Journal of Musculoskeletal Trauma

Original Articles

Progression of Compression and Related Factors in Conservative Management of Osteoporotic Vertebral Compression Fractures: Young Do Koh, Jeong Soo Park; J Korean Fract Soc 2015;28(2):132-138. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.132

PURPOSE
The purpose of this study is to determine the ideal period of brace application for thoracolumbar (T10-L2) osteoporotic vertebral compression fracture (OVCF) based on the progression of the vertebral compression with passage of time and to evaluate the factors associated with progression of thoracolumbar OVCF, when treated conservatively.
MATERIALS AND METHODS
This retrospective study included a total of 46 patients who were diagnosed with thoracolumbar OVCF and could be followed-up for at least 6 months. In this study, the increase of compression rate and the mean slope of compression rate per weeks were compared between two periods (from diagnosed date to 8 weeks and from 8 weeks to 6 months), as the standard point. Age, bone mineral density (BMD), osteoporosis treatment after injury, diabetes mellitus (DM) as underlying disease were also compared between two groups (setting up 15% as standard point of increase of compression rate, <15% and > or =15%). Statistical analyses were performed using the paired t-test to assess the increase of compression rate and using the linear mixed model to assess the mean slope change. The relationships between the factors and progression of compression were analyzed using t-test, chi-square test, and logistic regression analysis.
RESULTS
The increase of compression rate was 13.03% and 1.97% in each period and the difference between those two periods was 11.06% (p=0.00). At 8 weeks of follow-up, the mean slope was reduced by 1.12 (p=0.00). No statistically significant difference in related factors was observed between two groups.
CONCLUSION
Considering the increase of compression rate with passage of time, brace should be applied strictly for an initial 8 weeks. And age, BMD, osteoporosis treatment after injury, and DM as underlying disease are not predictors of progression of compression in vertebral fractures.

Citations

Citations to this article as recorded by

The Factors between the Progression of the Compression Rate and Magnetic Resonance Imaging Findings in Osteoporotic Vertebral Fracture Patients Treated with Teriparatide
Taebyeong Kang, Seung-Pyo Suh, Jeongwoon Han, Byungjun Kang, Changhyun Park
Journal of the Korean Orthopaedic Association.2023; 58(5): 392. CrossRef
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
Treatment Effect with Weekly Teriparatide in the Vertebral Compression Fractures in Patients with Severe Osteoporosis
Seok-Ha Hwang, Young-Kyun Woo, Ho-Seung Jeon, Seung-Pyo Suh, Joo-Young Kim, Jae-Nam Kim
Journal of the Korean Orthopaedic Association.2019; 54(6): 528. CrossRef
The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
Journal of the Korean Orthopaedic Association.2018; 53(4): 341. CrossRef
A Retrospective Clinical Survey of Vertebral Compression Fractures
Ji Hye Oh, Yun Kyu Lee, Jae Soo Kim, Hyun Jong Lee, Sung Chul Lim
Journal of Acupuncture Research.2018; 35(4): 219. CrossRef

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The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture: Young Do Koh, Jong Seok Yoon, Sung Il Kim; J Korean Fract Soc 2008;21(1):57-61. Published online January 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.1.57

Abstract PDF: 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.

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Randomized Controlled Trial

Comparison of the Result of Vertebroplasty and Conservative Treatment in Osteoporotic Vertebral Compression Fracture: Ye Soo Park, Woo Jin Cho, Jae Lim Cho; J Korean Fract Soc 2006;19(3):363-368. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.363

Abstract

PURPOSE
To evaluate the results of vertebroplasty and conservative treatment in osteoporotic vertebral compression fractures.
MATERIALS AND METHODS
Patients were divided randomly into 2 groups; Group I (conservative treatment) and Group II (vertebroplasty). There are 14 cases in group I and 16 cases in group II. Radiologically, the progression of compression was observed. Clinical evaluation was done using Denis pain scale. In both groups, prolonged pain with nonunion or avascular necrosis that resulted in surgical intervention was evaluated as complication. In group II, the complication associated the procedures were evaluated.
RESULTS
Group II was superior to conservative treatment in terms of maintaining vertebral height radiologically. The characteristics of symptom improvement were the same in two groups. There were cement leakage among group II but they did not influence to the results. In group I, 2 subjects needed surgery due to prolonged pain. In group II, 1 subject needed surgery due to prolonged pain and there were 3 cement leakage cases which were insignificant.
CONCLUSION
In vertebroplasty group, complications associated the procedures were noted. In conservative treatment group, more patients needed operation. Therefore, we should be very prudent when we choose the treatment of the osteoporotic vertebral compression fracture.

Citations

Citations to this article as recorded by

A Case Report of the Korean Medical Treatment of Dysphagia and Anorexia after Lumbar Compression Fracture
Hye-mi Jo, Eun-chang Lee, Hye-soo Youn, Choong-hyun Park, Da-young Han, Da-hae Jung, Jung-eun Lee
The Journal of Internal Korean Medicine.2022; 43(2): 219. CrossRef
A Retrospective Clinical Survey of Vertebral Compression Fractures
Ji Hye Oh, Yun Kyu Lee, Jae Soo Kim, Hyun Jong Lee, Sung Chul Lim
Journal of Acupuncture Research.2018; 35(4): 219. CrossRef
Lumbar Spine Fracture
Seung-Wook Back, Hyun-Joong Cho, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(3): 277. CrossRef

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Original Article

Vertebroplasty for the Treatment of Painful Osteoporotic Compression Fractures: Young Woo Kim, Ho Guen Chang, Kee Byoung Lee, Yong nam Ji, Yong Beom Lee, Jeong Mo Ku; J Korean Fract Soc 2004;17(1):49-54. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.49

Abstract PDF

PURPOSE
To evaluate results regarding pain relief, spinal stabilization, and complication after treatment with percutaneous vertebroplasty.
MATERIALS AND METHODS
108 patients (12 men, 96 women; aged 42~84 years) underwent 156 percutaneous injections of surgical cement into a vertebra (vertebroplasty) with fluoroscopic guidance in 119 procedures. All patients had severe pain,osteoporotic fractures and had failed medical therapy. Immediate and long-term pain response, spinal stability, and complications were evaluated. Assessment criteria were the changes over time (Days 3, 30, 90, 180) in visual analogue scale (VAS: 0~100 mm) and McGill-Melzack scoring system. The height of vertebral body was checked at three portions (anterior, middle, posterior) with lateral view of plain radiographs.
RESULTS
A statistically significant decrease of both VAS and McGill-Melzack scoring system was observed at Day 3. The results were also significant at Days 30, 90, and 180 both scales. We observed no adverse event, but 26 vertebral fractures had occured in the adjacent level during 12 months of follow-up. The leakage of cement was observed in 57 vertebral bodies (36.5%). But there was no neurological symptoms associated with cement leakage. The vertebral body height was increased after vertebroplasty.
CONCLUSION
Vertebroplasty is safe and effective, and have a useful role in the treatment of painful osteoporotic vertebral compression fractures that do not respond to conventional treatments. Continuous management of osteoporosis and patient education is mandantory to prevent subsequent fracture of the adjacent vertebral bodies.

Citations

Citations to this article as recorded by

Comparison of Outcomes of Conservative Treatment, Early Vertebroplasty, and Delayed Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures
Se-Hyuk Im, Young-Joon Ahn, Bo-Kyu Yang, Seung-Rim Yi, Ye-Hyun Lee, Ji-Eun Kwon, Jong-Min Kim
Journal of Korean Society of Spine Surgery.2016; 23(3): 139. CrossRef
The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture
Young-Do Koh, Jong-Seok Yoon, Sung-Il Kim
Journal of the Korean Fracture Society.2008; 21(1): 57. CrossRef
Compatibility of Self-setting DBM-CP Composites in Percutaneous Kyphoplasty
Jung Hee Lee
Journal of the Korean Fracture Society.2007; 20(3): 266. CrossRef

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