The Dynamic Mobility of Vertebral Compression Fractures

McKiernan, Fergus; Jensen, Ron; Faciszewski, Tom

doi:10.1359/jbmr.2003.18.1.24

Cited by 263 publications

(228 citation statements)

References 20 publications

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“…vertebroplasty site is the dynamic nature of vertebral fractures with clefts [21,22,37]. Clefted vertebral fractures can be lined by fibrocartilage forming intervertebral pseudoarthroses, providing a potential space for infection.…”

Section: Discussionmentioning

confidence: 99%

Revision strategies for complications and failure of vertebroplasties

Yang

Chen

et al. 2008

Eur Spine J

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Percutaneous vertebroplasty is widely discussed in the management of osteoporotic spinal compression fracture, but few reports are available concerning salvage procedures after failure of this technique. We studied 22 percutaneous vertebroplasty patients who required revision surgery upon presentation of new symptoms postoperatively. The indications for revision surgery included recurrent intractable back pain with no response to medical treatment, infectious spondylitis, cement leakage with neurologic deficit, and cement dislodgement and/ or fragmentation. Five patients underwent repeated percutaneous vertebroplasty of the initially cemented vertebrae. Seventeen patients underwent anterior, posterior, or combined anterior and posterior surgery. Four patients required a third surgical procedure because of poor augmentation with cement, subsidence of the anterior bone graft, or pullout of the instrumentation. Finally, four (18%) patients underwent repeat vertebroplasty, two (9%) patients underwent anterior surgery only, one (5%) patient underwent posterior surgery only, and 15 (68%) patients underwent combined anterior and posterior surgery; all but one regained ambulatory status equivalent to that prior to surgery. In conclusion, percutaneous vertebroplasty is a simple and effective, but not risk-or complication-free procedure for the treatment of osteoporotic spinal compression fracture. The spine surgeon should be familiar with varied approaches and techniques for revision surgery. Combined anterior and posterior surgery seems to be the most secure salvage method to treat severely osteoporotic patients in whom percutaneous vertebroplasty initially failed.

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Section: Discussionmentioning

confidence: 99%

Revision strategies for complications and failure of vertebroplasties

Yang

Chen

et al. 2008

Eur Spine J

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“…Union status was evaluated by measuring the dynamic mobility of the affected vertebra. Preoperatively vertebral dynamic mobility was calculated by measuring the difference of the vertebral height (anterior wall) between the sitting lateral radiograph and the supine lateral radiograph [17] ( Fig. 1a, b).…”

Section: Methodsmentioning

confidence: 99%

Conversion to hypertrophic vertebral pseudarthrosis following percutaneous vertebroplasty

et al. 2010

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To determine the role of percutaneous vertebroplasty (PVP) in bone formation and the union of vertebral pseudarthrosis, we analyzed 14 patients with an average follow-up duration of 21 months. Evaluation methods included back pain (visual analog scale: VAS), wedge angle, dynamic mobility, radiographic remodeling including callus and spur formation, and union status. The Student's t test was used for statistical analysis and a probability of less than 0.05 was determined as a significant difference. Back pain improved in all 14 patients with a VAS score of 57.8 ± 23.5 mm (average ± standard deviation) preoperatively and 14.7 ± 16.4 mm at the final follow-up (P \ 0.001). The wedge angle decreased from 21.6°± 8.3°(average ± standard deviation) preoperatively to 13.2°± 6.9°at the final follow-up (P \ 0.001). Callus formation was seen in four patients. Bony spurs were seen in the affected vertebra in preoperative radiographs in all patients, and were further developed to a solidified form during follow up after PVP. Dynamic mobility of the affected vertebrae was 6.9 ± 2.9 mm preoperatively, which decreased to 1.1°± 0.7°at the final follow-up (P \ 0.001). Notably, all patients showed the dynamic vertebral mobility of 2 mm or less. Nevertheless, only two patients exhibited the dynamic vertebral mobility of 0 mm at the final follow-up, which is referred to as bone union. These findings indicate that PVP serves as a mechanical stabilizer for vertebral pseudarthrosis, which leads to immediate pain relief and segmental bony responses.

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“…Osteonecrotic vertebral fractures may lead to persistent chronic pain. 20 Balloon kyphoplasty confers a lower risk of complications such as leakage and pulmonary embolism [1][2][3] and is effective for pain relief. It is suitable for patients with osteonecrosis who usually have a poor healing capacity and dynamic instability.…”

Section: Discussionmentioning

confidence: 99%

Balloon Kyphoplasty for Vertebra Plana with or without Osteonecrosis

Becker

Tuschel

Chavanne

et al. 2008

J Orthop Surg (Hong Kong)

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Purpose. To compare efficacy of balloon kyphoplasty in restoring vertebral height and correcting kyphosis in patients having vertebra plana with or without osteonecrosis. Methods. 12 women and 3 men (mean age, 76 years), who had a complete vertebra plana with or without osteonecrosis (n=8 vs n=7), underwent balloon kyphoplasty. No external manoeuvres were performed before or during balloon kyphoplasty, except for positioning the patients in a prone posture on the operating table. The anterior, middle, and posterior vertebral height and the kyphotic angle were measured pre-and post-operatively with a digital imaging system. The vertebral height was measured as a percentage of the adjacent normal vertebral height. Results. Respectively in vertebra plana patients with or without osteonecrosis, the mean corrections of (1) kyphosis were 10º and 4º (p=0.099), (2) anterior vertebral height were 33% and 5% (p<0.001), (3) middle vertebral height were 38% and 18% (p=0.004), and (4) posterior vertebral height were 19% and 2% (p=0.031).

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The Dynamic Mobility of Vertebral Compression Fractures

Cited by 263 publications

References 20 publications

Revision strategies for complications and failure of vertebroplasties

Revision strategies for complications and failure of vertebroplasties

Conversion to hypertrophic vertebral pseudarthrosis following percutaneous vertebroplasty

Balloon Kyphoplasty for Vertebra Plana with or without Osteonecrosis

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