Abstract
Study design:
By analyzing a large number of surgical patients, we identified the roles of wedge-shaped changes in related surgeries.
Objectives:
To illustrate the relevance of vertebral wedge-shaped changes in X-ray imaging at supine and standing positions in patients with percutaneous kyphoplasty as well as the postoperative effect.
Setting:
All patient data were collected from a hospital in China.
Methods:
Between June 2006 and May 2010, 77 surgical patients (9 men and 68 women) with wedge-shaped compression fractures were retrospectively analyzed. Patients were divided into group A (ΔWR⩾2.5%) and group B (ΔWR<2.5%) according to the dynamic changes in the percentage of vertebral body wedge-shaped variable ratio (WR) at supine and standing positions. The intensity of back pain in different positions pre- and postoperatively was evaluated with a visual analog pain scale (VAS).
Results:
The WRs in both standing and supine positions were significantly reduced by kyphoplasty in both groups A and B. In agreement with the improvement in WRs, the VAS was significantly decreased in three positions for patients in group A and in turning over and standing position for patients in group B. With respect to ΔWR changes, group B revealed significantly lower values compared with group A preoperatively (P<0.001), but there was no significant difference between groups A and B postoperatively and at 1-month follow-up (P=0.179 and P=0.558, respectively).
Conclusions:
Improvement in symptoms after kyphoplasty is better in patients with wedge-shaped changes in supine and standing positions, and the efficacy of height restoration of the spine would be better in unstable vertebrae by balloon dilatation.
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References
Reginster JY, Burlet N . Osteoporosis: A still increasing prevalence. Bone 2006; 38: S4–S9.
Riggs BL, Melton LJ 3rd . The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 1995; 17: 505S–511S.
Felsenberg D, Silman AJ, Lunt M, Armbrecht G, Ismail AA, Finn JD et al. Incidence of vertebral fracture in Europe: results from the European prospective osteoporosis study (epos). J Bone Miner Res 2002; 17: 716–724.
Rao RD, Singrakhia MD . Painful osteoporotic vertebral fracture. Pathogenesis, evaluation, and roles of vertebroplasty and kyphoplasty in its management. J Bone Joint Surg Am 2003; 85-A: 2010–2022.
Francis RM, Baillie SP, Chuck AJ, Crook PR, Dunn N, Fordham JN et al. Acute and long-term management of patients with vertebral fractures. QJM 2004; 97: 63–74.
Yamato M, Nishimura G, Kuramochi E, Saiki N, Fujioka M . Mr appearance at different ages of osteoporotic compression fractures of the vertebrae. Radiat Med 1998; 16: 329–334.
Gu XH, Yang HL, Tang TS . Balloon kyphoplasty for aged multiple osteoporotic spinal fractures. Chinese J Bone Joint Injury 2005; 20: 151–153.
Dai LY . Mri in diagnosis of osteoporotic vertral fractures: Avascular necrosis of the vertebral body. J Clin Orthipaedics 2000; 3: 9–10.
Mehta JS, Reed MR, McVie JL, Sanderson PL . Weight-bearing radiographs in thoracolumbar fractures: Do they influence management? Spine 2004; 29: 564–567.
McKiernan F, Faciszewski T . Intravertebral clefts in osteoporotic vertebral compression fractures. Arthritis Rheum 2003; 48: 1414–1419.
Toyone T, Tanaka T, Wada Y, Kamikawa K, Ito M, Kimura K et al. Changes in vertebral wedging rate between supine and standing position and its association with back pain: a prospective study in patients with osteoporotic vertebral compression fractures. Spine 2006; 31: 2963–2966.
Ismail AA, Cooper C, Felsenberg D, Varlow J, Kanis JA, Silman AJ et al. Number and type of vertebral deformities: Epidemiological characteristics and relation to back pain and height loss. European vertebral osteoporosis study group. Osteoporos Int 1999; 9: 206–213.
Cantor JB, Lebwohl NH, Garvey T, Eismont FJ . Nonoperative management of stable thoracolumbar burst fractures with early ambulation and bracing. Spine 1993; 18: 971–976.
Hoang-Kim A, Gelsomini L, Luciani D, Moroni A, Giannini S . Fracture healing and drug therapies in osteoporosis. Clin Cases Miner Bone Metab 2009; 6: 136–143.
Galibert P, Deramond H, Rosat P, Le Gars D . Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 1987; 33: 166–168.
Watts NB, Harris ST, Genant HK . Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporos Int 2001; 12: 429–437.
Lai PL, Tai CL, Chen LH, Nien NY . Cement leakage causes potential thermal injury in vertebroplasty. BMC Musculoskelet Disord 2011; 12: 116.
Teng MM, Cheng H, Ho DM, Chang CY . Intraspinal leakage of bone cement after vertebroplasty: A report of 3 cases. AJNR Am J Neuroradiol 2006; 27: 224–229.
Lieberman IH, Dudeney S, Reinhardt MK, Bell G . Initial outcome and efficacy of "kyphoplasty" in the treatment of painful osteoporotic vertebral compression fractures. Spine 2001; 26: 1631–1638.
Aebli N, Krebs J, Schwenke D, Davis G, Theis JC . Pressurization of vertebral bodies during vertebroplasty causes cardiovascular complications: An experimental study in sheep. Spine 2003; 28: 1513–1519.
Ahn Y, Lee JH, Lee HY, Lee SH, Keem SH . Predictive factors for subsequent vertebral fracture after percutaneous vertebroplasty. J Neurosurg Spine 2008; 9: 129–136.
Lin EP, Ekholm S, Hiwatashi A, Westesson PL . Vertebroplasty: Cement leakage into the disc increases the risk of new fracture of adjacent vertebral body. AJNR Am J Neuroradiol 2004; 25: 175–180.
Trout AT, Kallmes DF, Kaufmann TJ . New fractures after vertebroplasty: Adjacent fractures occur significantly sooner. AJNR Am J Neuroradiol 2006; 27: 217–223.
Mathis JM, Barr JD, Belkoff SM, Barr MS, Jensen ME, Deramond H . Percutaneous vertebroplasty: A developing standard of care for vertebral compression fractures. AJNR Am J Neuroradiol 2001; 22: 373–381.
Barr JD, Barr MS, Lemley TJ, McCann RM . Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 2000; 25: 923–928.
Oleksik A, Lips P, Dawson A, Minshall ME, Shen W, Cooper C et al. Health-related quality of life in postmenopausal women with low bmd with or without prevalent vertebral fractures. J Bone Miner Res 2000; 15: 1384–1392.
Huang C, Ross PD, Wasnich RD . Vertebral fracture and other predictors of physical impairment and health care utilization. Arch Intern Med 1996; 156: 2469–2475.
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Qian, L., Pan, J., Liu, Z. et al. The correlation between vertebral wedge-shaped changes in X-ray imaging at supine and standing positions and the efficacy of operative treatment of thoracolumbar spinal fracture in the elderly. Spinal Cord 51, 904–908 (2013). https://doi.org/10.1038/sc.2013.102
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DOI: https://doi.org/10.1038/sc.2013.102
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