Treatment of osteoporotic vertebral compression fracture with posterior wall bone defects by percutaneous kyphoplasty with sequential infusion of bone cement" />
Treatment of osteoporotic vertebral compression fracture with posterior wall bone defects by percutaneous kyphoplasty with sequential infusion of bone cement
LIU Yongtao1, HUANG Dong1, ZHOU Xiaoji2, LI Zhiwen3, XIN Bing1
(1. Department of Spine Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu 221000; 2. Department of Orthopaedics, 904 Hospital of PLA Joint Logistics Support Force, Wuxi Jiangsu 214000; 3. Health Care Research Institute of Xuzhou Medical University, Xuzhou Jiangsu 221000, China)
Abstract:Objective:To evaluate the clinical efficacy of the sequential infusion of bone cement when percutaneous kyphoplasty(PKP) was conducted for the treatment of osteoporotic vertebral compression fracture(OVCF) with posterior wall bone defects. Methods: Patients with posterior wall bone defects OVCF treated in our department from May 2016 to July 2020 were retrospectively analyzed. A total of 32 patients meeting the inclusion and exclusion criteria were treated by the sequential infusion of bone cement when PKP was applied. The visual analog score(VAS), Oswestry disability index(ODI), Cobb angle and height of injured vertebra were recorded and compared before surgery and 1 and 3 months after surgery. Postoperative bone cement leakage and complications were also recorded. Results:The postoperative VAS,ODI and Cobb angle of injured vertebra were significantly lower than those before surgery(P<0.05).The postoperative height of the injured vertebra was significantly higher than that before surgery(P<0.05). However, there was no significant differences between followup results at 1 and 3 months postoperatively(P>0.05). There were 3 cases (9.38%) of bone cement leakage, without any cases of spinal canal leakage. No surgical complications such as nerve injury and pulmonary embolism were observed. Conclusion:Sequential infusion of bone cement during PKP is a safe and effective surgery for the OVCF with posterior wall bone defects, which could effectively reduce the bone cement leakage.
[3]Zhan Y, Jiang J, Liao H, et al. Risk factors for cement leakage after vertebroplasty or kyphoplasty: a metaanalysis of published evidence[J]. World Neurosurg, 2017, 101: 633-642.
[4]Taylor RS, Taylor RJ, Fritzell P. Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety[J]. Spine (Phila Pa 1976), 2006, 31(23): 2747-2755.
[6]Ha KY, Lee JS, Kim KW, et al. Percutaneous vertebroplasty for vertebral compression fractures with and without intravertebral clefts[J]. J Bone Joint Surg Br, 2006, 88(5): 629-633.
[7]Walter J, Haciyakupoglu E, Waschke A, et al. Cement leakage as a possible complication of balloon kyphoplasty—is there a difference between osteoporotic compression fractures (AO type A1) and incomplete burst fractures (AO type A3.1)?[J]. Acta Neurochir (Wien), 2012, 154(2): 313-319.
[9]Greene DL, Isaac R, Neuwirth M, et al. The eggshell technique for prevention of cement leakage during kyphoplasty[J]. J Spinal Disord Tech, 2007, 20(3): 229-232.
[11]Amar AP, Larsen DW, Esnaashari N, et al. Percutaneous transpedicular polymethylmethacrylate vertebroplasty for the treatment of spinal compression fractures[J]. Neurosurgery, 2001, 49(5): 1105-1115.