No abstract available.
Fractures ; Compression Pain

Percutaneous vertebroplasty (PV) is a minimally invasive procedure for osteoporotic vertebral compression fractures that fail to respond to conventional conservative treatment. It significantly improves intolerable back pain within hours, and has a low complication rate. Although rare, PV is not free of complications, most of which are directly related to cement leakage. Because of its association with new adjacent fracture, the importance of cement leakage into the adjacent disc space is paramount. Here, we report an interesting case of cement leakage into the adjacent upper vertebral body as well as disc space following PV. To the best of our knowledge, there has been no report of cement leakage into the adjacent vertebral body following PV. This rare case is presented along with a review of the literature.
Back Pain ; Fractures, Compression ; Osteoporosis ; Vertebroplasty*

Vertebral compression fractures are the most prevalent complications of osteoporosis, with symptoms of low back pains. Basically, the vertebral compression fractures are regarded as a self-limiting disease, and thus, conservative treatment is enough for most cases, but nevertheless, they have the potential to cause significant rates of disability and morbidity. Percutaneous vertebroplasty is a widely used minimally invasive procedure, where the outcome is largely affected according to appropriate selections of patients and the time of the procedures. We hereby report a multi-level percutaneous vertebroplasty for a patient with multiple compression fractures which accompanies the Kummell's disease with rapidly deteriorating general condition despite his conservative treatments.
Fractures, Compression* ; Humans ; Low Back Pain ; Osteoporosis ; Vertebroplasty*

Osteoporotic patients who undergo percutaneous vertebroplasty (PVP) have the risk of a repeated collapse of their adjacent vertebral body due to alteration of load transfer into the adjacent vertebral body. The authors have experienced a rare case of repeated osteoporotic vertebral compression fractures (VCF) resulting in extreme multi-level PVP. A 74-year-old female developed severe back pain after slipping down one month ago. Her X-ray and MR images indicated a T11 VCF. She underwent successful PVP with polymethylmethacrylate (PMMA). Two weeks later, she returned to our hospital due to a similar back pain. Repeated X-ray and MR images showed an adjacent VCF on T12. A retrial of PVP was performed on T12, which provided immediate pain relief. Since then, repeated collapses of the vertebral body occurred 12 times in 13 levels within a 24-month period. Each time the woman was admitted to our hospital, she was diagnosed of newly developed VCFs and underwent repeated PVPs with PMMA, which finally eased back pain. Based on our experience with this patient, repeated multiple PVP is not dangerous because its few and minor complications. Therefore, repeated PVP can serve as an effective treatment modality for extreme-multi level VCFs.
Aged ; Back Pain ; Female ; Fractures, Compression ; Humans ; Polymethyl Methacrylate ; Vertebroplasty

Vertebral compression fractures result in vertebral height loss and alter sagittal spinal alignment, which in turn can lead to increased morbidity and mortality. Acute osteoporotic vertebral compression fractures are known to increase mobility and instability of the spine. There are limited published data correlating the degree of dynamic mobility and the efficacy of kyphoplasty on vertebral compression fractures. Here we report a 73-year-old female with a severe acute osteoporotic L2 compression fracture who obtained total vertebral height restoration following kyphoplasty, with resolution of back pain.
Aged ; Back Pain ; Female ; Fractures, Compression ; Humans ; Kyphoplasty ; Osteoporosis ; Spine

The authors report 2 patients with benign vertebral compression fracture with intravertebral vacuum. Both patients suffered from back pain after minor back trauma and were treated by kyphoplasty. The spine images of one case shows intra-and inter-vertebral vacuum dots since 1weeks after trauma. The other's shows only intravertebral vacuum dots immediately after trauma and then intravertebral vacuum cleft(Kummell's disease) 5 weeks after trauma. The authors speculate that Kummell's disease(delayed posttraumatic vertebral collapse with intravertebral vacuum cleft) was evolved from untreated or unrecognized vertebral compression fracture. Kummell's disease is not a independent disease entity.
Back Pain ; Fractures, Compression ; Humans ; Kyphoplasty ; Spine ; Vacuum

OBJECTIVES: To evaluate the effectiveness of facet joint injection for acute phase of osteoporotic vertebral compression fracture as alternative method for vertebrolplasty. MATERIALS AND METHODS: From January 2001 to May 2007, a total 275 patient of osteoporotic vertebral compression fracture treated with conservative treatment or facet joint injection were selected. We divided all patients into two groups as treated only conservative treatment or facet joint injection. RESULTS: In comparison, group of patient who took facet joint injection showed significantly increased effects than the other group in pain, using pain controller and activity (P<0.05). Group of patient who took conservative treatment, are treated with vertebroplasty in 52 patients, are showed the loss of height in vertevral body in 4 patients. Group of patient who took facet joint injection, are treated with vertebroplasty in 43 patients, are showed the loss of height in vertevral body in 29 patients. There was no complication with facet joint injection or vertebroplasty. CONCLUSIONS: Facet joint injection is the effective and stable technique for acute pain on acute osteoporotic vertebral compression fracture. The loss of height in vertevral body is more frequent at group of patient who took facet joint injection.
Acute Pain ; Fractures, Compression ; Humans ; Vertebroplasty ; Zygapophyseal Joint

As we get older, our bones get thinner and their strength decreases. Osteoporosis is a disease in which bones become very weak and are more likely to break. It often develops unnoticed over many years, showing no symptoms or discomfort until a bone breaks. Fractures caused by osteoporosis occur most often in the spine. These spinal fractures-called vertebral compression fractures-occur in nearly 700,000 patients each year. They occur almost twice as often as do other fractures typically linked to osteoporosis, such as broken hips and wrists. Recently, several reports have been published on the results of vertebral augmentation procedures and fusion. However, many questions have been raised about the amount of pain relief that can be expected after such procedures. Although these few studies have sparked some debates in the medical community, it is important to remember that many procedures have also shown significant improvement in relief in back pain from vertebral compression fractures.
Back Pain ; Fractures, Compression ; Hip ; Humans ; Osteoporosis ; Spine ; Wrist

Percutaneous vertebroplasty is an effective, minimally invasive procedure for the treatment of vertebral compression fractures, and is a technique for treating lower back pain that appears to be increasingly popular throughout the world. We experienced two cases involving a rare complication of percutaneous vertebroplasty, namely pulmonary embolism caused by acrylic cement. One patient showed no subjective symptoms after vertebroplasty, while the other experienced chest pain. In the former, fluoroscopy demonstrated perivertebral venous leakage during vertebroplasty, and at chest radiography, tubular or branching high-density linear structures were observed. In addition, intravascular emboli were identified at CT. In the second patient, symptomatic therapy led to reduced chest pain.
Chest Pain ; Fluoroscopy ; Fractures, Compression ; Humans ; Low Back Pain ; Pulmonary Embolism* ; Radiography ; Thorax ; Vertebroplasty*

OBJECTIVE: This retrospective study of 215 patients with 383 symptomatic osteoporotic vertebral compression fractures (VCFs) treated by percutaneous vertebroplasty (PVP), was performed to evaluate the clinical outcomes, and to analyze the various clinical factors affecting these results. METHODS: The authors assessed the clinical outcome under the criteria such as the pain improvement, activity, requirement of analgesics, and the patient's satisfaction, and determined the relation to various peri- and intra-operative factors, and postoperative imaging findings. RESULTS: The outcome was determined as 84.2% in relief of pain, 72.0% in change in activity, 65.7% in analgesics use, and 84.7% of satisfaction rate. More severe focal back pain, high uptake bone scan, and the lower mean T-score were related to the better pain relief following PVP. The longer the duration between fracture and PVP, the less severe focal back pain, low uptake bone scan, and leakage of PMMA into the paravertebral space were related to the less improvement in activity. Female and low uptake bone scan showed a correlation with more analgesic use. The longer the duration between fracture and PVP, low uptake bone scan, and the higher the mean T-score were correlated with the less the patients satisfaction. CONCLUSION: Our study suggests that PVP may be more effective in the acute phase of VCFs, more severe focal pain, and far advanced osteoporosis on BMD. Leakage of PMMA into the paravertebral spcae also could be affecting the surgical results.
Analgesics ; Back Pain ; Female ; Fractures, Compression ; Humans ; Low Back Pain ; Osteoporosis ; Polymethyl Methacrylate ; Retrospective Studies ; Vertebroplasty