Accidents, Traffic ; Adult ; Fractures, Compression ; diagnostic imaging ; etiology ; pathology ; surgery ; Humans ; Male ; Radiography ; Spinal Fractures ; diagnostic imaging ; etiology ; pathology ; surgery

OBJECTIVE: To explore the risk factors of hidden blood loss in osteoporosis vertebral compression fractures during percutaneous vertebral augmentation. METHODS: From October 2018 to December 2019, 360 patients with osteoporosis vertebral compression fractures who received percutaneous vertebral augmentation were enrolled in this study. The factors analyzed included gender, age, surgical methods, disease course, height, weight, the operative segment, bone mineral density, amount of bone cement, operative time, percentage of height loss, percentage of vertebral height restoration, cement leakage, blood clotting function, preoperative and postoperative hemoglobin and hematocrit and other internal diseases. Total blood loss was calculated by Gross's formula, influential factors of the hidden blood loss were further analyzed by t-test, multivariate linear regression and one-way ANOVA analysis. RESULTS: Surgical methods, the operative segment, disease course, cement leakage, preoperative hemoglobin, cement leakage via the basivertebral and segmental vein were significantly correlated with hidden blood loss(P<0.05). CONCLUSION Patients with percutaneous kyphoplasty, two-level and multi-level surgery, the course of the disease beyond 6 weeks, cement leakage via the basivertebral and segmental vein, and lower preoperative hemoglobin had more perioperative hidden blood loss.
Bone Cements/adverse effects* ; Fractures, Compression/etiology* ; Humans ; Kyphoplasty/methods* ; Osteoporosis/complications* ; Osteoporotic Fractures/surgery* ; Retrospective Studies ; Risk Factors ; Spinal Fractures/etiology* ; Treatment Outcome ; Vertebroplasty/adverse effects*

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 explore the methods and therapeutic efficacy of restitution combined with percutaneous vertebroplasty (PVP) for treating osteoporosis vertebral compression fracture (OVCF).

METHODSRecruited were 132 senile patients with OVCF who were willing to receive minimally invasive therapy were assigned to the comprehensive treatment group and the percutaneous kyphoplasty (PKP) group. The 89 vertebral bodies in the 68 cases of the comprehensive treatment group received restitution combined with PVP, while the 81 vertebral bodies in the 64 cases of the control PKP group received PKP alone. All patients completed the follow-ups for more than 3 years. The therapeutic efficacy was assessed using visual analogue scale (VAS), Oswestry disability index (ODI), Cobb's angle, the height ratios of the diseased vertebral anterior edge and middle edge. The operation time for a single centrum, the perspective time during the operation, the incidence of bone cement leakage, the injection rate of the bone cement, the cost of hospitalization, and the hospital days were compared between t he comprehensive treatment group and the PKP group.

RESULTSCompared with before treatment in the same group, the VAS and ODI were significantly lower, the height ratios of the diseased vertebral anterior edge and middle edge, and the Cobb's angle were obviously improved in the two groups, showing statistical difference (P < 0.01). There was no significant difference in the aforesaid indices between the two groups after treatment at the same time point (P > 0.05). There was no significant difference in the incidence of bone cement leakage, th e injection rate of the bone cement, or the hospital days between the two groups (P > 0.05). But the operation time f or individual vertebral body, the perspective time during the operation, and the cost of hospitalization were obviously less in the comprehensive treatment group than in the PKP group (P < 0.01).

CONCLUSIONSRestitution combined PVP could achieve the same therapeutic efficacy as that of the PKP. It could effectively restore the diseased vertebral height and correct the spinal kyphosis. Besides, there was no statistical difference in the incidence of bone cement leakage.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; etiology ; therapy ; Humans ; Kyphoplasty ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Osteoporosis ; complications ; Posture ; Spinal Fractures ; etiology ; therapy ; Vertebroplasty ; methods

OBJECTIVETo comparatively study the efficacy and safety of unilateral and bilateral balloon kyphoplasty in the treatment of painful multi-vertebral osteoporotic compression fractures.

METHODSFrom May 2002 to June 2007, 41 consecutive patients with painful multi-vertebral osteoporotic compression fractures underwent unilateral or bilateral kyphoplasty. The unilateral group included 3 male and 14 female with an average age of 70.4 (range 52 to 91 years old). The bilateral group included 4 men and 20 women with an average age of 72.4 (range 61 to 87 years old). Each procedure included insertion of inflatable balloon, fracture reduction and cement filling under "C"-arm monitoring. Preoperative and postoperative pain level, SF-36 score, radiographs and complications were recorded and analyzed.

RESULTSAll 41 patients tolerated the operation well. The mean operation time were (86 +/- 32) min and (120 +/- 26) min for unilateral and bilateral groups respectively; the mean volume of cement injected into one level were (3.9 +/- 1.6) ml and (5.4 +/- 2.1) ml for unilateral and bilateral groups respectively. The mean follow-up were (32.5 +/- 17.2) months and (30.7 +/- 14.3) months for unilateral and bilateral groups respectively. The mean VAS pain score of unilateral group decreased significantly from 7.4 +/- 2.1 preoperatively to 2.7 +/- 1.9 postoperatively (t = 2.50, P < 0.05) and 3.1 +/- 2.2 at final follow-up, the mean VAS pain score of bilateral group decreased significantly from 7.9 +/- 2.1 preoperatively to 2.3 +/- 2.5 postoperatively (t = 2.41, P < 0.05) and 2.7 +/- 2.2 at final follow-up, no significant difference was found between two groups. Significant increase of the mean height of anterior and medial vertebral body were recorded after the operation and maintained at final follow-up. The mean correction of local kyphosis was 7.2 degrees +/- 4.9 degrees for unilateral group and 7.3 degrees +/- 5.9 degrees for bilateral group, no significant difference was found between two groups. Postoperatively, 6 of 8 subscales measured by SF-36 were significantly improved for both groups. Complications were found in 7 patients including 6 cases of cement leakage and 1 case of pulmonary embolization.

CONCLUSIONAs a minimally invasive procedure, unilateral or bilateral kyphoplasty is effective and relatively safe for multi-vertebral osteoporotic compression fracture.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Fractures, Compression ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Spinal Fractures ; etiology ; surgery ; Treatment Outcome ; Vertebroplasty ; methods

OBJECTIVETo analyze the perioperative complications of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture.

METHODSFrom June 2009 to December 2011, 63 patients with osteoporotic vertebral compression fracture underwent PKP, there were 18 males and 45 females with an average age of 75.3 years ( ranged, 62 to 91). All patients with severe back pain and without neurological symptoms and signs, which were confirmed by X-ray and MRI. Among them,there were 63 cases with severe osteoporosis, 37 cases with hypertension, 10 with coronary artery disease, 29 with anemia, 26 with diabetes, 11 with chronic obstructive pulmonary diseases and 8 with gastritis and peptic ulcer. The common perioperative complications were retropectively reviewed.

RESULTSPreoperative complications occured in 9 cases (14.3%), including hypostatic pneumonia (1 case), electrolyte disturbances (2 cases), urinary tract infection (2 cases), moderate anemia(2 cases),electrolyte disturbances combined with moderate anemia (1 case), hypostatic pneumonia combined with delirium (1 case). Intraoperative and postoperative. complications occurred in 17 cases (26.9%), there were bone cement correlated complications in 9 cases (14.3%), in which 2 cases of toxic reaction of bone cement and 7 cases of leakage (2 cases had clinical symptoms); there were non-bone cement correlated complications in 3 cases (4.8%), in which 1 case of focal hematoma caused by paracentesis, 1 case of transient nerve injury, 1 case of left intercostal neuralgia;there were transient hyperpathia in 5 cases after operation. All complications result in no severe consequence after treatment.

CONCLUSIONPerioperative complications of percutaneous kyphoplasty are not uncommon,however,these complications may not cause serious consequence after active treatment,so prevention and treatment are important for it.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Intraoperative Complications ; etiology ; Kyphoplasty ; adverse effects ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; adverse effects ; Male ; Osteoporotic Fractures ; surgery ; Pain, Postoperative ; etiology ; Spinal Fractures ; surgery

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

OBJECTIVETo investigate the correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures(OVCFs).

METHODSFrom August 2009 to September 2011, 126 patients who underwent single-level PVP for OVCFs were included in this study. They were followed up with an average time of 13.6 months,divided into the refracture group and non-refracture group according to the onset of non-surgical vertebral fractures or not. In refracture group,there were 14 males and 18 females with an average age of (67.63+/-7.28) years(ranged, 54 to 82); and in non-refracture group,there were 40 males and 54 females with an average age of (66.26+/-6.79) years (ranged, 55 to 76). The refracture group wps divided again into adjacent vertebral fracture (AVF) group (7 males and 13 females) and remote vertebral fracture(RVF) group (4 males and 8 females). The age, sex, bone mineral density(BMD), injecting bone cement volume, the recovery rate of vertebral body height,kyphosis corrected degree were recorded and the correlative factors of non-surgical vertebral fractures were analyzed.

RESULTSThere was no statistically significant differences in age, sex, BMD, injecting bone cement volume and kyphosis corrected degree between refracture group and non-refracture group (P>0.05), and there was statistically significant difference in the recovery rate of vertebral body height (P<0.05). There was no statistically significant difference in BMD, kyphosis corrected degree between adjacent vertebral fracture group and non-refracture group (P>0.05); and there was statistically significant difference in injecting bone cement volume,recovery rate of vertebral body height(P<0.05). There was no statistically significant difference in BMD,injecting bone cement volume,recovery rate of vertebral body height, kyphosis corrected degree between remote vertebral fracture group and non-refracture group (P>0.05).

CONCLUSIONRecovery of vertebral body height may prefigure increasing risk of refracture in non-surgical vertebral body for the patient with OVCFs after PVP, and the adjacent vertebral fracture maybe concerned with injecting bone cement volume and recovery rate of vertebral body height.

Aged ; Aged, 80 and over ; Bone Density ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Spinal Fractures ; etiology ; Vertebroplasty ; adverse effects

Bone Cements ; Fractures, Compression/etiology* ; Humans ; Kyphoplasty/adverse effects* ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Spine ; Treatment Outcome ; Vertebroplasty/adverse effects*