Cement Distribution Research Articles

Precooling storage of bone cement in percutaneous vertebroplasty for osteoporotic vertebral compression fracture

PurposeThis study aimed to investigate the effect of precooling storage of bone cement in percutaneous vertebroplasty(PVP) for the patients with osteoporotic vertebral compression fracture (OVCF).MethodsA total of 207 OVCF patients who underwent PVP were included in this study. Two different storage methods for the bone cement were randomly utilized: an operating room (NT group, 23 °C) and a refrigerator (PC group, 4 °C). Clinical outcomes were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI) scores. In addition, radiographic evaluations were performed using anterior vertebral height and Cobb angle.ResultsThe time of cement infusion was 10.8 ± 2.1 min in the PC group, which was significantly longer compared to the NT group (6.9 ± 1.8 min)(P < 0.0001). However, the postoperative VAS score was lower in the PC group than the NT group (P < 0.0001). Moreover, compared to the NT group, the cement distribution score and rate of cement touching both upper and lower vertebral endplates were higher in the PC group (P < 0.0001 and = 0.037, respectively). Additionally, the anterior vertebral height was higher in the PC group compared to the NT group at both the 2-day postoperative assessment and the final follow-up (P = 0.046 and 0.026, respectively). Lastly, the rates of cement leakage and re-compression were lower in the PC group (P = 0.016 and 0.034, respectively) compared with the NT group.ConclusionPrecooling storage of bone cement may prolong manipulation time in percutaneous vertebroplasty, optimize pain relief for patients, and mitigate the risk of bone cement leakage and re-compression.Trial registrationTrial registration number: ChiCTR2400092330. Retrospective registration date: 14/11/2024 (www.chictr.org.cn).

Association between vertebral bone quality score and residual back pain following percutaneous vertebroplasty for osteoporotic vertebral compression fractures.

Residual back pain (RBP) is one of the complications following percutaneous vertebroplasty (PVP) in older people with osteoporotic vertebral compression fractures (OVCFs). The vertebral bone quality (VBQ) score obtained from magnetic resonance imaging (MRI) can be used to evaluate bone quality. The objective of this study aimed to explore the potential relationship between the VBQ score and RBP after PVP. From January 2018 to January 2022, patients with OVCFs who underwent PVP in our hospital were retrospectively reviewed. Each patient's lumbar VBQ score was recorded. The RBP was defined as a visual analog scale (VAS) score ≥ 4 for back pain postoperatively. Other variables included demographic, clinical, radiological, and surgical data. The univariate and multivariate logistic regression analyses were used to determine the independent risk factors. The incidence of RBP was 8.0% among 598 patients. The results of the multivariate regression analysis showed that preoperative VBQ score (OR 3.295, P < 0.001), BMD (OR 0.545, P = 0.007), lumbodorsal fascia contusion (OR 4.297, P = 0.034), and cement distribution (OR 4.556, P = 0.006) were risk factors associated with RBP after PVP. The preoperative high VBQ score was an independent risk factor associated with RBP after PVP. Moreover, other risk factors included low BMD, lumbodorsal fascia contusion, and cement distribution. The MRI-VBQ score may serve as a useful tool for assisting in evaluating patients at risk of RBP following PVP.

Study on the effect of the distribution of bone cement of residual back pain after percutaneous vertebra plasty

To investigate the effect of bone cement distribution on efficacy of residual back pain after percutaneous vertebra plasty(PVP). From January 2017 to December 2020, a total of 65 cases with single segment osteoporotic thoracolumbar vertebral fractures underwent parallel vertebroplasty surgery. On the basis of the postoperative X-ray films of bone cement distribution were divided into two groups. The bone cement was biased to the lateral side of the vertebral body (partial group, 20 cases), there were 9 males and 11 famales with an average age of (70.3±7.4) years old ranging from 60 to 84 years old. The bone cement was over the vertebral midline, and completely filled with contralateral vertebral body (bilateral group, 45 cases), there were 10 males and 35 famales with an average age of (70.7±8.0) years old ranging from 60 to 86 years old. All of them underwent PVP surgery, bone cement was injected into the vertebral body through paitail transpedicular approach. The amount of bone cement injection, the visual analogue scale(VAS) of preoperation and 1 day, 1 month, 3 months after surgery between two groups were observed and compared. The amount of cement injection was (4.25±0.99) ml in the partial group, and (4.07±1.18) ml in the bilateral group, there was no significant difference between two groups (P>0.05). Postoperative pain was relieved than preoperative pain (P<0.05), the VAS of 1 day, 1 and 3 months after operation (3.90±1.37), (2.35±0.67) and (1.55±0.51) in the partial group were higher than (2.67±0.60), (1.62±0.58) and (1.31±0.47) in the bilateral group (P<0.05). There were 9 cases in partial group, the pain was not relieved due to unfilled cement until the contralateral bone was injected into the bone cement. The distribution of bone cement is one of the main factors affecting residual back pain after PVP, and in the clinical, we should make sure the distribution of bone cement over the midline of vertebral body.

Impact of Cement Distribution on the Efficacy of Percutaneous Vertebral Augmentation for Osteoporotic Fractures

Impact of Cement Distribution on the Efficacy of Percutaneous Vertebral Augmentation for Osteoporotic Fractures

Biomechanical Effects of Different Spacing Distributions Between the Cemented Superior Boundary and Surgical Vertebral Superior Endplates After Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures: A Three-Dimensional Finite Element Analysis.

Patients with osteoporotic vertebral compression fractures (OVCF) treated with vertebroplasty (PVP) are experiencing an increasing number of problems such as pain recurrence, mainly due to recompression fractures of the operated vertebral body within a certain period of time after the operation, which is closely related to the distribution of intraoperative bone cement. The aim of this study is to investigate the effect of different spacing distributions between the upper boundary of the cement and the upper endplate of the operated vertebra on the biomechanics of the operated vertebra after percutaneous vertebroplasty for OVCF using finite element analysis (FEA). One patient with L1 vertebral body OVCF was selected, and computed tomography (CT) of the thoracolumbar segment was performed. The CT data were extracted to establish an FEA model of the T12-L2 vertebral bodies. Bone cement was injected into the L1 vertebral body. Based on the spacing between the upper boundary of the bone cement and the vertebral body's upper endplates, the model vertebrae were divided into 0, 2, 4, and 6 mm spacing groups, and the human body's upright, flexion-extension, lateral flexion, and rotational positions were simulated. The biomechanical effects of different spacing distributions on the postoperative L1 vertebral body and the injected bone cement were evaluated. In this paper, we found that the Von Mises stress of the L1 vertebrae was the smallest when the spacing between the upper boundary of the bone cement and the vertebral body's upper endplates was 0 mm. The larger the spacing in a certain range between the upper boundary of the bone cement and the vertebral body's upper endplates, the greater the Von Mises stress of the L1 vertebrae. However, in the stress comparison of the injected bone cement, the Von Mises stress of the bone cement was greatest when the spacing between the upper boundary of the bone cement and the upper endplate of the vertebral body was 0 mm; the larger the spacing, the smaller the Von Mises stress. When the contact spacing between the upper boundary of the bone cement and the upper endplate of the vertebral body is 0 mm, it can effectively eliminate and transfer the pressure caused by the load, thus reducing the stress on the cancellous bone and further reducing the risk of vertebral refracture after surgery.

Analysis of the Effect of Bone Cement Distribution Patterns on Surgical Outcomes of Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures

Objective: To evaluate the impact of bone cement distribution patterns on the surgical outcomes of percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF). Methods: Sixty-four patients with OVCF treated at our hospital from January 2022 to December 2023 were included and divided into two groups based on bone cement distribution patterns: the clustered group and the diffuse group. Both groups underwent PVP. We compared the incidence of bone cement leakage, operative time, blood loss, changes in Visual Analog Scale (VAS) pain scores, and Oswestry Disability Index (ODI) scores before and after treatment between the two groups. Results: The number of cases with bone cement leakage was significantly higher in the diffuse group compared to the clustered group (P &lt; 0.05). There were no significant differences between the two groups in terms of volume of bone cement injected, intraoperative blood loss, or surgical time (P &gt; 0.05). Post-treatment, both VAS and ODI scores were lower than pre-treatment scores in both groups, with the diffuse group showing significantly lower scores than the clustered group (P &lt; 0.05). No postoperative adverse complications were observed in either group. Conclusion: PVP is highly effective for treating OVCF. A more uniform distribution of bone cement is associated with a greater reduction in postoperative pain and improved functional outcomes. However, careful attention is needed to prevent bone cement leakage.

A novel unilateral extrapedicular approach applied to percutaneous vertebral augmentation to treat thoracic and lumbar Osteoporotic Vertebral Compression Fracture: a retrospective study

ObjectiveTo design and apply a novel puncture method, named P TO P technique, and to evaluate its efficacy and safety.MethodThe data of patients treated with PVA in medical institution from January 2020 to December 2022 were reviewed and analyzed. The degree of pain relief and recovery from daily activities were evaluated using VAS and LAS scores, and radiological parameters were evaluated using local kyphosis angle and excellent cement distribution. Complications such as cement leakage and recurrent vertebral fractures were also recorded.Results157 patients with thoracolumbar OVCF were successfully treated with novel puncture techniques. All postoperative clinical and radiological parameters significantly decreased in all patients, except for an increase in local kyphosis angle at the last follow-up compared to postoperative. All other above indicators remained statistically significant at the last follow-up compared to postoperative improvement. Except for 2 patients with poor cement distribution, the remaining 155 patients successfully achieved satisfactory results in unilateral puncture and bilateral cement distribution, achieving an excellent rate of 98.73%. In addition, 18 cases (11.46%) of cement leakage occurred during the operation, fortunately none of them were uncomfortable. During the postoperative follow-up period, 4 cases (2.55%) of recurrent fractures occurred. No other serious complications such as neurologic or named vascular injuries occurred.ConclusionThe application of P TO P technology in thoracolumbar OVCF patients is safe and effective. It can not only reduce pain and quickly recover daily activities, but also achieve the perfect effect of unilateral puncture and bilateral cement filling.

From loose sand to sandstone: An experimental approach on early calcite precipitation in sands of siliciclastic and mixed carbonate-siliciclastic composition.

Artificially cemented sandstones were produced to assess the impact of detrital texture and composition on the precipitation and distribution of early calcite cement, and cement-related degradation in porosity. To simulate early-calcite cementation, loose sediment of variable composition (siliciclastic and calcareous) and grain size was exposed to a calcite supersaturated solution for 35 to 58 days at 23°C. Identification and distribution of the newly precipitated crystals was performed with high resolution 2D optical and scanning electron microscopy. The experimental results show the precipitation of grain-coating, pore-bridging and pore-filling granular calcite cement with up to 100 μm crystal size. Despite a positive correlation between the amount of detrital carbonate grains and calcite crystals, calcite cement does not preferentially nucleate on bioclast surfaces, irrespectively of their favourable mineralogy. Siliciclastic grains show high calcite cement coverage with altered feldspar, particularly plagioclase, displaying coverage of 94.3%. Grain size variations within the sand packs have influence on the precipitation pattern of calcite with coarse-grained layers (500-710 μm) showing minor calcite cementation (6.3%), while medium- (250-500 μm) to fine-grained layers (125-250 μm) comprise average calcite cement contents of 16.3% and 28.2%, respectively. The findings of this study enhance our knowledge regarding the precipitation processes of calcite in porous material with heterogeneous reacting mineral phases, shapes and pore connectivity.

Enhanced bone cement distribution in percutaneous vertebroplasty using a curved guide wire: a propensity score matching analysis

BackgroundOsteoporotic vertebral compression fractures (OVCF) severely affect the quality of life in the aged population. Percutaneous vertebroplasty (PVP) alleviates pain and stabilizes vertebrae, but suboptimal bone cement distribution can cause complications. Hence, this study aimed to clarify whether a new technique for PVP, using a curved guide wire, enhances the distribution of bone cement and improves clinical outcomes in patients with OVCF.MethodsPatients with single-segment OVCF underwent PVP or curved guide wire percutaneous vertebroplasty (C-PVP). Propensity score matching (PSM) was employed to balanced the baseline characteristics. The primary outcomes were the visual analog scale (VAS) and Oswestry disability index (ODI) scores. The secondary outcomes included assessments of bone cement distribution, bone cement injection volume, radiological parameters, and general clinical results. Additionally, Complications and adverse events were documented.ResultsAfter PSM analysis, each group comprised 54 patients, which significantly reduced baseline differences. The C-PVP group showed better clinical outcomes compared to the traditional PVP group. One month after surgery, the C-PVP group had significantly lower VAS and ODI scores (p < 0.001). These improvements persisted at six months and the final follow-up. Additionally, bone cement distribution scores were better (p < 0.001), injection volume was higher (p = 0.03), leakage was less frequent (p = 0.02), and adjacent vertebral fractures occurred less frequently (p = 0.04) in the C-PVP group. Radiological parameters and overall clinical outcomes revealed no significant differences between the two groups.ConclusionThe use of curved guide wire in PVP significantly improves bone cement distribution and injection volume, resulting in better clinical efficacy in patients with OVCF.

Method for introducing carbon nanotubes into fine-grained concrete

This work discusses the use of a modifying complex additive to concrete with the inclusion of carbon nanotubes “Taunit-M” and the SP-3 plasticizer. Two methods of introducing nano-sized additives into the composition of fine-grained concrete, as well as their combination, are considered. The results of a series of tests of beam samples aged 28 days are presented using two methods of introducing nanotubes, namely: the use of an ultrasonic dispersant and the use of a linear induction rotator (LIR). The positive effect of introducing nanotubes on the strength characteristics of concrete has been established. It has been determined that the use of LIR technology provides an increase in strength due to a double effect: activation of the cement binder and distribution of the nanoadditive using active mixing due to vortex action. Ultrasonic dispersion, in turn, ensures the effective introduction of the plasticizer into the mixing water.

Comparative analysis of percutaneous vertebroplasty and kyphoplasty in the treatment of Stage III Kummell’s disease without neurological symptoms: a retrospective study

ObjectiveThis study analyzes the safety and efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) treatments for Stage III Kummell’s disease without neurological symptoms, comparing the advantages and disadvantages of these two minimally invasive surgical methods.MethodsA retrospective analysis was conducted on 53 patients with non-neurological Stage III Kummell’s disease treated with PVP and PKP at our hospital from December 2018 to January 2023. Patients were divided into PVP (25 cases) and PKP (28 cases) groups based on the surgical method. There were no significant differences in general preoperative data between the two groups (all p > 0.05), ensuring comparability. The study compared surgical duration, volume of bone cement injected, distribution pattern of bone cement, rate of bone cement leakage, and preoperative, postoperative, and final follow-up scores of Visual analogue scale(VAS) and Oswestry disability index(ODI). Additionally, relative anterior height of the injured vertebrae, and Cobb angle of deformity, along with their changes at preoperative, postoperative, and final follow-up stages were calculated and analyzed.ResultsNo significant preoperative differences were observed between the groups (p > 0.05). The PKP group had longer surgeries, higher cement volumes (p < 0.001), and lower leakage rates (p < 0.05), with primarily chunky cement distributions versus mixed distributions in the PVP group. No complications other than cement leakage occurred. VAS and ODI scores showed no significant changes at various time points (p > 0.05) but improved significantly from preoperative (p < 0.001). Both groups saw improved vertebral heights and Cobb angles post-surgery (p < 0.05), with more significant improvements in the PKP group (p < 0.05). Over time, both groups experienced gradual vertebral height loss and increased Cobb angles, more pronounced in the PKP group (p < 0.05). At the final follow-up, there were no statistical differences in vertebral height and Cobb angle between the two groups (p > 0.05).ConclusionThe study evaluates the safety and efficacy of PVP and PKP for Stage III Kummell’s disease without neurological symptoms, comparing the merits of both minimally invasive techniques.

Clinical significance of modified unilateral puncture percutaneous vertebroplasty guided by 3D- printed guides in the treatment of osteoporotic vertebral compression fractures: a retrospective study

ObjectiveTo investigate the clinical significance of using 3D printing guides in modified unilateral puncture percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fractures (OVCF), and to explore a new method for preventing paravertebral vein leakage during PVP in conjunction with a previous study of the optimal puncture-side bone cement/vertebral volume ratio(PSBCV/VV%).MethodsThis retrospective study analyzed 99 patients who underwent unilateral puncture PVP between January 2023 and December 2023. Patients were divided into a guide plate group (46 patients) and a conventional group (53 patients). The guide plate group underwent modified unilateral puncture PVP with the guidance of 3D printing guides, while the conventional group underwent unilateral puncture PVP using the conventional pedicle approach. The distribution of bone cement, surgical outcomes, and the occurrence of cement leakage into paravertebral veins were observed in both groups.ResultsThe guide plate group had significantly shorter operating time and required fewer fluoroscopies compared to the conventional group. The amount of bone cement volume (BCV) used in the guide plate group was higher, but the amount of bone cement volume on the puncture side(PSBCV), the PSBCV/VV%, and the rate of paravertebral vein leakage were lower in the guide plate group compared to the conventional group (P < 0.05). Within each group, significant improvements in anterior vertebral margin height, Cobb angle, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) were observed at 1 day and 1 month postoperatively compared to preoperative values (P < 0.05).ConclusionUsing 3D printing guides in modified unilateral puncture PVP is a safe and effective method for treating OVCF. And it has the advantages of short operation time, less fluoroscopy, even distribution of bone cement, and a low rate of paravertebral vein leakage.

Synthetic Clay Application to Reduce the Segregation of Barite-Based Oil-Well Cement.

In the oil and gas industry, cement segregation is a significant concern that can have disastrous consequences, such as the failure of cement. The change of hardened cement's properties is observed, resulting in a decrease in its strength and an increase in its permeability. Therefore, providing some solutions to prevent this is crucial. The objective of this study is to assess the efficacy of synthetic clay in mitigating the problem of segregation in cement having barite. Six concentrations of synthetic clay were used to prepare six heavy-weighted cement samples with a high density of 18 lb/gal using the barite weighting material. The approaches of density distribution and nuclear magnetic resonance (NMR) were employed to characterize the heterogeneity in the hardened cement samples with the aim of identifying the potential of cement segregation. Then, the optimum concentration of the synthetic clay was selected and its effects on the rheological, strength, petrophysical, and elastic properties were evaluated and compared with the properties of the base cement (without synthetic clay). The results showed that 0.4% by weight of cement (BWOC) synthetic clay was the optimum concentration, which yielded the minimum cement segregation as represented by a 61% reduction in the density variation compared to the control specimen. The results obtained from the NMR technique validated the findings of the density distribution method, indicating that the porosity distribution of the synthetic clay cement with a concentration of 0.4% BWOC exhibited uniformity across its top, middle, and bottom sections, with a slight deviation window, while the porosity distribution of the control cement specimen displayed noticeable variation. Moreover, the synthetic clay had better properties than the control cement specimen. For example, the rheological properties were improved as represented by a 22% reduction in plastic viscosity and 42 and 11% increase in the yield point and gel strength, respectively. Compared to the base cement, the compressive and tensile strength were increased by 39 and 43%. The synthetic clay decreased the permeability and porosity by 73 and 24%, respectively. The synthetic clay enhanced the elastic properties as represented by a 1.5% reduction in Young's modulus and a 1.3% increase in Poisson's ratio compared to the base cement sample.

Quantitative dispersion characterization of cement particles in hardened cement matrix

Optimizing the cement particle distribution in hardened cement matrix is one of the effective means to utilize cement efficiently, and obtaining information about cement distribution is a prerequisite for this. In view of this, this paper investigates the quantitative dispersion of cement particles in hardened cement paste from an experimental perspective. Cement pastes with different water-binder (W/B) ratios were prepared as the objects. BSE images of these samples were acquired for further analysis, including Delaunay triangulation algorithm, nearest neighbor distance function G(r) and fractal theory. Results showed that when the W/B ratio increases from 0.36 to 0.42, the average cement particle spacing rises from 32.7 μm to 34.9 μm and the proportion of particles with spacing between particle centroids <20 μm decreases from 41.96 % to 25.98 %. Similarly, the increasing W/B ratio causes the nearest neighbor distance function G(r) to shift towards larger distances. When the W/B ratio is 0.34, the median distance between particles (R50) exhibits the most significant change. Additionally, the intricate details of cement particle spacing information can be accurately described by fractal theory. Parameters such as R50 and the proportion of particles with spacing between centroids <20 μm demonstrate strong fits with various fractal parameters. Notably, they exhibit optimal fitting with the spectral width of the generalized fractal spectrum, with an R2 value of 0.99.

Outcomes of Birmingham Hip Resurfacing Based on Clinical Aspects and Retrieval Analysis of Failed Prosthesis.

This research aims to identify the prevalence of failure for Birmingham Hip Prosthesis (BHR) in total hip arthroplasty and to analyze its reasons from biomaterials and biofunctional perspectives. We present our current analysis and tests on a series of different BHR-retrieved prostheses after premature failure. Relevant clinical data, such as X-ray investigations and intraoperative images for clinical case studies, were analyzed to better understand all factors involved in BHR prosthesis failure. A detailed analysis of the failures highlighted uneven cement distribution, overloading in certain areas, and void formation in the material. A closer investigation using microscopical techniques revealed the presence of a crack originating from the gap between the cement mantle and human bone. Additionally, scanning electron microscopy analyses were conducted as part of the investigation to examine bone cement morphology in detail and better understand the interactions at the interfaces between implant, cement, and bone. In conclusion, this research emphasizes the importance of surgical technique planning and the cementation procedure in the success rate of BHR prostheses. It also underscores the need to carefully evaluate patient characteristics and bone quality to minimize the risk of BHR prosthesis failure. The cementation procedure seems to be essential for the long-term functionality of the BHR prosthesis.

Incidence and prognostic factors of residual back pain in patients treated for osteoporotic vertebral compression fractures: a systematic review and meta-analysis.

Osteoporotic vertebral compression fracture (OVCF) is a common consequence of osteoporosis and can significantly impact the quality of life for affected individuals. Despite treatment options such as vertebroplasty and kyphoplasty, many patients continue to experience residual back pain (RBP) even after the fracture has healed. The incidence of RBP after OVCF treatment varies among studies, and there is a need for further research to understand the risk factors associated with RBP. A systematic review and meta-analysis were conducted following the PRISMA guidelines. Electronic databases were searched, and relevant studies were selected based on inclusion and exclusion criteria. Data extraction and quality assessment were performed independently by two authors. Statistical analysis included single-proportion meta-analyses and pooling of odds ratios (OR) using the inverse-variance method, to calculate the overall incidences of RBP and cement leakage and identify risk factors associated with RBP. A total of 19 studies were included in the analysis. The overall incidences of RBP and cement leakage were found to be 16% and 18%, respectively. Several risk factors were identified, including gender, bone mineral density, depression, baseline visual analog scale (VAS) score, intravertebral vacuum cleft, number of fractured segments, cement distribution, history of vertebral fracture, thoracolumbar fascial injury, and fracture non-union. This study provides potential value within the scope of the incidence and risk factors of RBP following treatment of OVCFs. The identified risk factors can help clinicians identify high-risk patients and tailor appropriate interventions. Future research should focus on standardizing the definition of RBP and patient selection criteria to improve the accuracy of estimates and facilitate better management strategies for OVCF patients.

Comparison of the efficacy and safety of vertebroplasty with different pedicle approaches for osteoporotic vertebral.

To compare the efficacy and safety of vertebroplasty through different pedicle approaches in the treatment of osteoporotic vertebral compression fracture osteoporotic vertebral compression fractures (OVCF) by network meta-analysis. Pubmed, Embase, Cochrane Library, Web of Science. Database for literature retrieval, retrieval time from the establishment of the database to April 2023, the randomized controlled trials of unilateral vertebroplasty (UVP), bilateral vertebroplasty (BVP), unilateral kyphoplasty (UKP), bilateral kyphoplasty (BKP), curved vertebroplasty (CVP) and curved kyphoplasty (CKP) were screened, evaluated and the data were extracted and included in the analysis. STATA 15.0 and ReMan 5.3 were used for data analysis. This study was registered in the National Institute for Health Research (NIHR) with the registration number CRD42023405181. This study included 16 articles with a total of 1712 patients. The order of visual analogue scale (VAS) improvement from good to bad is CVP > BVP > UVP > CKP > BKP > UKP. The order of kyphotic angles improvement from good to bad is CKP > UKP > UKP > UVP > BVP > CVP. The order of bone cement injection from less to more is UVP > CVP > UKP > CKP > BVP > BKP. The order of bone cement leakage rate from less to more is CKP > CVP > UKP > BKP > UVP > BVP. The order of X-ray exposure time from less to more is CKP > CVP > UVP > BVP > UKP > BKP. The order of operation time from less to more is CVP > UVP > UKP > CKP > BVP > BKP. For patients with kyphotic angles, kyphoplasty has unique advantages in improving kyphotic angles. But generally speaking, curved approach can optimize the distribution of bone cement through unilateral approach to achieve the orthopedic effect of bilateral approach, which is a minimally invasive technique with better curative effect and higher safety in the treatment of OVCF.

Revisiting mixing uniformity effect on strength of cement-based stabilized soft clay

Despite the fact that mixing uniformity (i.e. the consistency of binder distribution) significantly influence the quality of ground improvement during in situ soil mixing projects, its quantitative evaluation was rarely concerned due to the difficulty of measurement from an engineering perspective. A methodology was proposed to quantitatively evaluate the mixing uniformity of stabilized soil using handheld X-fluorescence spectrometry (XRF), which is helpful to elucidate the significance of mixing uniformity on strength. In other words, the calcium content was monitored to ascertain the distribution of cement within the matrix, and a quantitative index was subsequently established. It was observed that an increase in mixing uniformity resulted in a transition in the behavior of the stabilized clay from a plastic to a brittle failure mode, and from a localized failure to a global shear failure under unconfined compression. Subsequent observation of the destruction process revealed that cracks were more readily formed in the low cement zones and then bypass the high cement zones. Furthermore, the effect of mixing uniformity on strength is likely to be amplified with prolonged curing periods. The enhancement of uniformity would increase the volume of the high binder zones, thereby enhancing the overall high-strength performance. The proposed methodology is capable of characterizing the discreteness between the tracked element's measured and theoretical contents, thusing avoiding the uncertainty associated with other indirect indicators. The convenience of the portable handheld XRF apparatus was confirmed, as it can be readily deployed in situ or ex situ to track calcium content within the stabilized mass after borehole sampling.

Factors influencing further vertebral height loss following percutaneous vertebroplasty in osteoporotic vertebral compression fractures: A 1-year follow-up study.

Osteoporotic vertebral compression fractures (OVCFs) contribute to back pain and functional limitations in older individuals, with percutaneous vertebroplasty (PVP) emerging as a minimally invasive treatment. However, further height loss post-PVP prompts investigation into contributing factors. To investigate the factors associated with further height loss following PVP with cement augmentation in OVCF patients. A total of 200 OVCF patients who underwent successful PVP between January 2021 and December 2022 were included in this study. "Further height loss" during 1 year of follow-up in OVCF patients with bone edema was defined as a vertical height loss of ≥ 4 mm. The study population was divided into two groups for analysis: The "No Further Height Loss group (n = 179)" and the "Further Height Loss group (n = 21)." In comparing two distinct groups of patients, significant differences existed in bone mineral density (BMD), vertebral compression degree, prevalence of intravertebral cleft (IVF), type of bone cement used, and cement distribution patterns. Results from binary univariate regression analysis revealed that lower BMD, the presence of IVF, cleft distribution of bone cement, and higher vertebral compression degree were all significantly associated with further height loss. Notably, the use of mineralized collagen modified-poly(methyl methacrylate) bone cement was associated with a significant reduction in the risk of further height loss. In multivariate regression analysis, lower BMD and the presence of IVF remained significantly associated with further height loss. Further height loss following PVP in OVCF patients is influenced by a complex interplay of factors, especially lower BMD and the presence of IVF. These findings underscore the importance of assessing and managing these factors when addressing height loss following PVP in OVCF patients.

Comparison of the Clinical Outcomes of Percutaneous Vertebroplasty Using Different Surgical Approaches and Bone Cement Distribution

Objective: To compare clinical outcomes of percutaneous vertebroplasty (PVP) through different surgical approaches and bone cement distribution in the treatment of osteoporotic vertebral compression fractures (OVCF). Methods: The clinical data of 231 patients with OVCF who underwent PVP from June 2020 to June 2022 were retrospectively analyzed. Clinical characteristics and surgical data were collected for statistical analysis. The total patients were divided into a unilateral approach group (Group UA) and a bilateral approach group (Group BA) according to different surgical approaches. Then, patients in Group BA were divided into a continuous bone cement group (Group CBC) and a discontinuous bone cement group (Group DBC) according to the distribution of bone cement. Results: In each group, the postoperative visual analog scale (VAS) score and Oswestry disability index (ODI) score were significantly decreased (P &lt; 0.001). The operation time and fluoroscopy times of Group UA were less than those of Group BA (P &lt; 0.001). However, compared with Group BA, Group UA had a lower mean VAS score (P = 0.013) and ODI score (P = 0.004) at the last follow-up. The VAS (P = 0.032) and ODI (P = 0.024) scores in the CBC group were significantly lower than those in the DBC group at the last follow-up. Conclusions: Unilateral PVP presented several advantages over bilateral PVP, particularly in terms of shorter surgery time, less fluoroscopy frequency, and less trauma. Continuous bone cement was closely related to good clinical outcomes. In clinical practice, we suggest unilateral PVP is performed for patients and ensure the continuity of bone cement for better clinical outcomes.