Journal of Musculoskeletal Trauma

Original Article

Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures: Jin Young Han, Ki Youn Kwon; J Korean Fract Soc 2020;33(1):1-8. Published online January 31, 2020; DOI: https://doi.org/10.12671/jkfs.2020.33.1.1

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 Î”Kyphotic 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 1.7Â°Â±1.2Â° vs PPSF 5.9Â°Â±3.2Â°, 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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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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Review Article

Treatment Options of Osteoporotic Vertebral Compression Fractures: Yu Mi Kim, Tae Kyun Kim, Dae Moo Shim, Kyeong Hoon Lim; J Korean Fract Soc 2018;31(3):114-121. Published online July 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.3.114

Abstract PDF

This paper reviews previous studies on the treatment of osteoporotic vertebral compression fractures in elderly patients to determine what factors should be considered for successful treatment. In osteoporotic vertebral compression fractures, the primary treatment is conservative treatments. Other treatments include osteoporosis treatment, pain control, orthosis, and physical therapy. Recently, percutaneous catheterization or balloon plasty is performed for rapid pain recovery and early ambulation. Percutaneous catheterization or balloon posterior plasty is effective in reducing pain and improving the activity ability. Surgical treatment should be considered in cases of nonunion or osteonecrosis, dent, deformation, and spinal cord compression after conservative treatment has failed. In surgical treatment, posterior spinal fixation and vertebroplasty are more advantageous in terms of the amount of bleeding, operation time compared to the anterior approach, but the most appropriate method should be selected through the patient's condition and understanding of each surgical method.

Citations

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Maigne Syndrome and Thoracolumbar Compression Fracture – An Overlooked Combination in Low Back Pain: A Case Report
Jae-Yong Shim, Myung-Hoon Shin
The Nerve.2025; 11(1): 21. CrossRef
Effects of Herbal Medicines on Bone Mineral Density Score in Osteoporosis or Osteopenia: Study Protocol for a Systematic Review and Meta-Analysis
Su Min Hong, Eun Jung Lee
Journal of Korean Medicine Rehabilitation.2021; 31(2): 49. CrossRef
Spinal Stability Evaluation According to the Change in the Spinal Fixation Segment Based on Finite Element Analysis
Cheol-Jeong Kim, Seung Min Son, Jin-Young Heo, Chi-Seung Lee
Journal of the Computational Structural Engineering Institute of Korea.2020; 33(3): 145. CrossRef

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Case Report

Clay-Shoveler's Fracture in an 18-Year-Old Cheerleader: A Case Report: Il Yeong Hwang, Sun Jae Park, Jae Ryong Cha; J Korean Fract Soc 2018;31(2):57-60. Published online April 30, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.2.57

Abstract PDF

Clay-Shoveler's fracture refers to a fracture that is solely developed on the spinous process of the cervical spine or the thoracic vertebrae. This fracture rarely occurs during sporting activities. In this case, an 18-year-old female developed the fracture on the spinous process of the 7th cervical spine and 1st thoracic vertebrae due to the repetitive practice of cheerleading. The patient's pain was improved by wearing a support device and taking an anti-inflammatory analgesic drug and muscle relaxant. Her case is being followed-up at the outpatient department.

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Clay-Shoveler’s Fracture on the Baseball Diamond: A Case of Noncontact Thoracic Spine Pain in an Adolescent Athlete
Jason S. Silver, Jordan Bork, Charles D. Kenyon
Current Sports Medicine Reports.2025; 24(6): 140. CrossRef
An unusual cause of neck pain in the physiotherapy clinic: Neglected clay-shoveler's fracture
GaneshSingh Dharmshaktu
Indian Journal of Physical Therapy and Research.2020; 2(2): 147. CrossRef

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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

Abstract PDF

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

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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 Diagnosis of Osteoporotic Occult Vertebral Fracture and Vertebroplasty: Seong Jun Ahn, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Yeong Joon Kim; J Korean Fract Soc 2012;25(3):208-214. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.208

Abstract PDF: PURPOSE
To evaluate the effectiveness of magnetic resonance imaging (MRI) for the diagnosis and usefulness of vertebroplasty in osteoporotic occult vertebral fractures.
MATERIALS AND METHODS
Of 472 osteoporotic vertebral fractures treated from May 2003 to July 2009, 45 patients were diagnosed with occult osteoporotic vertebral fracture. Their medical charts and radiographs were reviewed. The degree of vertebral body collapse was graded by a semiquantitative method. In order to increase the reliability, interpretation was based on radiographic diagnoses from 3 orthopedic surgeons. Vertebroplasty was performed at 31 of the 45 patients, for whom conservative treatment failed. Pre-operatively and post-operatively, pain was evaluated using a visual analog scale (VAS).
RESULTS
We observed 55 occult fractures in 45 patients. Forty vertebrae (72.7%) among the 55 vertebrae were just adjacent to an old vertebral fracture with deformation of the vertebral body. The rediagnosis rate of occult fracture attempted without MRI was only 21.8%. The average pre-operative VAS score of 8.07 (6~9) was improved to 2.43 after surgery and showed no delayed vertebral body collapse.
CONCLUSION
Gadolinium enhancement of MRI is critical to the diagnosis of occult vertebral fractures, which are 9% of whole osteoporotic vertebral fractures. Seventy-two point seven percent of occult vertebral fractures were just adjacent to an old vertebral fracture with collapse of the vertebral body. This means that if vertebroplasty is performed without thorough MRI examination, it may fail.

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The Relationship between Progression of Body Collapse and MRI Findings in Osteoporotic Stable Thoracolumbar Fractures: Young Do Koh, Jong Seok Yoon, Ji Young Hwang, Hyun Sik Park; J Korean Fract Soc 2008;21(4):304-311. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.304

Abstract PDF

PURPOSE
To find out the relationship between the initial Magnetic Resonance Image (MRI) findings and the progression of vertebra collapse when treated with Jewett brace in osteoporotic stable thoracolumbar fractures.
MATERIALS AND METHODS
We divided 38 cases of 37 patients of thoracolumbar osteoporotic stable thoracolumbar fractures who were treated with Jewett brace into two groups. One group was composed of those body collapse progressed more than 10% compared with the initial state, and the other group less than 10%. We analyzed the relationships between the progression of collapse and the superior endplate fractures, the fracture line extending to posterior cortex, the size of bone marrow edema, the signal intensity on T1 and T2 weighted MR images, the presence of paravertebral hematoma, and the degree of posterior extensor muscle atrophy using MR images.
RESULTS
The body collapse was more likely to progress when there was superior endplate fracture, when it showed larger size of bone marrow edema on T1 weighted image, and transverse low signal on T2 weighted image. But extending of fracture line to posterior cortex, presence of paravertebral hematoma, and degree of posterior extensor muscle atrophy did not show any statistical correlations to progression of collapse.
CONCLUSION
The body collapse is more likely to progress when there was superior endplate fracture, larger low signal on T1 weighted image and low signal on T2 weighted image at initial MRI treated with Jewett brace.

Citations

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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
Statistical Analysis on Hospitalized Patients with Thoracolumbar Compression Fracture at Single Korean Medicine Hospital: Retrospective Review
Hyun jin Jang, So jeong Kim, Min Ju Kim, Hyeon Kyu Choi, Pil Je Park, Kang Yeon soo, Jeong Kyo Jeong, Ju Hyun Jeon, Young Il Kim
Journal of Korean Medicine.2023; 44(2): 149. 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
The Relationship between the Progression of Kyphosis in Stable Thoracolumbar Fractures and Magnetic Resonance Imaging Findings
Deuk Soo Jun, Won Ju Shin, Byoung Keun An, Je Won Paik, Min Ho Park
Asian Spine Journal.2015; 9(2): 170. 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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Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty: Myung Ho Kim, Sang Hyuk Min, Suk Ha Jeon; J Korean Fract Soc 2007;20(3):260-265. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.260

Abstract PDF

PURPOSE
To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty.
MATERIALS AND METHODS
The study was conducted on 46 patients in whom 296 patients were performed during last 9 years. We were especially concerned with the restoration rate of vertebral height and kyphotic angle and estimated them on simple X-ray films.
RESULTS
In patients experienced subsequent vertebral fractures and no subsequent vertebral fractures after vertebroplasty, the mean height restoration rate of treated vertebra were 16.7% and 7.07%, and the kyphotic angle difference were 2.53 degree and 4.2 degree. The greater degree of height restoration of the vertebral body, especially in middle vertebral height and the lesser degree of kyphotic angle difference increased the risk of adjacent vertebral fracture risk. This results were available statistically (all p<0.05, Logistic regression test, SPSS 13.0).
CONCLUSION
It may be thought that the vertebral body height restoration rate will become risk factor of adjacent vertebral fractures.

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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
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
Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty
Myung-Ho Kim, Andrew S. Lee, Sang-Hyuk Min, Sung-Hyun Yoon
Asian Spine Journal.2011; 5(3): 180. CrossRef
The Effect of Adjacent Vertebral Body on Vertebroplasty for Compression Fracture
Yong-Chan Kim, Ho-Geun Chang, Kee-Byung Lee
Journal of the Korean Fracture Society.2010; 23(1): 97. 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

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Comparison of Uniportal and Biportal Vertebroplasty in Bone Cement Distribution and Leakage: Jae Hyup Lee, Kang Sup Yoon, Seung Baik Kang, Hyunchul Jo, Sang Ki Lee, Bong Soon Chang, Choon Ki Lee, Ji Ho Lee; J Korean Fract Soc 2006;19(4):471-476. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.471

Abstract: 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.

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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

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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 Articles

Correlation between Progression of Compression and Bone Densiometry Index in Osteoporotic Compression Fracture of Thoracolumbar Spine: Jung Hoon Kim, Jeong Gook Seo, Jong Ho Ahn; J Korean Fract Soc 2006;19(2):254-258. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.254

Abstract

PURPOSE
To evaluate whether progression of compression correlates with bone densiometry index in patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine.
MATERIALS AND METHODS
Using the results of bone densiometry, 30 patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine between March 2002 to March 2005 were categorized into 4 groups; above 80%, 70 to 80%, 60 to 70%, and below 60%. We compared the measurements of sagittal index and anterior vertebral height from the plain radiographs taken at the time of injury and following three consecutive months after the injury.
RESULTS
Patients with lower bone densiometry index had greater amount of compression at the time of injury and more rapid progression of compression. We also found that progression of compression was lowest during the first month after injury in all groups.
CONCLUSION
Patients with low bone densiometry index in osteoporotic thoracolumbar compression fracture are susceptible to more rapid progression of compression and should have early brace application and longer duration of treatment for osteoporosis.

Citations

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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
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
Progression of Compression and Related Factors in Conservative Management of Osteoporotic Vertebral Compression Fractures
Young Do Koh, Jeong Soo Park
Journal of the Korean Fracture Society.2015; 28(2): 132. CrossRef

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Vertebroplasty in the Treatment of Osteoporotic Compression Fracture: More Than 1 Year Follow Up: Jaekwang Hwang, Chunghwan Kim, Joohyun Kim; J Korean Fract Soc 2004;17(4):368-373. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.368

Abstract PDF

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.

Citations

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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
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

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Treatment of Vertebral Pseudarthrosis after Compression Fracture: Young Do Koh, Hoon Jeong; J Korean Fract Soc 2004;17(2):191-196. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.191

Abstract PDF: PURPOSE
To clarity the features of vertebral pseudarthrosis and to evaluate the efficacy of posterior instrumentation and fusion in treatment of it.
MATERIALS AND METHODS
Twelve patients with severe back pain and intravertebral pseudarthrosis showing vacuum phenomenon were treated by in situ posterior instrumentation and fusion. The kyphotic angle of pre- and post-treatment was measured on a lateral radiograph. MRI was performed in all patients. The intravertebral instability was confirmed from the dynamic lateral view. The pain level was assessed both before and after the treatment using a visual analog scale. The kyphotic angle at last follow up was also checked.
RESULTS
In eight cases, intravertebral instability was shown at the clefts in flexion-extension radiographs. MRI showed that the cleft was low intensity on the T1- weighted image and high intensity on the T2-weighted image. The pre-and postoperative mean kyphotic angles were -18.3degrees and -8.5degrees respectively. The preoperative average pain score was nine and postoperative four. At last follow up the mean kyphotic angle was -16.6degrees CONCLUSION: The cleft with intravertebral vacuum phenomenon and magnetic resonance findings of low intensity on the T1-weighted scans and high intensity on the T2-weighted scans suggests that the cleft is a pseudarthrosis associated with avascular necrosis of the vertebral body. The posterior instrumentation and fusion provides satisfactory pain relief in patient with vertebral pseudarthsosis.

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Bone & Soft Tissue Injuries Diagnosed by Magnetic Resonance Imaging in Thoracolumbar Fractures: Yong Min Kim, Dong Soo Kim, Eui Seong Choi, Hyun Chul Shon, Kyoung Jin Park, Gi Seok Han, Jae Jung Jeong, Kyoung Il Jeong, Yung Sung Kim; J Korean Fract Soc 2004;17(2):184-190. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.184

Abstract PDF

PURPOSE
To assess diagnostic efficacy of the MRI in thoracolumbar fractures, especially in changes of bone and soft tissue which cannot be documented by other diagnostic tools.
MATERIALS AND METHODS
Among 85 patients managed for thoracolumbar fractures between January 1997 and June 2003, MRI was performed in 30 patients to get more informations. Plain X-ray, CT and MRI of these cases were reviewed retrospectively by two orthopaedic spine surgeons and one radiologist to investigate the informations which only MRI could afford.
RESULTS
14 (46.7%) among 30 patients had occult fractures of vertebrae other than main fracture which had not been diagnosed as fractured. Besides 6 patients who showed distraction of posterior structure on plain X-ray, injury of posterior ligament complex was confirmed by MRI in 12(40%) patients. Additionally, MRI visualized other soft tissue injuries such as intramuscular and subcutaneous hematoma, changes of the spinal cord and intervertebral disc. In 16 among 30 patients, informations achieved from MRI were the most important factors in deciding treatment modality.
CONCLUSION
MRI seems to be efficient in visualizing not only soft tissue injury such as ligament but also occult fractures of additional vertebra in thoracolumbar fractures, therefore MRI seems to be an important diagnostic tool in decision of treatment modalities, especially in cases of uncertain stability.

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Measurement Discrepancy of Sagittal Parameters between Plain Radiography and 3D Computed Tomography in Thoracolumbar and Lumbar Fractures
Dong-Soo Kim, Yong-Min Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Ji-Kang Park, Hyun-Cheol Lee
Journal of the Korean Orthopaedic Association.2012; 47(3): 198. CrossRef
Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon
Journal of the Korean Fracture Society.2011; 24(3): 256. CrossRef

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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.

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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
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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Fracture of Vertebral Body in Flexion-Distraction Injury of Thoracolumbar Spine: Young Do Koh, Jong Oh Kim, Yeo Hon Yun, Jae Doo Yoo, Jun Mo Jung; J Korean Soc Fract 2003;16(2):262-269. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.262

Abstract PDF

PURPOSE
To evaluate the configuration of vertebral body fractures in flexion-distraction injuries of thoracolumbar spine.
MATERIALS AND METHODS
We investigated the location of fractures, anterior or posterior vertebral body height, kyphotic angle of injured segments, canal encroachment and severity of comminution on radiologic examinations of 21 cases.
RESULTS
There were 11 compression fractures and 9 burst fractures. 85% of fractures were located in the inferior vertebrae of injured segments. Anterior vertebral height decreased by 27% on average with decrease of 18% in compression fractures and 40% in burst fractures. Posterior height decreased by 1% on average with increase of 1% in compression fractures and decrease of 4% in burst fractures. The average kyphotic angle of injured segments was 19.5 degrees with 15.4degrees in compression fractures and 26.8 degrees in burst fractures. The canal encroachment in 9 burst fractures was 27% on average, and the comminution of vertebral body was mild in 74%.
CONCLUSION
The fracture of vertebral body in flexion-distraction injuries of thoracolumbar spine was very common, and located on the inferior vertebrae of injured segment. The decrease of vertebral height, canal encroachment and severity of comminution was relatively less than the estimated from mechanism of injury, with offset effect of distraction force.

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Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
Journal of Korean Society of Spine Surgery.2012; 19(2): 47. CrossRef

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The Surgical Reconstruction of Osteoporotic Vertebral Fractures: Suck Woo Kim, Yung Khee Chung; J Korean Soc Fract 2001;14(1):30-36. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.30

Abstract PDF

PURPOSE
The purpose of this study is to analyze the surgical results of 11 patients who underwent posterior instrumentation and anterior interbody fusion using titanium mesh vertebral ring(MOSS) in osteoporotic vertebral fracture. MATERIAL AND METHODS: From May 1997 to July 1999, we checked plain radiographs every 3 months and evaluated the change of kyphotic angle, fusion rate, change of clinical, neurologic symptoms and complications of these patients.
RESULTS
There were only average 0.2 degree correction of preoperative kyphotic angle at last follow-up X-ray. However, we confirmed successful bony fusion at nine of eleven patients(82%) and ten of eleven patients(90.9%) got satisfactory clinical results. Four patients with neurologic symptoms have recovered from their original neurologic status. Only one patient reoperated her back because of displacement of surgical device used in previous operation.
CONCLUSION
Among the surgical treatment methods in osteoporotic vertebral fractures, posterior instrumentation and anterior interbody fusion using titanium mesh vertebral ring(MOSS) is recommended as one of the effective surgical methods in severe osteoporotic patients.

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Kümmell's Disease Treated with Percutaneous Vertebroplasty: Minimum 1 Year Follow-Up
Jae Won Park, Jong-Hwa Park, Hong Jun Jeon, Jong Young Lee, Byung Moon Cho, Se-Hyuck Park
Korean Journal of Neurotrauma.2017; 13(2): 119. CrossRef
Peculiarities of Treatment of Patients with Complicated Compression Fractures of Thoracic and Lumbar Spine Vertebral Bodies on the Background of Osteoporosis
S T Vetrile, Aleksandr Alekseevich Kuleshov, L Yu Darchiya, S T Vetrile, A A Kuleshov, L Yu Darchiya
N.N. Priorov Journal of Traumatology and Orthopedics.2009; 16(2): 34. CrossRef
Delayed vertebral collapse with neurological deficits secondary to osteoporosis
K-T Kim, K-S Suk, J-M Kim, S-H Lee
International Orthopaedics.2003; 27(2): 65. CrossRef
Surgical Treatment of Kümmell Disease with Neurologic Deficits - Posterolateral Decompression and Posterior Reconstruction -
Ki-Tack Kim, Kyung-Soo Suk, Jin-Moon Kim
Journal of Korean Society of Spine Surgery.2001; 8(2): 136. CrossRef

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The Change of Kyphotic Angle and Anterior Vertebral Height after Posterior or Posterolateral Fusion with Transpedicular Screws for Thoracolumbar Bursting Fractures: Jae Sung Ahn, June Kyu Lee, Deuk Soo Hwang, Young Mo Kim, Won Jung Kim, Kyu Hwan Byun; J Korean Soc Fract 1999;12(2):379-387. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.379

Abstract PDF

The purposes of this study are to make an operative treatment option of thoracolumbar burst fractures by the degree of initial kyphotic deformity or by the degree of initial loss of anterior vertebral height. We analyzed sixty-three cases of one segmental thoracolumbar bursting fractures treated surgically by posterior or posterolateral fusion with short segmental transpedicular screws fixation method using Diapason or CD from January, 1992 to October, 1996. Indications of operative treatment were that the degree of initial kyphotic deformity was above 15degreesor initial loss of anterior vertebral height was above 30%. Minimum follow-up period was 12 months and the results were as follows : 1. Entirely, mean kyphotic angle was 21.6degreesinitially, 11.3degreespostoperatively and 14.2degrees at the end of follow-up. Mean anterior vertebral height was 59.6% initially, 83.8% postoperatively and 80.8% at the end of follow-up. So 10.3degrees , 24.2% was corrected postoperatively and loss of correction was 2.9degrees , 3% at the end of follow-up. 2. In the respect of the degree of initial kyphotic deformity, when compared above 30degrees with below 30degrees , loss of correction was 7.3degrees , 1.4degrees at the end of follow-up respectively and this result had significant difference between these two groups statistically. 3. In the respect of initial loss of anterior vertebral height, when compared above 55% with below 55%, loss of correction was 7.7%, 2.2% at the end of follow-up respectively and this result had significant difference between these two groups statistically. 4. In the respect of time interval from injury to operation, when compared within 2 weeks with after 2 weeks, respectively loss of correction was 1.7-2.2degrees , 3-3.9% and 4.1degrees , 6.7% at the end of follow-up and this results had significant difference between these two groups statistically. These data suggested if initial kyphotic angle is below 30degrees or initial loss of anterior vertebral height less than 55%, short segmental transpedicular screw fixation provide sufficient stability but if initial kyphotic angle is above 30degrees or initial loss of anterior vertebral height is above 55%,additional anterior interbody fusion may be considered.

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Jin Young Han, Ki Youn Kwon
Journal of the Korean Fracture Society.2020; 33(1): 1. CrossRef
Nonfusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Jae-Jung Jeong, Young-Chan Cha, Ji-Kang Park
Spine.2011; 36(2): 170. CrossRef
Efficiency of Implant Removal for Treatment of the Thoraco-lumbar Unstable Fractures - Multi Segments Fixation · Single Segment Fusion -
Heui-Jeon Park, Young-Jun Shim, Wan-Ki Kim, Tae-Yeon Cho, Sung-Min Kwon
Journal of Korean Society of Spine Surgery.2011; 18(3): 103. CrossRef
Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level
Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 39. CrossRef
Clinical Efficacy of Implant Removal after Posterior Spinal Arthrodesis with Pedicle Screw Fixation for the Thoracolumbar Burst Fractures
Kyung-Jin Song, Kyu-Hyung Kim, Su-Kyung Lee, Jung-Ryul Kim
The Journal of the Korean Orthopaedic Association.2007; 42(6): 808. CrossRef
Results of Non-fusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Seong Choi, Hyun-Chul Shon, Kyoung-Jin Park, Kyeong-Il Jeong, Young-Chan Cha, Hu-Shan Cui
Journal of Korean Society of Spine Surgery.2005; 12(2): 132. CrossRef
Relationships between Posterior Ligament Complex Injury and Plain Radiograph in Thoracolumbar Spinal Fracture
Heui-Jeon Park, Phil-Eun Lee, Byung-Ho Lee, Myung-Soon Kim
Journal of Korean Society of Spine Surgery.2005; 12(2): 140. CrossRef

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