Efficacy Of Percutaneous Kyphoplasty Research Articles

Percutaneous kyphoplasty through unilateral puncture on the convex side for the treatment of painful osteoporotic vertebral compression fracture with scoliosis

PurposeTo assess the clinical safety, accuracy, and efficacy of percutaneous kyphoplasty (PKP) surgery using an enhanced method of unilateral puncture on the convex side for the treatment of painful osteoporotic vertebral compression fractures (P-OVCF) with scoliosis.MethodsClinical and radiographic data of P-OVCF patients with scoliosis who underwent PKP via unilateral puncture on the convex side from January 2018 to December 2021 were retrospectively analyzed. This technique’s detailed surgical steps and tips were described. The local kyphosis angle (LKA), scoliosis Cobb angle (SCA), and local scoliosis Cobb angle (LSCA) were measured using X-ray and compared at pre-operation, post-operation, and the last follow-up. The width of pedicle (POW), inner inclination angle (IIA), lateral distance (LD), and puncture course length (PCL) were measured on the axial computed tomography image and compared between two sides. Postoperative computed tomography was employed to evaluate the condition of cement distribution and puncture. Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back pain (BP).ResultsThirty-six patients, 23 women and 13 men, with an average age of 76.31 ± 6.28 years were monitored for 17.69 ± 4.70 months. The median surgical duration of single vertebrae was 35 min. The volume of bone cement for single vertebrae was 3.81 ± 0.87 ml and the proportion of sufficient cement distribution of the patients was 97.22. LKA was considerably improved from pre-operation to post-operation and sustained at the last follow-up. SCA and LSCA were not significantly modified between these three-time points. IIA, PCL, and LD were lower on the convex side than on the concave side. POW was considerably wider on the convex side. The ODI and VAS-BP scores were significantly improved after surgery and sustained during the follow-up.ConclusionsCombining with the proper assessment of the pre-injured life status of patients, PKP surgery using unilateral puncture on the convex side for the treatment of P-OVCF with scoliosis can achieve safe, excellent clinical, and radiographic outcomes.

Influence of sarcopenia on surgical efficacy and mortality of percutaneous kyphoplasty in the treatment of older adults with osteoporotic thoracolumbar fracture

BackgroundSarcopenia is an age-related condition that causes loss of skeletal muscle mass and disability. Sarcopenia is closely related to the prognosis of patients suffering osteoporotic thoraco-lumbar compression fractures (OTLCF). The purpose of this study was to investigate the effect of sarcopenia on the efficacy of percutaneous kyphoplasty (PKP) in the treatment of older adults with OTLCF surgery and postoperative mortality. MethodsFrom February 2016 to June 2019, 101 patients who met the inclusion and exclusion criteria were included in this study. The grip strength of the dominant hand was measured using an electronic grip tester. The diagnostic cutoff value of grip strength for sarcopenia was <27 kg for males and <16 kg for females. The cross-sectional area (cm2) of the musculature at the level of the pedicle of the thoracic 12th vertebra (T12) was measured by chest CT. The skeletal muscle index (SMI) was calculated by dividing the muscle cross-sectional area at the T12 pedicle level by the square of the height. The diagnostic cut-off value of SMI at T12 level is 42.6 cm2/m2 for males and 30.6 cm2/m2 for females. Sarcopenia was diagnosed when the grip strength and SMI values were both lower than the diagnostic cut-off value. All included patients received PKP treatment for OTLCF. The age, gender, operation time, bleeding volume, time to ground, length of hospital stay, visual analog scale (VAS) score before operation and one month after operation, Oswestry Disability Index (ODI) one month after operation and the incidence of refracture within 36 months after operation were compared between the two groups. The survival curves of the two groups were analyzed by Kaplan Meier. Chi-square test was used to compare the differences in survival rates between the two groups at 12, 24, and 36 months after operation. Univariate and multivariate Cox regression analysis compared multivariate factors on OTLCF postoperative mortality. ResultsThere was no significant difference in gender, operation time, blood loss and preoperative VAS score between the two groups (χ2 = 1.750, p = 0.186; t = 1.195, p = 0.235; t = −0.582, p = 0.562; t = −1.513, p = 0.133), respectively. The patients in the sarcopenia group were older (t = 3.708, p = 0.000), and had longer postoperative grounding time and hospitalization time (t = 4.360, p = 0.000; t = 6.458, p = 0.000). The VAS scores and ODI scores one month postoperatively were also higher in sarcopenia group (t = 5.900, p = 0.000; t = 7.294, p = 0.000), and there was a statistical difference between the two groups. Interestingly, there was no significant difference in the incidence of spinal refracture within 36 months between the two groups (χ2 = 1.510, p = 0.219). The sarcopenia group had a higher mortality rate at 36 months after operation, and the difference was statistically significant (p = 0.002). Sarcopenia is an independent risk factor for long-term mortality in OTLCF patients received PKP surgery. ConclusionsPatients with sarcopenia combined with OTLCF have poor postoperative recovery of limb function and a high risk of death in the long-term (36 months) after surgery. Active and effective intervention for sarcopenia is required during treatment.

Is there a risk of further displacement of the fractured fragment into the spinal canal in osteoporotic vertebral burst fractures after unilateral PKP? A prospective study

BACKGROUND CONTEXTThe optimal treatment for osteoporotic vertebral burst fracture (OVBF) without neurological symptoms is still a matter of debate. PURPOSETo evaluate the safety and efficacy of percutaneous kyphoplasty (PKP) for OVBF. STUDY DESIGNThe study is a prospective study and is registered in the China Clinical Trials Registry with the registration number ChiCTR-OOC-17013227. PATIENT SAMPLEThe study involved 119 patients with 137 fractured vertebrae who underwent unilateral PKP for OVBF. OUTCOME MEASURESThe measurements were carried out independently by two physicians and measured with picture archiving and communication system (PACS) and ImageJ software (National Institutes of Health, Bethesda, MD, USA). METHODSThe change in the spinal canal area and posterior wall protrusions (PWP) were measured before and after surgery via three-dimensional computed tomographic imaging (CT). Preoperative, postoperative, and final follow-up standing X-rays were used to measure the height of the anterior wall (HAW), height of the posterior wall (HPW), and local kyphotic angle (LKA). Additionally, visual analogue scale (VAS) and the Oswestry Disability Index (ODI) were also determined. RESULTSAmong the 137 vertebrae assessed, 79 exhibited an increased postoperative canal area, while 57 showed a decrease, with mean values of 8.28±6.871 mm² and −9.04±5.991 mm², respectively. Notably, no significant change in postoperative canal area was identified on the entire dataset (p>.01). There was a significant decrease between median preoperative (3.9 [IQ1-IQ3=3.3-4.8] mm) and postoperative (3.7 [IQ1-IQ3=3.0-4.4] mm) PWP (p<.01). Preoperative and postoperative HAW measurements were 19.4±6.1 mm and 23.2±5.2 mm, respectively (p<.01). However, at the final follow-up, the HAW was lower than the postoperative value. The HPW was also significantly improved after surgery (p<.01), but at the final follow-up, it was significantly decreased compared with the postoperative measurement. Following surgery, KA was significantly corrected (p<.01); however, at the final follow-up, relapse was detected (average KA: 18.4±10.3°). At the final follow-up, both VAS and ODI were significantly improved compared with the preoperative period (p<.01). As for complications, 50 patients experienced cement leakage, and 16 patients experienced vertebral refracture. All patients did not develop neurological symptoms during the follow-up. CONCLUSIONSOVBF without neurological deficits showed significant improvement in symptoms during the postoperative period after PKP. There was no notable alteration in the spinal canal area, but a significant decrease in PWP was observed. Consequently, we posit that PKP stands as a secure and efficacious surgical intervention for treating OVBF cases devoid of neurological symptoms.

Comparison of three techniques in the surgical management of metastatic vertebral fracture with posterior wall damage: a retrospective study

BackgroundTo retrospectively compare the safety and efficacy of percutaneous kyphoplasty (PKP), internal fixation (IF), and kyphoplasty combined with internal fixation (KP + IF) in treating metastatic vertebral fracture (MVF) with posterior wall damage.Methods87 patients with MVF with posterior wall damage underwent surgery. In Group PKP, 36 patients underwent PKP; in Group IF, 20 patients underwent pedicle screw fixation; and in Group KP + IF, 31 patients underwent kyphoplasty combined with pedicle screw fixation. Operative time, intraoperative blood loss, clinical and radiological results, and complication rate in each group were evaluated and compared.ResultsSignificant improvement on the VAS, ODI scores, vertebral height and local kyphotic angle (LKA) was noted in each group (P < 0.001). Group PKP and Group KP + IF achieved better pain relief than Group IF (P < 0.05). At postoperative 3 days, Group PKP had better pain relief than Group KP + IF (P < 0.05). At other follow-up time points, there were no differences between Group PKP and KP + IF (P > 0.05). Group KP + IF and Group IF were more efficacious than Group PKP in terms of height restoration and LKA correction (P < 0.05). Group KP + IF had a higher incidence of postoperative complications than Group PKP and Group IF(P < 0.05).ConclusionsPKP was safe and effective in treating MVF with posterior wall damage. It can achieve similar clinical outcomes compared to KP + IF, but associated with less operative time, less blood loss and fewer complications. IF alone should not be the first treatment option for its poorer analgesic effect.

Effect of Sarcopenia on the Efficacy of Percutaneous Kyphoplasty in the Treatment of Osteoporotic Spinal Compression Fractures in Elderly Patients

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 cm2/m2for males and 30.6 cm2/m2 for females.Sarcopenia is confirmed when both grip strength and SMI are below the cut-off values.The patients with OSCF all received PKP.The patients in the sarcopenia and non-sarcopenia groups were compared in terms of age,gender,body weight,operation duration,the amount of bleeding,time to ambulation,hospital stay,visual analogue scale(VAS)before and 1 month after operation,Oswestry disability index(ODI)1 month after operation as well as the incidence of refracture within 1 year after operation. Results Gender,body weight,operation duration,the amount of bleeding and the preoperative VAS score showed no significant difference between the two groups(χ2=3.563,P=0.059;t=0.406,P=0.686;t=1.119,P=0.267;t=-0.166,P=0.868;z=-1.076,P=0.282).The patients in the sarcopenia group showed longer time to ambulation,longer hospital stay,higher VAS score and ODI 1 month after operation than those in the non-sarcopenia group(t=3.938,P<0.001;t=5.655,P<0.001;z=-4.562,P<0.001;z=-5.222,P<0.001).There was no significant difference in the incidence of refracture within 1 year after operation between the two groups(χ2=0.596,P=0.440).Linear regression results showed that age did not affect the hospital stay,rehabilitation duration,VAS score or ODI(P=0.519,P=0.870,P=0.332,P=0.126),whereas sarcopenia had significant effects(P<0.001,P=0.001,P<0.001,P<0.001). Conclusions Sarcopenia with OSCF has poorer limb function recovery.Reasonable rehabilitation exercise and dietary therapy are necessary for patients with sarcopenia.

The Early Results of Vertebral Pathological Compression Fracture of Extra- nodal Lymphoma with HIV-positive Patients Treated by Percutaneous Kyphoplasty.

Vertebral pathological compression fracture involving extra-nodal lymphoma impacts negatively on the quality of life of HIV-positive patients. The choice of a safe and effective approach to palliative care in this condition remains a challenge. The purpose of this study was to investigate the safety and efficacy of percutaneous kyphoplasty (PKP) in the treatment of vertebral pathological compression fracture of extra-nodal lymphoma in HIV-positive patients. A retrospective analysis, from January 2016 to August 2019, was performed on 7 HIVpositive patients, 3 males and 4 females, with extra-nodal lymphoma with a vertebral pathological compression fracture. The patients were treated using percutaneous kyphoplasty in our hospital. Preoperative assessment of the patients was conducted regarding their hematological profile, biochemical indicators, liver and kidney function, blood coagulation function, CD4+T lymphocyte count and viral load. Subsequently, the patients were placed on highly active antiretroviral therapy (HAART) and rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP) regimen. Besides, antibiotics, nutritional support and immune-modulating drugs were also administered, rationally. Postoperatively, the height of the anterior edge of the injured vertebrae, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) values were evaluated. Patients were also monitored for any complications related to the operation. The average CD4+T cell count for the patients was 164 (range 114 ~247 / ul), while the viral load was 26,269 (range 5,765 ~82,321 copies/ul). All patients received nutritional and immune support and registered significant improvements in the levels of ALB and Hb (P<0.05). In all cases, the operation was uneventful with neither cement leakage nor toxic reactions observed. Similarly, no opportunistic infections, other complications or deaths were reported. The height of the anterior vertebral body and the ODI score of the injured vertebrae were significantly improved immediately after surgery (P<0.05). Compared to the preoperative VAS (7.71±1.11), postoperative values were significantly reduced immediately after surgery (3.85±0.90) and at 2 weeks, 1 month and 6 months post-surgery: 2.71±0.76, 3.29±1.11, and 4.00±0.82, respectively (P<0.01). Supported with appropriate perioperative treatment measures, PKP is safe and effective in the treatment of pathological vertebral compression fracture due to extra-nodal lymphoma in HIV-positive patients.

Percutaneous kyphoplasty for stage III Kümmell＇s disease with no neurological symptom

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of stage Ⅲ Kummell＇s disease with no neurological symptom. Methods From January 2009 to June 2018, 45 patients underwent PKP for stage Ⅲ Kummell＇s disease with no neurological symptom at Department of Orthopaedics, The First Hospital Affiliated to Soochow University. They were 12 males and 33 females, aged from 61 to 85 years (average, 70.9 years). Their visual analog scale (VAS) scores for back pain, Oswestry disability indexes (ODI), heights of fractured vertebrae and kyphosis cob angles were recorded and compared between preoperation, one day, 3 months and final follow-up after operation. Results All the 45 patients were followed up for 12 to 48 months (average, 28.0 months). Their VAS scores (2.4±0.7, 2.2±0.7 and 2.3±0.6), ODI sores (34.7±6.8, 34.2±6.5 and 34.1±6.6) and cobb angles (15.7°±2.2°, 15.8°±2.2° and 15.9°±2.4°) at one day, 3 months and final follow-up after operation were significantly lower than those (8.2±1.1, 75.3±9.0 and 25.2°±3.9°) before operation (P<0.001). Their anterior height ratios of the fractured vertebra (54.0%±4.3%, 53.7%±4.2% and 53.6%±4.0%) and median height ratios of the fractured vertebra (56.8%±4.0%, 56.5%±3.9% and 56.6%±3.9%) at one day, 3 months and final follow-up after operation were significantly higher than those (25.8%±3.9% and 27.2%±3.1%) before operation (P<0.001). The rate of cement leakage was 13.3%(6/45). No patients had neurological symptoms after operation. Conclusion PKP is a minimally invasive, safe and effective treatment for stage Ⅲ Kummell's disease with no neurological symptom, because it can relieve the symptoms of the patients, restore the height of the fractured vertebral body and reduce the local kyphosis cobb angle. Key words: Vertebroplasty; Kyphosis; Spinal cord compression; Kummell’s disease

Percutaneous kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures with spinal canal compromise

BackgroundVery severe osteoporotic vertebral compression fractures (vsOVCFs) are osteoporotic vertebral compression fractures with vertebral body collapse to less than one third of their original height. Few data are available about the use of percutaneous kyphoplasty (PKP) in treating vsOVCFs with spinal canal compromise. The aim of this study was to evaluate the safety and efficacy of percutaneous kyphoplasty (PKP) for the treatment of vsOVCFs with spinal canal compromise.MethodsThirty-five patients who suffered vsOVCFs with spinal canal compromise but without neurological deficits were treated by PKP between January 2009 and October 2014. The vertebral height, local kyphotic angle (LKA), visual analogue scale (VAS) and Oswestry Disability Index (ODI) values were assessed before the operation, 1 day after the operation and at the final follow-up.ResultsSignificant improvements on the VAS and ODI were noted 1 day post-operatively (p < 0.01), and these results were preserved at the final follow-up. The vertebral height was restored and the LKA was improved after surgery (p < 0.01). No neurological deterioration was found. Five of 35 vertebrae (14.3%) of cement leakages were all asymptomatic. Four new OVCFs in three patients were identified.ConclusionPKP is a safe and effective procedure for the treatment of vsOVCFs with spinal canal compromise, achieving significant vertebral height restoration and kyphotic angle reduction and leading to a significant pain relief and improvement in function.

Efficacy of percutaneous kyphoplasty for osteoporosis vertebral compression fractures

Objective To conclude the technology and clinical outcomes of percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Methods From June 2011 to June 2014, 29 cases of osteoporoticthoracic and lumbar vertebral compression fractures patients, who were diagnosed by ultrasonic bone mineral density measurement. X-ray, CT and MRI were treated with percutaneous kyphoplasty in Beijing 401 Hospital of China Nuclear Industry. Observed and recorded the degree of pain, patient's activity and the recovery of vertebral height in patients with 24 hours, 3 months and 6 months after operation. The index data were analyzed by SPSS17.0 statistical software, and the measurement data were analyzed by paired t test. Results Twenty-nine patients were operated successfully, 17 cases (58.62%)of back pain disappeared and 12 cases (41.38%) of back pain significantly reduced. Twenty-seven cases (93.1%) were allowed to get off bed after 24 hours of operation and 2 cases (6.9%) after 3 days. Three cases (10.34%) occurred PMMA leakage. After 24 hours, 3 months and 6 months VAS and vertebral height of the original vertebral height percentages are much better than before surgery (P 0.05). Compared after surgery 3-month and 6-month with after surgery 24 hours, the vertebral height have lost, but the lost height of the vertebral was no statistical significance (P>0.05). No infection, hematoma, spinal nerve injury and PMMA poisoning complications occurred. Conclusions Percutaneous kyphoplasty can relieve the pain and restore part of the vertebral height satisfactory with better outcomes. Key words: Percutaneous kyphoplasty; Fractures, compression; Osteoporosis; Lumbar vertebrae

Percutaneous kyphoplasty for the treatment of spinal metastases.

The bones are the most common location for metastases, which may cause severe pain and damage, including osteolytic destruction and fractures. Pathological fractures of the spine are extremely painful and cause significant disability and morbidity in patients. Traditional open surgery has numerous complications, and radiation therapy may take weeks to become effective. To avoid the trauma and complication of open surgery, percutaneous kyphoplasty (PKP) is a minimally invasive procedure that has played a great role in the treatment of spinal metastases over the past several years. To evaluate the efficacy and safety of the treatment of spinal metastasis using PKP, the present study evaluated 282 patients who had received PKP between April 2009 and June 2014. The efficacy of PKP was evaluated using the visual analog scale for pain (VAS), Karnofsky performance score (KPS) and quality of life (QOL) score (short form with 36 questions). The KPS and QOL were measured pre-operatively and 3 months post-operatively. In addition, radiographical data, including the degree of restoration of the kyphotic angle and the anterior vertebral height, and leakage of bone cement, were measured. The safety of the surgery was assessed by complications and side effects reported during or subsequent to surgery. The present study measured the parameters prior to the surgery and at 24 h, 3 months, 6 months and 1 year post-surgery, as well as at the last follow-up date. The range of the follow-up time was between 105 days and 15 months (mean, 401 days). The 282 patients underwent successful operations and the pain felt by the patients prior to the surgery was significantly alleviated. In addition, the analgesic intake of patients greatly decreased following PKP. KPS improved prior to and 3 months after the surgery. QOL also improved prior to and 3 months after the surgery. Radiographical data demonstrated that the kyphotic angle decreased following PKP, and the anterior vertebral height increased. Paravertebral leakage of bone cement occurred in 10 patients through a cortical defect, but without spinal cord compression or pulmonary embolism. Therefore, as a minimally invasive procedure, PKP may not only rapidly relieve the pain and disability experienced by patients, but it may also restore the kyphotic angle observed at the 1-year follow-up. Notably, PKP may safely improve the QOL of patients.

Clinical efficacy of percutaneous kyphoplasty in management of osteoporotic thoracolumbar vertebral compression fracture in the elderly

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in surgical treatment of osteoporotic thoracolumbar vertebral compression fracture in the elderly. Methods From March 2007 to February 2013, 210 cases (100 males and 110 females; 55-91 years of age, mean 72.5 years) of osteoporotic vertebral compression fracture were treated with PKP. Single-segment fracture was observed in 180 cases, two-segment fracture in 20 cases and three-segment fracture in 10 cases. Lesion involved in 250 vertebrae located in the T6-L5 segment. Bone cement injected into each vertebra was 3-5 ml (mean, 4 ml). Treatment effects were assessed with vertebral height, Cobb angle and visual analogue score (VAS). Results At the follow-up of 6-15 months (mean 11 months), thoracic back pain significantly alleviated or disappeared. After operation, improvements were observed in VAS[(8.7±1.2) points vs (2.6±0.7) points], anterior vertebral height loss [(11.0±3.2) mm vs(5.5±0.8) mm], central vertebral height loss [(8.6±1.1) mm vs (3.3±1.0) mm], and Cobb angle [(29.8±4. 5)° vs (16.7±3.4)°] (P <0.01). Four patients appeared no pain or numbness in lower limbs although cement leak into disc. Whereas two patients had lower extremity nerve irritation because of cement leak into the spinal canal and recovered after symptomatic treatment. Conclusion PKP is an effective method for treatment of osteoporotic vertebral compression fracture in the elderly, for it can rebuild vertebral height, increase vertebral rigidity as well as stability and relieve thoracic back pain. Key words: Spinal fractures; Osteoporosis; Percutaneous kyphoplasty

Percutaneous kyphoplasty for old osteoporotic vertebral compression fractures

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) for old osteoporosis vertebral compression fracture (OVCF).Methods From January 2012 to August 2013,52 patients with old OVCF were treated in our department.They were 11 males and 41 females.Of them,32 were treated with PKP and 20 with conservative therapy.The 2 groups were comparable in baseline characteristics.All the patients were assessed before treatment,1 day,1,3,and 6 months after treatment using visual analogue scale (VAS),short form-36 health survey (SF-36) and Oswestry disability index (ODI).The midline vertebral body height and local sagittal cobb' s angle were measured before and after operation in the PKP group.Results All the patients were followed up for 6 to 16 months (average,10 months).Compared with the conservative therapy group,the PKP group scored significantly lower in VAS and ODI but significantly higher in SF-36 (P ＜ 0.05).In the PKP group,the scores of VAS,SF-36 and ODI,and the midline vertebral body heights at 1 day,1,3,and 6 months after treatment were all significantly improved compared with those before treatment (P ＜ 0.05); however,there were no significant differences regarding sagittal cobb's angle between pretreatment and all time points posttreatment (P ＞ 0.05).Conclusion In treatment of old OVCF,PKP is preferable to conservative therapy because it can lead to quicker effective relief of pain,better restoration of vertebral body height,enhanced vertebral stability and improved quality of life. Key words: Spinal fracture; Osteoporosis; Vertebroplasty

Value of Bone Scan Imaging in Determining Painful Vertebrae of Osteoporotic Vertebral Compression Fractures Patients With Contraindications to MRI

To assess the value of bone scan imaging in determining painful vertebrae of osteoporotic vertebral compression fractures (OVCFs) patients with contraindications to MRI. Twenty-three OVCFs patients with contraindications to MRI, diagnosed and treated in our hospital between December 2007 and November 2010, were enrolled in this retrospective study. There were 18 females and five males, aged from 57 to 87 years, with a mean age of 69.5 years. All patients underwent X-ray, CT scans examinations and bone scan to determine painful vertebrae. After the painful vertebra was defined, percutaneous kyphoplasty (PKP) was performed. Efficacy of PKP was assessed with visual analog (VAS) pain scale and the Oswestry Disability Index (ODI) preoperatively, postoperatively and during final follow-up assessments. The painful vertebrae shown on radiological films did not accord with those found based on bone scan imaging, with a high rate of incongruent findings (27.3%, 9/33). Radiological films showed 33 vertebrae with fractures, but only 26 vertebrae (22 patients) were selected as painful vertebrae for PKP based on bone scan imaging. There were statistically significant differences in mean VAS and ODI between the preoperative and the postoperative assessments; no significant differences were observed between postoperative and final follow-up assessments. For the OVCFs patients with contraindications to MRI, bone scan imaging could be used to determine painful vertebrae, which is an effective method.

Efficacy of Percutaneous Kyphoplasty in Treating Osteoporotic Multithoracolumbar Vertebral Compression Fractures

Percutaneous kyphoplasty is a minimally invasive technique that has become an effective and routine alternative for managing osteoporotic vertebral compression fractures. This article reports the clinical outcome of a series of 54 cases of osteoporotic thoracolumbar vertebrae compression fractures treated by percutaneous kyphoplasty. Fifty-four patients with confirmed osteoporosis and at least 1 level of thoracolumbar vertebrae compression fracture were retrospectively selected. Pre- and postoperative and last follow-up clinical evaluation and radiological data were analyzed, including change of visual analog scale (VAS), reduced use of painkillers, locomotor activity, Cobb's angle, and average vertebral body height. Mean follow-up was 20.4 months (range, 6-36 months). In all cases, percutaneous kyphoplasty treatment was successful, significantly increasing vertebral body height, diminishing kyphosis in the fractured vertebrae, and decreasing painkiller use. In all patients, percutaneous kyphoplasty partially or completely relieved back pain. No new deformity was found within the follow-up period, nor were any other complications. The cement leakage rate was 3.86% (8 of 207 vertebrae) with percutaneous kyphoplasty, but no neurological or other complaints were received. Percutaneous kyphoplasty is a simple and safe procedure in managing osteoporotic vertebrae compression fractures. It relieves pain quickly, restores vertebral height, prevents further fracture, and improves patient quality of life.

Clinical application of the Sky bone expander system in treatment of ache from senile vertebral bodies

Objective To investigate the clinical efficacy of percutaneous kyphoplasty using the Sky Bone Expander system in the treatment of ache from senile vertebral bodies.Methods From August 2004 to February 2007,82cases(126 Vertebraes) of ache from senile vertebral bodies underwent pereutaneous kyplasty with sky bone expander system.During the operation the sinqle or double technique was applied and the expansion height was reduced with sky bone expander for bone cement injection.Patients were evaluated with Oswestry disability Index (ODI) and Visual Analogue Sere(VAS).Results Back pain was efectively relieved after the operation in all cases.Extravertebral leakage of bone cement were observed in 5 cases (6 vertebraes),4 cases had not symptome,1 case had die hard neuralqia between ribs,2 cases had toxigenic reaction for hearts.2 postoperative cases with neoplasm metastasis had more pain,but one day after,the pain died away.The postoperative follow-up ranged from 9to 37 months.with an average of 20.5 months.The postoperative ODI(P=0.007) and VAS(P=0.012) had better than preoperative.Conclusion Kyphoplasty using the Sky Bone Expander system is an efecfive and safe treatment for ache from senile vertebral bodies.Sky bone expander system provids siguificant pain relief effect,and can improve the kyphosis deformity and remain vertebral height. Key words: Sky bone expander system; Osteoporesis; Spinal fractures; Neoplasm metastasis

The efficacy of percutaneous kyphoplasty in treating multi-osteoporotic thoracolumbar vertebral compressive fractures

The efficacy of percutaneous kyphoplasty in treating multi-osteoporotic thoracolumbar vertebral compressive fractures