PURPOSE The purpose of this study was to examine incidence of recompression and risk factors in the patients with osteoporotic vertebral compression fracture (OVCF) after vertebroplasty or kyphoplasty. MATERIALS AND METHODS This study was conducted on 179 vertebral bodies of 126 patients who underwent vertebroplasty or kyphoplasty on OVCF from January 2004 to August 2013. RESULTS When anterior vertebral height of fractured vertebrae declined by more than 3 mm from the height immediately after vertebroplasty or kyphoplasty, it was judged that recompression had occurred. Recompression was observed in a total of 58 vertebrae (32.4%). Recompression occurrences were found to be decreasing significantly when fractured vertebrae were the thoracic spine. In addition, osteonecrosis occurred in the preoperative vertebrae and restoration degree of anterior vertebral height immediately after vertebroplasty or kyphoplasty affected recompression occurrences significantly. The other factors (age, sex, bone mineral density, steroid medication history, follow-up duration, cement volume, vertebroplasty or kyphoplasty, and approach method) were compared, but no statistical significance was found. CONCLUSION The risk of vertebral recompression is more common, especially when osteonecrosis occurred in preoperative vertebrae or when vertebroplasty or kyphoplasty achieved remarkable restoration of anterior vertebra height. When performing vertebroplasty or kyphoplasty, such conditions should be considered carefully.
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Effect of Weekly Teriparatide Administration Followed by Percutaneous Balloon Kyphoplasty on Post-Menopausal Osteoporotic Compression Fracture Treatment Sung-Ha Hong, Seung-Pyo Suh, Woo Jin Shin, Seung Gi Lee, Byung Jun Kang Journal of the Korean Orthopaedic Association.2022; 57(1): 35. CrossRef
Analysis of the Cement Distribution Pattern and Other Risk Factors that Affect the Incidence of Recompression Fractures of Vertebral Bodies after Vertebroplasty or Kyphoplasty Deuk Soo Jun, Jong Min Baik, Young Hyun Yoon Journal of the Korean Orthopaedic Association.2022; 57(3): 204. CrossRef
Clinical Characteristics of Elderly People with Osteoporotic Vertebral Compression Fracture Based on a 12-Year Single-Center Experience in Korea Seung-Kwan Lee, Deuk-Soo Jun, Dong-Keun Lee, Jong-Min Baik Geriatrics.2022; 7(6): 123. CrossRef
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PURPOSE This study aims to investigate the relationship between cement leakage into the disc during percutaneous balloon kyphoplasty and subsequent compression fractures in adjacent vertebrae during treatment of osteoporotic vertebral compression fracture. MATERIALS AND METHODS 103 patients (118 vertebrae) who have been treated with balloon kyphoplasty due to osteoporotic compression fracture from June 2007 to July 2010 were retrospectively analyzed. The group was composed of 13 males and 90 females. The mean age was 75 years (57~95 years). The mean follow-up period was 10 months (6~30 months). Patients were divided into two groups; one with cement leakage into the disc and the other without cement leakage into the disc. The study was performed to determine whether subsequent compression fractures in adjacent vertebrae were related to several factors. RESULTS The cement leakages into the disc occurred in 16 of 118 vertebrae. Of the 16 vertebrae with cement leakage into the disc, 5 (31%) had subsequent adjacent vertebral compression fractures; however, of the 102 vertebrae in which cement leakage did not occur, only 11 (11%) had subsequent adjacent vertebral compression fractures (p<0.05). Of the 16 vertebrae with cement leakage into the disc, subsequent adjacent vertebral compression fractures occurred 1 vertebrae of 10 vertebrae with definite trauma history. Out of the 6 vertebrae with cement leakage and no definite trauma history, 4 vertebrae (67%) had subsequent adjacent vertebral compression fractures (p<0.05). CONCLUSION The cement leakage into the disc significantly increases the incidence of subsequent adjacent vertebral compression fractures. Most of the subsequent fractures occurred in the early post-operative period. When cement leakage into the disc occurred in patients with no definite trauma history such as slip down, the incidence of subsequent adjacent vertebral compression fracture increased significantly.
Kyphoplasty has recently attended as a potential treatment for sacral insufficiency fracture. We report a 85-years-old female patient with osteoporotic S1 insufficiency fracture with absence of trauma history treated with kyphoplasty which has no symptom improve with conservative treatment. Kyphoplasty is an effective and useful procedure in the treatment of the sacral insufficiency fracture, additionally reviewed of the literatures.
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Pelvic Insufficiency Fracture in Severe Osteoporosis Patient Woong Chae Na, Sang Hong Lee, Sung Jung, Hyun Woong Jang, Suenghwan Jo Hip & Pelvis.2017; 29(2): 120. CrossRef
PURPOSE To study which factors affect the deformity correction of vertebral body during kyphoplasty procedure. MATERIALS AND METHODS 25 osteoporotic vertebral compression fractures were treated with balloon kyphoplasty from October 2006 to May 2007. Lateral radiographs were taken at 5 different stages with preoperative lateral decubitus position, after placing the patient in prone position on an operation table, after inflating balloon, after deflation and removal of the balloon, after inserting the cement. Then we analyzed the compression ratios and kyphotic angles of the vertebral bodies in each stage. RESULTS Placing the patient in prone position showed significant postural reduction in kyphotic angle and restorement of the anterior and middle body height. The inflation of the balloon demonstrated significant reduction of kyphotic angle and restorement of the anterior and middle body height. After the deflation, anterior and middle body height has decreased significantly. After the deflation, the kyphotic angle and the anterior and middle body heights were not restored signigicantly compared with those of initial prone position. CONCLUSION Vertebral height and kyphotic angle were partially recovered by inflating the balloon, but the correction was lost after deflating the balloon. Statistically, the body deformity was not restored significantly after deflating the balloon compared with that of intraoperative prone position. Therefore, we concluded that, in kyphoplasty of osteoporotic compression fractures, the postural reduction is the most important factor in deformity correction of fractured vertebral bodies.
PURPOSE To analyze the physical properties of demineralized bone matrix (DBM) and self-setting calcium phosphate cement (CPC) composite for its compatibility to percutaneous kyphoplasty. MATERIALS AND METHODS According to tap volume method, DBM was mixed with CPC in variable ratio 0%, 20%, 30%, 40% and 50%. Distilled water was used as a hardening fluid. Its properties, including injectability, mold applicability, setting time and its behavior, maximum temperature, and mechanical strength, were analyzed. RESULTS The DBM-CP composites has a good injectability and mold applicability, a maximum temperature of less than 5oC, a initial setting time of 3 to 10 minutes. The outer surface of DBM-CP composites showed their even distribution in optical microscopy. Injectability, mold applicability and compressive strength were in inverse proportion to the amounts of DBM. CONCLUSION This study suggests that the DBM-CP composites has a good injectability and mold applicability with a low setting temperature and even distribution of compound. Therefore this composite might be used as a substitute of PMMA in kyphoplasty.
PURPOSE We are to find the method to objectify postoperative prognosis, analyzing the factors confluencing the result of kyphoplasty in osteoporotic vertebral compression fracture (OVCF). MATERIALS AND METHODS Our study included 50 patients (55 vertebral bodies) who have undergone kyphoplasty from Sep. 2004 until Oct. 2005. We divided in the group according to bone mineral density (BMD), compression rate, recovery rate and cement leakage. We verified the significance of each group, using independent t-test, and ANOVA test among observers. RESULTS We performed kyphoplasty on 55 vertebral bodies, 12 cases with more than 0.4 g/cm2 in BMD (mean: 0.53 g/cm2) and their mean preoperative compression rate (CR), immediate postoperative recovery rate (RR-IPO), and recovery rate after 6 months (RR-6M) was each 30.58%, 12.35%P, 9.93%P. 15 cases under 0.4 g/cm2 (mean 0.31 g/cm2), and their CR, RR-IPO and RR-6M was 26.73%, 11.77%P, 5.26%P respectively. The p-value was 0.004. Another studies according to CR, RR-IPO and leakage of cement revealed the better results in the cases of the lower CR, the smaller reduction and abscecnce of cement leakage, but statistically insignificant (p=0.309, 0.069, 0.356). CONCLUSION Preoperative BMD was most important factor that confluencing postoperative radiological result in OVCF. Other factors were also thought to be confluencing factors, but statistically insignificant..
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Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures? Hoon-Sang Sohn, Seong-Kee Shin, Eun-Seok Seo, Kang-Seob Chang Journal of the Korean Fracture Society.2011; 24(4): 361. CrossRef