinical follow-up involved the use of a pain intensity numerical rating scale (PI-NRS, 0 to 10), the Short-Form 36 (SF-36) QoL questionnaire and an anamnestic questionnaire before and at seven days (PI-NRS only), and one, three, 12 and 36 months post-operatively. A total of 30 consecutive patients received percutaneous vertebroplasty for 62 vertebral compression fractures with a mean time between fracture and treatment of 7.7 months (2.2 to 39). An immediate, significant and lasting reduction in the average and worst back pain was found, represented by a decrease of 3.1 and 2.7 points after seven days and 3.1 and 2.8 points after 36 months, respectively (p < 0.00). Comparison of the pre- and post-vertebroplasty scores on the various SF-36 domains showed an ultimate significant increase in six of eight domains and both summary scores. Asymptomatic leakage of cement was found in 47 of 58 (81%) of treated vertebrae. Two minor complications occurred, an asymptomatic pulmonary cement embolism and a cement spur along the needle track. Percutaneous vertebroplasty in the treatment of chronic vertebral compression fractures results in an immediate, significant and lasting reduction in back pain, and overall improvement in physical and mental health.

Surgical procedure and initial radiographic results of a new augmentation technique for vertebral compression fractures

“…Spinal deformities resulting from VCF have been shown to have adverse effects on the quality of life, physical function, mental health, as well as survival [3,4]. These effects are related to the severity of the spinal deformity [3,5] and are independent of the patient's pain [3].…”

Balloon reduction and cement fixation in intra-articular calcaneal fractures: a percutaneous approach to intra-articular calcaneal fractures

“…Percutaneous reduction techniques using balloons inflated with contrast medium as a means of reduction have been used for a number of years in the spine [12], initially as a treatment of osteoporotic fractures and more recently in the setting of acute traumatology [23]. The technique is of widespread use in many countries and is gaining momentum, although two recent studies claimed it is no better than sham surgery [24,25].…”

“…We looked for a way to provide reduction of these fragments in a simpler and more effective fashion than the open procedure or closed manipulation techniques. Having an extensive experience in kyphoplasty and vertebroplasty techniques in the spine, and confident that such techniques can be used to achieve adequate reduction, as confirmed by the literature [12], we tried to extend its use to the calcaneal fracture patients by using a percutaneous balloon reduction technique similar to that used in vertebral compression fractures. Bano et al [13], in 2009, published one case treated by a percutaneous technique including a double lateral approach in order to reduce the thalamic surface and the shape of the os calcis, with an excellent outcome.…”

Perkutan Transpedikuler Vertebroplastide Kemik Cimento Kacagi: Yirmi Hastanin Analizi

“…Bizim yaptığımız çalışmada kemik çimento kaçağı insidansı %53,9 (14/26) olarak saptanmıştır ve sonuçlarımız daha önceki yapılan çalışmalarla uyumludur (26,31). Beş vertebrada kanül trasesine kaçak (%19.2) izlenmiş olup bu oran önceki çalışmalara bakıldığında yüksek görünmektedir (25) ancak bu komplikasyonun yapılan ilk 8 hastada meydana gelmesi ve daha sonraki vakalarda izlenmemesinde çimento viskositesinin ve miktarının daha uygun seçiminin rol aldığı düşünüldü (32,33).Bu bulguya dayanılarak daha önceki çalışmalarda da görüldüğü gibi işlem için cerrahi öğrenim sürecinin önemli olduğu düşünüldü.…”