BACKGROUND: Percutaneous vertebroplasty (PV) is a minimally invasive, image-guided therapy used to relieve pain from osteoporotic vertebral compression fractures. Venography before injection of bone cement has been advocated as a means of identifying sites of potential venous leakage during the procedure. However, venography has been used only in selected situations, and its need is debatable. We aimed to analyze the usefulness of venography with percutaneous vertebroplasties for osteoporotic compression fractures and to report our recent experiences in treating such patients. METHODS: One hundred PVs performed on 93 patients were evaluated. To identify the usefulness of venography, our cases were divided into 2 groups. Group A patients had venographies before the PVs, whereas Group B patients were treated without venography. We analyzed their clinical status, pain status, and complications linked to leakage of bone cement. RESULTS: There were no significant differences in any of the collected data for the two groups. CONCLUSION: Our results indicate that PVs can be performed safely without venography beforehand. However, venography may be beneficial for less experienced physicians or trainees.
Fractures, Compression ; Humans ; Intraoperative Complications ; Phlebography ; Vertebroplasty

BACKGROUND: Percutaneous vertebroplasty (PV) is a minimally invasive, image-guided therapy used to relieve pain from osteoporotic vertebral compression fractures. Venography before injection of bone cement has been advocated as a means of identifying sites of potential venous leakage during the procedure. However, venography has been used only in selected situations, and its need is debatable. We aimed to analyze the usefulness of venography with percutaneous vertebroplasties for osteoporotic compression fractures and to report our recent experiences in treating such patients. METHODS: One hundred PVs performed on 93 patients were evaluated. To identify the usefulness of venography, our cases were divided into 2 groups. Group A patients had venographies before the PVs, whereas Group B patients were treated without venography. We analyzed their clinical status, pain status, and complications linked to leakage of bone cement. RESULTS: There were no significant differences in any of the collected data for the two groups. CONCLUSION: Our results indicate that PVs can be performed safely without venography beforehand. However, venography may be beneficial for less experienced physicians or trainees.
Fractures, Compression ; Humans ; Intraoperative Complications ; Phlebography ; Vertebroplasty

Humans ; Histiocytosis, Sinus/diagnosis* ; Fractures, Compression/complications* ; Diagnosis, Differential

Objective To investigate the effect of sarcopenia on the efficacy of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic spinal compression fracture(OSCF)in elderly patients. Methods From February 2017 to June 2018,a total of 77 elderly patients who met the inclusion and exclusion criteria were included in this study.Grip strength of dominant hand was measured by an electronic grip dynamometer with cut-off values of 27 kg for males and 16 kg for females.The cross-sectional area of the pedicle level muscle of the 12th thoracic vertebra(T12)was measured by chest CT.The skeletal muscle index(SMI)was calculated by dividing the T12 pedicle level muscle cross-sectional area by the square of body height.The SMI cut-off value used to diagnose sarcopenia was 42.6 cm
Aged ; Female ; Fractures, Compression/surgery* ; Humans ; Kyphoplasty ; Male ; Osteoporotic Fractures/surgery* ; Retrospective Studies ; Sarcopenia/complications* ; Spinal Fractures ; Treatment Outcome

OBJECTIVETo study therapeutic effects of Sky-bone expander for the treatment of osteoporotic vertebral compressed fractures.

METHODSFifteen patients (18 vertebrae) suffering from vertebral compression fractures were treated with Sky bone expander system which expanded and reconstructed the vertebral body with PMMA cement. The clinical effect was evaluated by observing the changing of visual analogue scale (VAS). The preoperative and postoperative mean VAS scores were compared by paired-sample t test. All the patients were followed up by telephone or clinic consulting after being discharged from our hospital.

RESULTSThe procedure was performed successfully in 15 patients. The operation time ranged from 45 to 110 minutes (65 minutes per vertebra on average). The patients were followed up and the duration ranged from 6 to 12 months (8 months on average). The mean VAS score of the patients were improved significantly at the third postoperative day compared with those before the operation (2.5 +/- 1.3, vs 7.7 +/- 1.1, all P < 0.05). The mean VAS score at the end of the follow-up was 2.2 +/- 1.2.

CONCLUSIONSky bone expander system provides significant pain relief effect in the cases of osteoporotic vertebral compression fractures, shortens the duration of lying in bed, and its procedure is convenient with few complications.

Aged ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Pain Measurement ; Spinal Fractures ; surgery ; Vertebroplasty

OBJECTIVETo explore the clinical efficacy and safety of balloon kyphoplasty for the aged osteoporotic vertebral compression fractures.

METHODSFrom June 2006 to August 2009, balloon kyphoplasty was performed on 26 patients (30 vertebral bodies), who presented painful vertebral compression fractures. They were 10 males and 16 femals, with an average age of 70 years ranging from 59 to 78 years. The operative segments were 4 cases in T11 vertebraes, T12 in 10, L1 in 12, L2 in 3, L4 in 1. The reduction of compressed vertebrae was displayed by X-ray, and the patients were followed up by observation of the visual analog scale and complications.

RESULTSAll cases had rapid, significant and sustained improvements in postoperative pain following balloon kyphoplasty. Visual analog scale was reduced from (8.6 +/- 0.2) to (2.0 +/- 0.3) points. The anterior and midline vertebral body heights in 30 fractured vertebral bodies increased from pre-operative (18.34 +/- 3.25) mm, (14.36 +/- 2.56) mm up to pro-operative (20.51 +/- 1.34) mm, (19.66 +/- 1.28) mm (P < 0.05) respectively. No severe leakage occured.

CONCLUSIONBalloon kyphoplasty in treatment of osteoporotic vertebral compression fractures can restore the height of fractured vertebra, relieve pain and improve the spinal function with satisfactory clinical outcomes.

Aged ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Pain Measurement ; Spinal Fractures ; surgery ; Vertebroplasty ; methods

Humans ; Spinal Fractures/etiology* ; Fractures, Compression/etiology* ; Osteoporotic Fractures/complications* ; Vertebroplasty/adverse effects* ; Bone Diseases, Metabolic/complications* ; Punctures/adverse effects* ; Treatment Outcome ; Bone Cements ; Retrospective Studies

OBJECTIVETo evaluate the clinical outcome of percutaneous kyphoplasty in treating vertebral compression fractures.

METHODSFrom October 2008 to May 2010,41 patients with osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty. There were 10 males and 31 females, ranging in age from 61 to 83 years, with an average of 67.5 years. Fracture site was from T9 to L4 including 65 vertebral bodies. Clinical symptom was lumbar and back pain to affect orthobiosis. The pain, height of vertebral body, Cobb angle, function of daily activities were analyzed by VAS sore, imaging data, Oswestry score before and after operation.

RESULTSAll operations were successful and no severe complications were found. Bone cement leakage occurred in 7 vertebrae, but no clinical sympton. All lumbago obtained obviously anesis after operation. All patients were followed up from 7 to 26 months with an average of 14 months. Preoperative, postoperative and at final follow-up, VAS score was 8.38 +/- 0.60, 2.45 +/- 0.38, 2.53 +/- 0.36, respectively; Oswestry score was 40.00 +/- 1.16, 17.00 +/- 2.11, 15.00 +/- 1.41, respectively; height of vertebral body was (14.64 +/- 1.30), (25.11 +/- 1.12), (23.16 +/- 1.14) mm, respectively; Cobb angle was (30.17 +/- 1.45) degrees, (12.10 +/- 1.37) degrees, (14.31 +/- 0.51) degrees, respectively. There was significant difference between postoperative and preoperative, and between at final follow-up and preoperative (P<0.05). There was no significant difference between final follow-up and postoperative (P>0.05).

CONCLUSIONPercutaneous kyphoplasty is effective for treatment of senile osteoporotic vertebral compression fractures, which can expeditiously relieve pain and effectively recover height of vertebral body and kyphosis Cobb angle, has advantages of minimal trauma and good security.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Fractures, Compression ; complications ; surgery ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporosis ; complications ; Skin ; Spinal Fractures ; complications ; surgery

A 45 year old woman was diagnosed as having anteromedial radial head dislocation and distal radius fracture five months after her injury on right forearm. The radial head dislocation led to ulnar nerve compression. She had severe restriction of her elbow movements. She was treated with arthrolysis, decompression of the ulnar nerve and radial head resection. The reverse Essex Lopresti injury and radial head dislocation compressing the ulnar nerve has not been reported in English language literature to the best of our knowledge. A mechanism is proposed for the injury. In acute presentations, restoration of both the radioulnar joints should be done and neglected nature of such injury leads to suboptimal outcomes.
Female ; Humans ; Joint Dislocations ; complications ; Middle Aged ; Radius ; injuries ; Radius Fractures ; complications ; Ulna ; injuries ; Ulnar Nerve Compression Syndromes ; etiology

OBJECTIVETo explore the reasons of secondary fracture after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs) and discuss the measure of prevention and cure.

METHODSFrom January 2011 to January 2013, the clinical data of 180 patients with primary OVCFs treated by PVP were retrospectively analyzed. There were 75 males and 105 females, aged from 68 to 95 years old with an average of (79.50 ± 5.45) years. The involved vertebrae were identified according to the clinical symptoms and imaging data. PVP were performed in 362 vertebrae and the patients were followed up with an average of 12 months. Subsequent vertebral fractures were found through the pain's reappearance and MRI or bone scan. The patients were divided into secondary fracture group and no-secondary fracture group according to the subsequent fractures or no. Secondary fracture group was divided into two groups according to gender, and the patients with secondary fracture were also categorized into the original surgical vertebral fractures, adjacent vertebral fracture and remote vertebral fractures. The age, gender, the cement volume, the cement leakage, secondary fracture site, the incidence and type of secondary fracture were observed and compared among different groups.

RESULTSAmong the 362 vertebrae of PVP, there were 109 vertebrae in male and 253 vertebrae in female. And 27 vertebrae (10 in male and 17 in female) of 22 cases (9 males and 13 females) occurred secondary fracture. The second PVP were performed in 13 cases (16 vertebrae) and the third PVP in 2 cases (4 vertebrae); 7 cases (7 vertebrae) were treated with conservative therapy. There was no statistically significant difference on age, gender, cement volume and leakage between secondary fracture group and no-secondary fracture group (P > 0.05). There was no statistically significant difference on the incidence and type of secondary fracture between male and female (P > 0.05). No significant difference was found on the adjacent and remote vertebral fractures (P > 0.05). Most of secondary fracture occurred in 6 months, and whether the single and double side injection, cement leakage had no obvious relation.

CONCLUSIONThere is no significant difference in the subsequent fracture after PVP for the OVCFs different gender and fractured site, and also no significant difference in the adjacent and remote vertebral fractures. The report didn't support the biomechanical viewpoint that vertebral body stiffness increasing after PVP would lead to adjacent vertebral stress increasing and result easily in adjacent vertebral fracture. Secondary fracture occurs always in 6 months after operation, which is the natural course of osteoporosis.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; etiology ; Recurrence ; Retrospective Studies ; Spinal Fractures ; surgery ; Vertebroplasty