Overall, the percutaneous vertebroplasty has low complication rate. Nevertheless, severe complications can occur. The majority of these are related to cement leakage. The cement migration through perivertebral venous system can lead to fatal complication. We present a case of death by hemothorax due to cement leakage following percutaneous vertebroplasty with literature review.
PURPOSE To evaluate the differences of radiological outcomes of uniportal and biportal vertebroplasty in the point of bone cement distribution and leakage. MATERIALS AND METHODS A retrospective study reviewing the period between May 2002 and January 2006 investigated 100 vertebrae which underwent vertebroplasty and followed for more than three months by uniportal approach (55 vertebrae, group 1) and biportal approach (45 vertebrae, group 2). The operative time, the amount of bone cement injected, anterior vertebral height restoration, kyphotic angle, bone cement distribution, and bone cement leakage were evaluated. RESULTS The amount of injected bone cement of group 1 (3.9 cc) was statistically smaller than that of group 2 (5.1 cc) (p=0.016). There were no significant differences in the operative time, anterior vertebral height restoration, kyphotic angle in both groups. The rate of bone cement distribution over 8 zones was significantly higher in group 2 than in group 1 (p=0.014). However, the rate of bone cement distribution over 7 zones and the rate of bone cement distributed on whole anterior vertebral body were not significantly different in both groups. The cement leakage was not also significantly different in both groups. CONCLUSION Although the amount of injected bone cement was smaller in uniportal vertebroplasty, the radiological results and cement leakage were similar to biportal vertebroplasty. These findings suggest that uniportal vertebroplasty can be the operative options in osteoporotic vertebral fracture.
PURPOSE To evaluate retrospectively the results regarding pain relief, complication after percutaneous vertebroplasty, for an osteoporotic compression fractures. MATERIALS AND METHODS 260 patients (male 55, female 260, mean age 69.4 years old) treated by percutaneous vertebroplasty in Dankook University Hospital from July 1997 to July 2004 were reviewed. We performed percutaneous vertebroplasty and observed the degree of pain relief using pain scale pre-/postoperation. we evaluate the complication by plain radiographs and computed tomography, ABGA and chest X-ray. we evaluate pain relief and complication for 1 week by follow-up plain radiographs.
we recommended BMD follow-up per 1 year and osteoporosis medication at least 2 years. A clinical result was evaluated as excellent, good, fair, poor and visual analogue scale (VAS 0~10) for 1 year. We prefaced a statistical analysis by T-test using SPSS (version 11.0) correlating 1 week and 1 years effects. RESULTS 73 (28.3%) of the patients were evaluated as excellent: 123 (45.5%), as good: 45 (17.8%), as fair; and 23 (8.5%), as poor, show 73.8% over good in 1 week. 76 (29.3%) of the patients were evaluated as excellent; 120 (44.3%), as good; 43 (16.8%), as fair; and 25 (9.6%), as poor in 1 year, show 73.6% over good result. 1 week follow-up and 1 year follow-up show similar results. 1 patient had death (hemothorax), 4 patients had arrhythmia, 15 patients (21 vertebrae) had fracture around vertebroplasty. CONCLUSION Percutaneous vertebroplasty using PMMA is valuable method in the treatment of osteoporotic compression fracture, providing immediately pain relief, long term pain relief, prevention of complication originated from long term traction and bed rest, unwearing brace and early ambulation.
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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
Large Pulmonary Embolus after Percutaneous Vertebroplasty - A Case Report - Sang Ho Moon, Soo Won Lee, Byoung Ho Suh, Sung Hwan Kim Journal of Korean Society of Spine Surgery.2009; 16(1): 46. CrossRef
Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty Myung-Ho Kim, Sang-Hyuk Min, Suk-Ha Jeon Journal of the Korean Fracture Society.2007; 20(3): 260. CrossRef
PURPOSE To evaluate the result of percutaneous vertebroplasty in the treatment of osteorporotic stable burst fracture that has not neurologic symptom. MATERIALS AND METHODS A retrospective review was conducted in 37 vertebrae of 33 patinets with osteoporotic stable burst fracrure treated by percutaneous vertebroplasty from February 2000 to May 2003. Stable burst fracture was classified by McAfee. The operation was performed in the patient without neurologic symptom, BMD T-score was below -2.5 and hot uptake was seen in (99m)Tc bone scan. The operation was held from post-traumatic 7 to 32 days, average 17 days. Follow up period was from 5 months to 38 months, average 11 months. The result of the treatment was assesed by clinical finding (pain scale and work status by Denis) and radiologic findings (percentage height restored and change of kyphotic angle). RESULTS In clinical assessment, 27 had a satisfactory pain scale below the P3, 25 had a satisfactory work status below the W3. In the radiologic findings, percentage height restore was increased from 0% to 62%, average 23.3%. The preop. kyphotic angle was from -20 degree to 42 degree, average 8.9 degree. The postop. kyphotic angle was from -20 to 42 degree, average 6.5 degree. The kyphotic angle was decreased average 2.4 degree after operation. CONCLUSION Treatment of osteoporotic stable burst fracture with percutaneous vertebroplasty is the minimal invasive treatment that has satisfactory pain relief and reduction of fracture.
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Outcome Comparison between Percutaneous Vertebroplasty and Conservative Treatment in Acute Painful Osteoporotic Vertebral Compression Fracture Hwa-Yeop Na, Young-Sang Lee, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo Journal of Korean Society of Spine Surgery.2014; 21(2): 70. CrossRef
PURPOSE To assess the clinical and functional outcome of the patients who underwent percutaneous vertebroplasty with bone cement for the osteoporotic compression fracture and who had been followed up for minimum 1 year. MATERIALS AND METHODS Among 110 patients who had been undergone percutaneous vertebroplasty with bone cement for osteoporotic compression fracture in Gangneung Asan Hospital from January 2001 to August 2002, 75 patients who had been followed up for more than 1 year were selected. And retrospectively, we analyzed the clinical and radiographic finding of 1 year, 2 year and 3 year follow-up. The patients were divided into 3 groups, the first group who have follow-up period of the from 1 to 2 years had 75 patients, the second group who the from 2 to 3 years, 49 patients, and the third group who the more than 3 years, 20 patients. We graded the clinical results to excellent, good, normal, fair and poor. Also, we assessed the height of vertebral body, the adjacent vertebral body fracture and the leakage of bone cement. RESULTS 74 patients (98.6%) had the excellent or good results postoperatively. 69 patients (92%) of the first group, 46 patients (93.8%) of the second group and 16 patients (80%) of the third group had excellent or good results at last follow-up. There was no statistical correlation of each groups (p>0.05). In first group, the average height of body was 71.1% preoperatively, 73.5% postoperatively and 73.5% at follow-up. In second group, 71.5%, 75.5%, and 73.1%. In third group, 71.2%, 78.0% and 77.8%. There was no significant statistical correlation of each groups (p>0.05). 47cases (38.8%) had some leakage of cement immediate postoperatively. In 4 cases (7 vertebra), there were adjacent vertebral body fractures. CONCLUSION Based on the results of our study, percutaneous vertebroplasty is a useful method in the treatment for the osteoporotic compression fracture of vertebra body.
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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 Diagnosis of Osteoporotic Occult Vertebral Fracture and Vertebroplasty Seong Jun Ahn, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Yeong Joon Kim Journal of the Korean Fracture Society.2012; 25(3): 208. CrossRef
Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty Myung-Ho Kim, Sang-Hyuk Min, Suk-Ha Jeon Journal of the Korean Fracture Society.2007; 20(3): 260. 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
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.
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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
PURPOSE Percutaneous vertebroplasty is the procedure of bone cement injection and allogenous bone graft for pain relief in case of compression fracture, hemangioma etc. Recently, osteoporotic compression fracture increases as the old age increase. We analyzed the postoperative clinical symptoms and radiologic findings. MATERIALS AND METHODS From Jan. 2000 to Apr. 2001, we have analyzed 111 osteoporotic compression fractures(59 patients) at Kangneung hospital. Before the procedure, we checked BMD, bone scan and CT. Most common fracture site was the thoracolumbar junction area. Fluoroscopic control was necessary for the cement injection to prevent cement leakage. The amount of cement injection was 4.7ml. We have studied the increase of vertebral body height, symptom recovery time & pain relief, postoperative complications. RESULT The vertebral body height was increased from 55.5% to 70.3% postoperatively and the symptom was improved in 48 persons at POD 1, 3 persons at postoperative 2 weeks, and 4 persons at postoperative 2 months. Most common complication was cement leakage to the epidural vessel, disc space, and spinal canal. But serious complication-spinal canal leakage- was only 1 case and had been improved after decompression. CONCLUSION Percutaneous vertebroplasty with bone cement(PMMA) is effective treatment in osteoporotic compression fracture, especially in pain relief.
Citations
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Outcome Comparison between Percutaneous Vertebroplasty and Conservative Treatment in Acute Painful Osteoporotic Vertebral Compression Fracture Hwa-Yeop Na, Young-Sang Lee, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo Journal of Korean Society of Spine Surgery.2014; 21(2): 70. CrossRef
Adjacent Vertebral Compression Fracture after Percutaneous Vertebroplasty Chung-Hwan Kim, Jae-Kwang Hwang, Jun-Seok Park Journal of Korean Society of Spine Surgery.2013; 20(4): 163. CrossRef
The Diagnosis of Osteoporotic Occult Vertebral Fracture and Vertebroplasty Seong Jun Ahn, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Yeong Joon Kim Journal of the Korean Fracture Society.2012; 25(3): 208. CrossRef
Factor Analysis Affecting the Leakage of Bone Cement After Vertebroplasty Jae-Hoon Kim, Kyung-Jin Song, Tai-Seung Kim, Jae-Lim Cho, Ye-Soo Park Journal of Korean Society of Spine Surgery.2010; 17(1): 13. CrossRef
Treatment of Combined Degenerative Lumbar Disease and Adjacent Vertebral Fracture Jae-Lim Cho, IL-Hoon Sung, Seung-Wook Baek, Ye-Soo Park Journal of Korean Society of Spine Surgery.2008; 15(4): 236. CrossRef