Osteoporotic Compression Research Articles

Vertebral augmentation in osteoporotic and osteolytic fractures

To discuss recent advances in percutaneous minimally invasive vertebral augmentation techniques used in the treatment of osteolytic and osteoporotic compression fractures. Recent data have shown that outcomes in patients with vertebral compression fractures treated with vertebral augmentation techniques have been encouraging. Several studies demonstrated the positive effects of vertebral augmentation on maintenance of postoperative pain reduction at long-term follow-up. There is more evidence on the relationship between vertebral augmentation and adjacent segment vertebral compression fractures. In addition, the literature verifies that good outcomes can be expected in patients with spinal metastases and multiple myeloma. The incidence of symptomatic vertebral compression fractures is on the rise. For those patients with severe pain or progressive collapse due to osteoporotic or osteolytic vertebral compression fractures, early vertebral augmentation affords excellent early pain relief, early return to function, and restores and maintains sagittal alignment.

Clinical evaluation of vertebroplasty for multiple-level osteoporotic spinal compression fracture in the elderly

Outstanding results have been achieved using vertebroplasty for the treatment of osteoporotic spinal compression fractures. However, few reports are available in the management of multiple-level compression fractures due to severe osteoporosis. This study prospectively evaluated the clinical and surgical outcomes of patients receiving vertebroplasty due to multiple-level osteoporotic spinal compression fractures. Eighteen patients underwent more than four levels of vertebroplasty due to multiple-level osteoporotic spinal compression fracture. All patients received a preoperative magnetic resonance imaging (MRI) check-up to determine which level needed vertebroplasty. Detailed evaluations were made in accordance with the patients' clinical tracking, pre- and postoperative daily activities, Denis pain scale, and Roland-Morris score. After an average follow-up period of 36 months, the group receiving multiple-level vertebroplasty showed significant improvement, as registered on the Denis pain scale, Roland-Morris score, and in the activity of daily living. No major complications occurred during operation or postoperation, except one patient who expired due to suffocation at the rehabilitation center 3 weeks after vertebroplasty. The use of vertebroplasty with cement to treat multiple-level osteoporotic spinal compression fractures in the elderly does have value, and brings good results to patients which were previously unimaginable. Preoperative MRI to evaluate the non-union levels and determine which levels needed vertebroplasty is very important.

“SKyphoplasty”: A Single Institution's Initial Experience

The treatment of painful compression fractures has been revolutionized by vertebroplasty and kyphoplasty, two recently developed techniques that continue to evolve. This article describes a new device for the performance of kyphoplasty that uses a polymer device rather than a balloon to create a void in the bone. In nine consecutive patients, kyphoplasty was performed at 12 vertebral levels with osteoporotic compression with use of the new SKy bone expander polymer device. The device was successful in creating a void in the bone at all levels. The procedure was also effective in alleviating pain from compression fractures. There were no technical failures or complications. The SKy bone expander polymer device is effective and safe for the performance of kyphoplasty to alleviate pain from vertebral compression fractures.

A clinic report of transpedicular balloon kypho-plasty for osteoporotic spinal compression fractures

目的 评价经皮球囊扩张椎体后凸成形术治疗疼痛性胸腰椎骨质疏松压缩骨折的效果和安全性.方法回顾性分析2002年5月～2005年4月应用球囊扩张椎体后凸成形术治疗38例患者62个骨质疏松压缩骨折的椎体(T4～L4),有症状的节段均行MRI检查证实.从发病至手术时间2 d～1年.术后当天和随访1、3、6个月进行疼痛得分VAS测定和运动水平评价;手术前、后在侧位X线片测量骨折椎体前、中部的高度,评价手术效果.结果球囊扩张椎体后凸成形术可以快速止痛,明显增加脊柱负重能力,疼痛得分从8.2分降至2.4分,手术后62个骨折椎体前、中部的高度增加到了原椎体高度的(82.8±26.8)%和(88.8±21.8)%.椎体楔形变从15°降至8°,这种结果最长可以保持3年,本组患者无一例造成骨折后椎管狭窄加重,无严重并发症的发生.结论球囊扩张椎体后凸成形术可以快速改善运动功能和减轻疼痛,可安全增加椎体高度,迅速恢复老年患者活动水平,短期效果好,远期随访效果还有待最终评价。

Percutaneous vertebroplasty — initial clinical experience in osteoporotic and myelomatous compression fractures

To review the clinical impact of vertebroplasty in osteoporotic and myelomatous compression fractures Eleven compression fractures in eight patients were treated by percutaneous cement vertebroplasty over a three-year period, May 2000 to May 2003. Successful percutaneous stabilisation and cement injection was performed in all compression fractures. In five of eight patients (eight of eleven compression fractures) injection of cement yielded dramatic reduction in pain within 24 hours of the procedure. Preliminary experience suggests that percutaneous cement vertebroplasty is an effective well tolerated method of stabilisation of spinal wedge compression fractures resulting in dramatic reduction in associated pain in most cases.

Percutaneous vertebroplasty for treatment of osteoporotic thoracolumbar vertebral compression fracture by filling auto-solidification calcium phosphate cement

目的 探讨应用经皮椎体成形术(PVP)自固化磷酸钙人工骨(CPC)充填治疗骨质疏松性胸腰椎压缩性骨折的临床疗效.方法自2004年1月起,对26例29个椎体骨质疏松性胸腰椎压缩骨折患者,采用术中手法复位、PVP 自固化CPC充填治疗.结果 26例患者经单侧或双侧椎弓根穿刺椎体成形术成功治愈.胸腰椎自固化CPC平均充填量为4.6 mL.术中CPC渗漏者5例5个椎体.无一例出现严重并发症.经3～8个月(平均4.6个月)随访,术后所有患者疼痛消失.除3例椎体高度丢失15%外,其余椎体高度平均恢复达正常的80%.结论 PVP自固化CPC充填治疗骨质疏松性胸腰椎压缩性骨折是一种安全、简单、有效的方法。

Cold defect on bone scan in a vertebral body after percutaneous vertebroplasty

Percutaneous vertebroplasty using bone cements is increasingly being used to stabilize osteoporotic spinal compression fractures. Although the scintigraphic appearance of compression fractures has been well-described, the post-vertebroplasty bone scan appearance has not. This case report describes a characteristic cold defect of a vertebral body after percutaneous vertebroplasty.

Functional results after vertebroplasty in metastatic vertebral fractures

8049 Background: Percutaneous vertebroplasty may be indicated when a patient with a painful osteoporotic or metastaticvertebral compression fracture remains symptomatic despite of nonoperative mana...

Polymethylmethacrylate-vertebroplasty. A new and effective method of pain treatment in vertebral compression

Percutaneous polymethylmethacrylate (PMMA) vertebroplasty is increasingly used in the treatment of back pain related to compression of the vertebral bodies. After the procedure immediate mobilization of the patient is possible. The purpose of the study was to examine the change in quality of life of patients with vertebral collapse achieved by vertebroplasty during a six-month period. 28 patients with osteolytic metastases (mean age 59,7 +/- 7,8 years, 2,1:1male/female ratio) and 38 patients with osteoporotic vertebral collapse (mean age 73 +/- 6 years, 1:3,5male/female ratio ) of the thoracal and lumbar spine were treated with PMMA vertebroplasty and analysed prospectively. After admission, before, six weeks and 6 months after discharge from the hospital patients answered the Oswestry Low Back Pain Disability (OLBPD) questionnaire for assessment of treatment-related changes in disability. Immediately and 6 months after treatment 83 % of tumor patients and 92 % of ostoporotic patients had significant pain reduction. Extravasation of PMMA beyond the vertebral margins were observed in 26 % of the patients. No treatment-related clinical or neurological complications were observed. PMMA vertebroplasty is an efficacious and safe method of pain relief for patients with osteolytic metastases or osteoporotic compression with good long-term results.