Transdiscal mid- and upper thoracic vertebroplasty: first description of 2 exemplary cases

Filis, Andreas; Aghayev, Kamran; Schaller, Bernhard; Luksza, Jennifer; Vrionis, Frank D.

doi:10.3171/2015.12.spine15946

Cited by 4 publications

(2 citation statements)

References 12 publications

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“…In such cases, it is necessary to devise to change the approach to the VB. [ 26 ] Finally, the population size is relatively small and future studies would need a larger sample size.…”

Section: Discussionmentioning

confidence: 99%

Five-year follow up results of posterior decompression and fixation surgery for delayed neural disorder associated with osteoporotic vertebral fracture

Yasuda

Kawaguchi²,

Suzuki³

et al. 2017

Medicine

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Usually, after osteoporotic vertebral fracture (OVF), bone healing follows a normal clinical course leading to bone union with conservative treatment using a brace. However, some patients with OVF do not undergo the normal fracture healing process for a few months, possibly leading to delayed union and/or pseudoarthrosis. In these cases, we performed posterior surgery with combined decompression, vertebroplasty, and posterior spinal fusion with spinal instrumentation. This study aimed to determine the clinical results of posterior surgery for delayed neural disorder secondary to OVF over a 5-year follow-up.Forty-one Japanese patients who had posterior surgery for delayed paralysis secondary to OVF were enrolled in this study. All patients were followed for ≥5 years (mean, 67 months; range, 61–86 months). Patients comprised 12 men and 29 women with an average age of 76.3 ± 6.2 years (range 63–87 years) at the time of operation. We performed posterior fixation from 2 levels above to 1 level below the decompression and vertebroplasty as an all in one procedure. Vertebral height index (VHI) and kyphotic angle (KA) were evaluated on radiogram. For clinical symptoms, a visual analog scale of back and leg pain and the Frankel classification and Japanese Orthopaedic Association scores were used.During the operation and perioperative period, no serious complications occurred. In all patients, symptoms improved within 1 month and were maintained for 5 years postoperatively. In all patients, VHI and KA improved after surgery; however, reduction losses of 7.7% of VHI and 23% of KA were recognized. Five of 41 patients required reoperation due to adjacent vertebral fracture (AVF) and recollapse of the vertebral body.Operation time and blood loss were acceptable, even for elderly patients. In all patients, alignment and subjective symptoms improved. However, reoperation owing to AVF and recollapse was necessary within 1 year in 5 of 41 (12%) patients. Careful follow-up is required within 1 year after surgery for OVF.

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“…In such cases, it is necessary to devise to change the approach to the VB. [ 26 ] Finally, the population size is relatively small and future studies would need a larger sample size.…”

Section: Discussionmentioning

confidence: 99%

Five-year follow up results of posterior decompression and fixation surgery for delayed neural disorder associated with osteoporotic vertebral fracture

Yasuda

Kawaguchi²,

Suzuki³

et al. 2017

Medicine

View full text Add to dashboard Cite

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“…[2,3] Percutaneous vertebroplasty (PVP) has, therefore, been developed and is now a common surgical treatment for VCF, with proven effectiveness for rapidly improving pain and physical dysfunction. [4–6]…”

Section: Introductionmentioning

confidence: 99%

Influence of vertebral bone mineral density on total dispersion volume of bone cement in vertebroplasty

Liu²,

Luo

et al. 2019

Medicine

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The aim of this study was to investigate the influence of vertebral bone mineral density (BMD) on total diffusion volume of bone cement in percutaneous vertebroplasty (PVP). This study was a retrospective review of prospectively collected data of consecutive patients with A1.2 thoracolumbar compression fractures treated by PVP. Vertebral BMD was measured before surgery and participants were divided into 3 groups according to World Health Organization diagnostic criteria for osteoporosis: Group A (normal BMD), Group B (reduced BMD), and Group C (osteoporosis). All vertebrae were injected with 3 mL of bone cement via the unilateral pedicle and scanned by computed tomography after surgery. Actual injection volume (bone cement only) and total diffusion volume (bone cement plus trabeculae and space) were calculated. Pain severity was determined by the visual analog scale before surgery and at both 1 day and 1 month after surgery. There were no significant differences in injection volume among the groups ( P > .05), but the total dispersion volume was greater than injection volume in all groups ( P < .05). Pairwise comparison showed a significant difference in total diffusion volume of bone cement between groups, with Group A having the largest volume and Group C the smallest volume. Pain was significantly reduced 1 day after surgery in each group compared with before surgery, but there were no significant between-group differences at 1 day or 1 month. Increasing vertebral BMD was positively correlated with increasing total diffusion volume. BMD does not significantly affect pain relief, despite producing a significantly lower distribution volume in osteoporotic patients.

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Biomechanical analysis of a trans-discal, multi-level stabilization screw (MLSS) at the upper instrumented vertebra (UIV) of long posterior thoracolumbar instrumentations

Collins,

Shah,

Shekouhi

et al. 2024

Spine Deform

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Purpose To evaluate proximal junctional biomechanics of a MLSS relative to traditional pedicle screw fixation at the proximal extent of T10-pelvis posterior instrumentation constructs (T10-p PSF). Methods A previously validated three-dimensional osseoligamentous spinopelvic finite element (FE) model was used to compare proximal junctional range-of-motion (ROM), vertebral body stresses, and discal biomechanics between two groups: (1) T10-p with a T10-11 MLSS (“T10-11 MLSS”) and (2) T10-p with a traditional T10 pedicle screw (“Traditional T10-PS”). Results The T10-11 MLSS had a 5% decrease in T9 cortical bone stress compared to Traditional T10-PS. Conversely, the T10 and T11 bone stresses increased by 46% and 98%, respectively, with T10-11 MLSS compared to Traditional T10-PS. Annular stresses and intradiscal pressures (IDP) were similar at T9-T10 between constructs. At the T10-11 disc, T10-11 MLSS decreased annular stresses by 29% and IDP by 48% compared to Traditional T10-PS. Adjacent ROM (T8-9 & T9-10) were similar between T10-11 MLSS and Traditional T10-PS. T10-11 MLSS had 39% greater ROM at T10-11 and 23% less ROM at T11-12 compared to Traditional T10-PS. Conclusions In this FE analysis, a T10-11 MLSS at the proximal extent of T10-pelvis posterior instrumentation resulted in increased T10 and T11 cortical bone stresses, decreased discal annular stress and IDP and increased ROM at T10-11, and no change in ROM at the adjacent level. Given the complex and multifactorial nature of proximal junctional kyphosis, these results require additional biomechanical and clinical evaluations to determine the clinical utility of MLSS on the proximal junctions of thoracolumbar posterior instrumented fusions.

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Transdiscal mid- and upper thoracic vertebroplasty: first description of 2 exemplary cases

Cited by 4 publications

References 12 publications

Five-year follow up results of posterior decompression and fixation surgery for delayed neural disorder associated with osteoporotic vertebral fracture

Five-year follow up results of posterior decompression and fixation surgery for delayed neural disorder associated with osteoporotic vertebral fracture

Influence of vertebral bone mineral density on total dispersion volume of bone cement in vertebroplasty

Biomechanical analysis of a trans-discal, multi-level stabilization screw (MLSS) at the upper instrumented vertebra (UIV) of long posterior thoracolumbar instrumentations

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