Thoracolumbar Osteoporotic Vertebral Compression Fracture Treatment by Unilateral Percutaneous Vertebroplasty Using Curved Diffusion Needle

Spinal Endoscopy-Targeted Bone Grafting for the Vertebral “Shell” Phenomenon: A Case Report

“…The primary reasons for the vertebral "shell" phenomenon include severe compression fractures (>50% compression), compromised disc integrity, intraoperative overdistraction, failure of nail placement in the injured vertebra, and osteoporosis [1][2][3]. In the present case, the patient presented with the abovementioned features.…”

“…Owing to difficulties in the preoperative detection of the vertebral "shell" intraoperative interventions are often difficult. The choice of surgical approach is currently advocated in favour of vertebral pedicle screw-based fixation combined with Percutaneous Vertebroplasty (PVP) or vertebral body bone grafting [1][2][3]5,6]. Hu et al [3] have reported that intervention is required for patients with severe compression fractures (>50% compression) and osteoporosis.…”

“…Although the height of the vertebral body is restored after reduction, its skeletal structure is not, resulting in the formation of a bone defect area within the vertebral body, which is called the "shell" phenomenon. This "shell" phenomenon has a high incidence of approximately 52%-100% and is an unpredictable preoperative event, further increasing the incidence of associated complications, including vertebral collapse, height loss, internal fixation failure, and nonunion [1][2][3]. Moreover, the clinical treatment modalities and filler material selection are controversial, leading to the absence of a standardized treatment strategy [2,3].…”

“…This "shell" phenomenon has a high incidence of approximately 52%-100% and is an unpredictable preoperative event, further increasing the incidence of associated complications, including vertebral collapse, height loss, internal fixation failure, and nonunion [1][2][3]. Moreover, the clinical treatment modalities and filler material selection are controversial, leading to the absence of a standardized treatment strategy [2,3]. To the best of our knowledge, to date, no study has reported the treatment of the vertebral "shell" using spinal endoscopy-targeted bone grafting via superior pedicle notch approach.…”

Percutaneous Curved Vertebroplasty and Bilateral-Pedicle-Approach Percutaneous Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fracture: A Meta-Analysis

“…Bone cement is distributed more uniformly in the latter procedure, but it has many disadvantages, including a large amount of trauma, a lengthy operation time, and a high price tag. 7,8 Various clinical reports have described unilateral or bilateral puncture PVP over the last few years, but there have been many studies comparing the 2 puncture methods from a clinical 9 and biomechanical standpoint, with the results tending to favor unilateral puncture. 7 A unilateral PVP approach requires increasing the angle of the puncture unilaterally to create a diffuse and uniform distribution of bone cement between the vertebrae.…”