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Short-term Treatment Comparison of Teriparatide and Percutaneous Vertebroplasty in Patients with Acute Osteoporotic Vertebral Compression Fractures
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Joonoh Seo, Ki Youn Kwon, Bumseok Lee, Hoon-Sang Sohn
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J Korean Fract Soc 2024;37(1):15-21. Published online January 31, 2024
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DOI: https://doi.org/10.12671/jkfs.2024.37.1.15
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 Abstract
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- Purpose
This study compared the 3-month treatment effects of teriparatide and percutaneous vertebroplasty for acute osteoporotic vertebral compression fractures.
Materials and Methods
A retrospective study was conducted on 76 patients diagnosed with acute osteoporotic vertebral compression fractures from January 1, 2020 to December 31, 2022. The patients were divided into the teriparatide group and the percutaneous vertebroplasty+alendronate group. The visual analog scale (VAS), Oswestry disability index (ODI), and height of the vertebrae anterior wall were measured before treatment and at 1 and 3 months after treatment.
Results
Of the 76 patients, 42 were treated with teriparatide, and 34 were treated with percutaneous vertebroplasty. The symptoms improved in both groups, with a decrease in the VAS and ODI scores at 1 and 3 months after treatment, respectively. On the other hand, there was no significant difference in the VAS, ODI score, and anterior vertebral body height between the two groups before treatment and at 1 and 3 months after treatment.
Conclusion
In the treatment of acute osteoporotic vertebral compression fractures, conservative treatment using teriparatide showed similar short-term (3 months) treatment results to percutaneous vertebroplasty in terms of improvement in back pain and function and degree of reduction in anterior vertebral body height.
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Minimal Invasive Fixation Methods for the Metacarpal Fracture
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Ki Youn Kwon, Jin Rok Oh, Ji Woong Kwak
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J Korean Fract Soc 2022;35(1):9-15. Published online January 31, 2022
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DOI: https://doi.org/10.12671/jkfs.2022.35.1.9
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Abstract
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- Purpose
This study compared the radiologic and clinical outcomes of metacarpal fractures treated with two minimally invasive surgical techniques: Kirschner wire (K-wire) fixation and headless screw fixation.
Materials and Methods
This study included 52 patients (46 males and 6 females; age 18-55 years) with distal metacarpal fractures (middle and distal shaft, including the neck) who had undergone K-wire fixation or headless screw fixation. All subjects were followed up for at least six months. The radiologic assessments were performed to evaluate the angular deformity and shortenings. The total active motion (TAM), grip strength, and patients’ subjective functional assessment were measured to evaluate the hand function. The time taken to return to work (RTW) and adverse events were analyzed.
Results
Of the 52 cases, metacarpal fractures treated with headless screw fixation and K-wire fixation showed a significant difference associated with early RTW (p<0.05). There were no significant differences between the subjects treated with K-wire fixation and those with headless screw fixation in terms of the radiologic measurement, hand function examinations, complications, and adverse events (p>0.05).
Conclusion
After a six-month follow-up, minimally invasive K-wire fixation and headless screw fixation produced similar clinical and radiologic outcomes in subjects with metacarpal fractures. Compared to K-wire fixation, however, headless screw fixation led to earlier functional recovery and might be a better option for treating metacarpal fractures in this regard.
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Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
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Jin Young Han, Ki Youn Kwon
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J Korean Fract Soc 2020;33(1):1-8. Published online January 31, 2020
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DOI: https://doi.org/10.12671/jkfs.2020.33.1.1
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Abstract
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- PURPOSE
This study compared the clinical and radiological results between two groups of patients with percutaneous fixation or conventional fixation after hardware removal.
MATERIALS AND METHODS
The study analyzed 68 patients (43 open fixation and 43 percutaneous screw fixation [PSF] 25) who had undergone fixation for unstable thoracolumbar fractures. The radiologic results were obtained using the lateral radiographs taken before and after the fixation and at the time of hardware removal. The clinical results included the time of operation, blood loss, time to ambulation, duration of the hospital stay and the visual analogue scale.
RESULTS
The percutaneous pedicle screw fixation (PPSF) group showed better results than did the conventional posterior fixation (CPF) group (p<0.05) in regard to the perioperative data such as operation time, blood loss, and duration of the hospital stay. There were no significant differences in wedge angle, local kyphotic angle, and the ΔKyphotic angle on the postoperative plane radiographs between the two groups (p>0.05). There were no significant differences in the wedge angle and local kyphotic angle after implant removal (p>0.05) between the two groups as well. However, there were significant differences in the segmental montion angle (p<0.001), and the PPSF group showed a larger segmental motion angle than did the CPF group (CPF 1.7°±1.2° vs PPSF 5.9°±3.2°, respectively).
CONCLUSION
For the treatment of unstable thoracolumbar fractures, the PPSF technique could achieve better clinical results and an improved segmental motion angle after implant removal within a year than that of the conventional fixation method.
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Citations
Citations to this article as recorded by  - A Comparison of 2 Surgical Treatments for Thoracolumbar Burst Fractures: Temporary Osteosynthesis and Arthrodesis
Halil Ibrahim Süner, Rafael Luque Pérez, Daniel Garríguez-Pérez, Marta Echevarría Marín, Jose Luis Pérez, Ignacio Domínguez
World Neurosurgery.2022; 166: e419. CrossRef
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