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Medicine Apr 2017The debate on the efficacy of unilateral percutaneous kyphoplasty (UPKP) and bilateral percutaneous kyphoplasty (BPKP) for the treatment of osteoporotic vertebral... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
The debate on the efficacy of unilateral percutaneous kyphoplasty (UPKP) and bilateral percutaneous kyphoplasty (BPKP) for the treatment of osteoporotic vertebral compression fractures (OVCFs) is ongoing.This meta-analysis aimed to evaluate the clinical results of UPKP and BPKP in the treatment of OVCFs.
METHODS
Web of Science, PubMed, Embase, and the Chinese Biomedical Database publication databases were searched using a date range of January 2008 to November 2016, for studies comparing UPKP and BPKP for the treatment of OVCFs. The clinical effectiveness was assessed by comparing perioperative outcomes (surgery time, the volume of injected cement, X-ray exposure time, and kyphotic angle reduction), clinical outcomes (visual analogue scale [VAS] for pain relief and Oswestry Disability Index [ODI] for quality of life), and surgery-related complications (cement leakage and adjacent vertebral fractures). Data were analyzed using Stata/SE11.0 software.
RESULTS
Fourteen trials with 1194 patients were retrieved. The pooled results showed significant differences in surgery time (weighted mean difference [WMD] -21.44, 95% confidence interval [CI] [-23.57 to -19.30]; P < .001); volume of injected cement [WMD -1.90, 95% CI [-2.26 to -1.54); P < .001); and X-ray exposure time (WMD -13.66, 95%CI [-19.59 to -7.72]; P < .001) between UPKP and BPKP treatments. However, the pooled results showed no significant differences in kyphotic angle reduction, VAS in the short-term, VAS in the long-term, ODI, cement leakage, or adjacent vertebral fractures between the 2 surgical procedures. Following a subgroup analysis, the results based on randomized controlled trials (RCTs) indicated that there were significant differences in surgery time (WMD -24.65, 95%CI [-26.53 to -22.77]; P < .001) and the volume of injected cement (WMD -1.66, 95%CI [-1.97 to -1.36]; P < .001) between UPKP and BPKP treatment procedures, respectively. The results based on RCTs indicated that there were no significant differences, either in kyphotic angle reduction or in X-ray exposure time, between the 2 surgical procedures.
CONCLUSIONS
Compared to BPKP procedures, UPKP procedures may achieve similar clinical results in the treatment of OVCFs when assessed in terms of the pain relief, improvements in life quality, and surgery-related complications. However, UPKP procedures had a shorter operation time and volume of injected cement compared with BPKP procedures. Additional high quality and multicenter RCTs are needed to provide further robust evidence.
Topics: Fractures, Compression; Humans; Kyphoplasty; Osteoporotic Fractures
PubMed: 28445294
DOI: 10.1097/MD.0000000000006738 -
Pain Physician May 2021In the aging population, osteoporosis and related complications have become a global public health problem. Osteoporotic vertebral compression fractures are among the...
BACKGROUND
In the aging population, osteoporosis and related complications have become a global public health problem. Osteoporotic vertebral compression fractures are among the most common type of osteoporotic fractures and patients are at risk of secondary vertebral compression fracture.
OBJECTIVES
To identify risk factors for secondary vertebral compression fracture following primary osteoporotic vertebral compression fractures.
STUDY DESIGN
Retrospective study.
SETTING
Department of Orthopedic, an affiliated hospital of a medical university.
METHODS
This retrospective cohort study evaluated the risk factors for secondary vertebral compression fracture in 317 consecutive patients with systematic osteoporotic vertebral compression fractures who received percutaneous vertebroplasty and kyphoplasty or conservative treatment. Patients were divided into secondary vertebral compression fracture (n = 43) and non- secondary vertebral compression fracture (n = 274) groups. We retrospectively analyzed clinical characteristics and radiographic parameters, including gender, age, body mass index, number of primary fractures, primary treatment (percutaneous vertebroplasty and kyphoplasty or conservative treatment), nonspinal fracture history before primary fracture, primary fracture at the thoracolumbar junction, steroid use, bisphosphonate therapy, and Hounsfield units value of L1.
RESULTS
Comparison between the groups showed significant differences in age (P = 0.001), nonspinal fracture history (P < 0.001), and Hounsfield units value of L1 (P < 0.001). The receiver operating characteristic curves demonstrated that the optimal thresholds for age and Hounsfield units value of L1 were 75 (sensitivity: 55.8%; specificity: 67.5%) and 50 (sensitivity: 88.3%; specificity: 67.4%), respectively. In multivariate logistic regression analysis, nonspinal fracture history (OR = 6.639, 95% CI = 1.809 - 24.371, P = 0.004) and Hounsfield units value of L1 < 50 (OR = 15.260, 95% CI = 6.957 - 33.473, P < 0.001) were independent risk factors for secondary vertebral compression fracture.
LIMITATIONS
The main limitation is the retrospective nature of this study.
CONCLUSION
Patients with low Hounsfield units value of L1 or non-spinal fracture history are an important population to target for secondary fracture prevention.
Topics: Aged; Fractures, Compression; Humans; Kyphoplasty; Osteoporotic Fractures; Retrospective Studies; Risk Factors; Spinal Fractures; Treatment Outcome; Vertebroplasty
PubMed: 33988955
DOI: No ID Found -
Pain Physician May 2021In clinical practice, we have found that the pain caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) is sometimes not limited to the level of the...
BACKGROUND
In clinical practice, we have found that the pain caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) is sometimes not limited to the level of the fractured vertebrae but instead occurs in areas far away from the injured vertebrae, such as the lower back, area surrounding the iliac crest, or buttocks, and this type of pain is known as distant lumbosacral pain. The pathogenesis of pain in distant regions caused by thoracolumbar OVCF remains unclear.
OBJECTIVES
To compare the clinical efficacy and imaging outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of distant lumbosacral pain accompanied by thoracolumbar OVCF and to explore the possible pathogenesis of distant lumbosacral pain caused by thoracolumbar OVCF.
STUDY DESIGN
Retrospective study.
SETTING
A university hospital spinal surgery departments.
METHODS
A total of 62 patients who underwent vertebral augmentation for thoracolumbar OVCF with lumbosacral pain were included and divided into the PVP group (28 cases) and the PKP group (34 cases). The Visual Analog Scale (VAS) was used to evaluate the severity of local and distant lumbosacral pain, and the Chinese modified Oswestry Disability Index (CMODI) was used for functional assessment. The anterior vertebral height (AVH) of the fractured vertebrae and local kyphotic angle were measured on plain radiographs. The average follow-up time was 28.62 ± 8.43 months in the PVP group and 29.22 ± 9.09 months in the PKP group.
RESULTS
Within the 2 groups, the VAS score of local pain, VAS score of distant lumbosacral pain, and CMODI score at 3 days postoperatively and at the last follow-up improved significantly compared with the scores before surgery. However, there was no significant difference between the 2 groups. At 3 days postoperatively and at last follow-up, the AVH and Cobb angle in the 2 groups improved significantly compared with those before surgery, but the magnitudes of AVH improvement and Cobb angle correction were significantly larger in the PKP group than in the PVP group.
LIMITATIONS
First, this study is retrospective and may be prone to selection bias. Second, because of cultural and linguistic differences, the original version of the Oswestry Disability Index could not be properly understood and completed by people in mainland China. Therefore in this study, the CMODI was used, but the correlation coefficients of the CMODI within and between groups were 0.953 and 0.912, respectively. Third, a pain diagram was not used to accurately reflect the location of pain in the distant lumbosacral region.
CONCLUSIONS
Both PVP and PKP can effectively alleviate pain in the distant lumbosacral region caused by thoracolumbar OVCF, and distant lumbosacral pain associated with thoracolumbar OVCF may be considered vertebrogenic referred pain.
Topics: Fractures, Compression; Humans; Kyphoplasty; Low Back Pain; Lumbosacral Region; Osteoporotic Fractures; Retrospective Studies; Spinal Fractures; Treatment Outcome; Vertebroplasty
PubMed: 33988957
DOI: No ID Found -
Orthopaedics & Traumatology, Surgery &... Nov 2021Cement augmentation has been proven to be a safe procedure for the treatment of osteoporotic vertebral fracture, and the overall result is encouraging. However, failures...
INTRODUCTION
Cement augmentation has been proven to be a safe procedure for the treatment of osteoporotic vertebral fracture, and the overall result is encouraging. However, failures caused by different complications are not uncommon, and a few patients even need revision surgery. This retrospective study aimed to investigate the primary causes of revision surgery after cement augmentation for osteoporotic vertebral fracture and how to prevent them, and the second objective was to evaluate the clinical results of revision surgery.
HYPOTHESIS
The main hypothesis is that infection and neurological dysfunction are the prime causes of revision surgery after cement augmentation for osteoporotic vertebral fracture, and the second hypothesis is that revision surgery is effective to improve the quality of daily life.
MATERIALS AND METHODS
Twenty-one patients who underwent unplanned revision surgery after cement augmentation were retrospectively analyzed. The initial radiographic and medical records were reviewed to re-evaluate whether the initial diagnosis and surgical procedure were correct and suitable. The primary causes of revision surgery and the details were recorded. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the efficacy of the revision surgery, and patients with neurological dysfunction were evaluated with the American Spinal Injury Association (ASIA).
RESULTS
A total of 47.6% (10/21) of patients were misdiagnosed initially or had an incorrect indication for cement augmentation surgery, including 3 pre-existing spondylitis cases that were misdiagnosed as osteoporotic vertebral fracture and 7 cases of three column fractures that were treated with cement augmentation. The primary causes and details of the revision surgeries were as follows: 7 patients with infection underwent anterior and/or posterior debridement and fixation; 9 patients with progressive kyphosis underwent posterior osteotomy and fixation; and 5 patients with neurological dysfunction underwent posterior decompression and fixation. The mean follow-up time was 30.6±8.7 months, the VAS score decreased from 7.3±1.1 preoperatively to 2.3±0.3 (p<0.05) at the last follow-up, the ODI decreased from 61.1%±16.3% preoperatively to 20.6%±6.2% (p<0.05) at the last follow-up, and 5 patients with neurological dysfunction improved by at least one grade.
CONCLUSION
Infection, progressive kyphosis and neurological dysfunction are the primary causes of revision surgery after cement augmentation for osteoporotic vertebral fracture. Avoiding misdiagnosis and ensuring suitable indications might be the key points to decreasing unplanned revision surgery for cement augmentation for osteoporotic vertebral fracture. The quality of daily life and neurological function can be improved through revision surgery.
Topics: Bone Cements; Fractures, Compression; Humans; Kyphoplasty; Lumbar Vertebrae; Osteoporotic Fractures; Reoperation; Retrospective Studies; Spinal Fractures; Treatment Outcome; Vertebroplasty
PubMed: 33338678
DOI: 10.1016/j.otsr.2020.102796 -
Acta Orthopaedica Et Traumatologica... Jul 2022The aim of this study was to report the results of percutaneous vertebroplasty in managing symptomatic osteolytic cervical spine tumors.
OBJECTIVE
The aim of this study was to report the results of percutaneous vertebroplasty in managing symptomatic osteolytic cervical spine tumors.
METHODS
This study comprised a retrospective examination of patients who received percutaneous vertebroplasty between 2008 and 2020 for the treatment of tumor-induced symptomatic cervical vertebra involvement. The study summarized the demographics, vertebral levels, pain control rates, clinical results, and complications of percutaneous vertebroplasty using an anterolateral approach.
RESULTS
The study sample consisted of 6 female and 2 male patients aged between 20 and 56 (mean=41.37) years. Tumors were located at C2 in 6 cases, at C3 in 1 case, and at C5 in another. The mean volume of poly (methyl methacrylate) injected was 1.5 mL (range: 1-2 mL). Biopsy results showed the presence of metastasis in 5 cases and plasmacytoma in 3. No postoperative complications or mortality were observed after the procedure. Preoperative mean 7.75 visual analog scale score decreased to 2.62. Pain control was reported to be 66.2%.
CONCLUSION
Anterolateral cervical vertebroplasty seems to be a safe, effective, and helpful therapeutic alternative for the treatment of cervical spine tumors. It reduces the risk of infection compared to the transoral method.
LEVEL OF EVIDENCE
Level IV, Therapeutic Study.
Topics: Adult; Cervical Vertebrae; Female; Humans; Male; Middle Aged; Pain; Polymethyl Methacrylate; Retrospective Studies; Spinal Neoplasms; Vertebroplasty; Young Adult
PubMed: 35968618
DOI: 10.5152/j.aott.2022.22035 -
Pain Physician 2017Because of an aging population,osteoporotic vertebral fractures are becoming more frequent.Conservative therapy was considered the gold standard for treating... (Meta-Analysis)
Meta-Analysis Review
Does Percutaneous Vertebroplasty or Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures Increase the Incidence of New Vertebral Fractures? A Meta-Analysis.
BACKGROUND
Because of an aging population,osteoporotic vertebral fractures are becoming more frequent.Conservative therapy was considered the gold standard for treating osteoporotic vertebral compression fractures (OVCFs) in the past. Percutaneous vertebroplasty (PVP) or balloon kyphoplasty (BKP) as minimally invasive techniques are new treatments that are widely used for painful OVCFs. However, an increase in new vertebral compression fractures at non-treated levels following augmentation is of concern. There is no convincing evidence that new fractures are inevitable after augmentation compared to after conservative treatment, and it is still unclear whether further fractures are the consequence of augmentation or a result of the natural progression of osteoporosis.
OBJECTIVE
The objective of this study was to evaluate the new-level fracture risk after PVP or BKP compared with conservative (non-operative) treatment and to determine the dominant risk factor associated with new OVCFs.
STUDY DESIGN
A meta-analysis of comparative studies was performed to evaluate the incidence of new vertebral fractures between vertebral augmentation, such as vertebroplasty and kyphoplasty, and no operation.
SETTING
The PubMed, ISI Web of Science, ELSEVIER ScienceDirect, and Cochrane Library databases and abstracts published in annual proceedings were systematically searched.In addition, we also retrieved data from references when titles met our inclusion criteria.
METHODS
Detailed searches of a number of online databases comparing operative and non-operative groups were performed. We included randomized controlled trials,clinical controlled trials,and prospective clinical studies to provide available data. All studies were reviewed by two reviewers independently, and all the references that met our inclusion criteria were searched for additional trials, using the guidelines set by the QUOROM (Quality of Reporting of Meta-analysis) statement.
RESULTS
We evaluated 12 studies encompassing 1,328 patients in total, including 768 who underwent operation with polymethylmethacrylateand 560 who received non-operative treatments. For new-level vertebral fractures, our meta-analysis found no significant difference between the 2 methods, including total new fractures (P = 0.55) and adjacent fractures (P = 0.5). For pre-existing vertebral fractures, there was no significant difference between the 2 groups (operative and non-operative groups) (P = 0.24). Additionally,there was no significant difference in bone mineral density, both in the lumbar (P = 0 .13) and femoral neck regions (P = 0.37), between the 2 interventions.
LIMITATION
All studies we screened were published online except for unpublished articles. Moreover, only a few data sources could be extracted from the published studies.There were only 5 randomized clinical trials and 7 prospective studies that met our inclusion criteria.
CONCLUSION
Vertebral augmentation techniques, such as vertebroplasty and kyphoplasty, have been widely used to treat osteoporotic vertebral fractures in order to alleviate back pain and correct the deformity, and it has been frequently reported that many new vertebral fractures occurred after this operation. Our analysis did not reveal evidence of an increased risk of fracture of vertebral bodies, especially those adjacent to the treated vertebrae, following augmentation with either method compared with conservative treatment.Key words: Vertebroplasty, kyphoplasty, new osteoporotic compression vertebral fracture, meta-analysis.
Topics: Controlled Clinical Trials as Topic; Fractures, Compression; Humans; Incidence; Kyphoplasty; Osteoporotic Fractures; Randomized Controlled Trials as Topic; Spinal Fractures; Treatment Outcome; Vertebroplasty
PubMed: 28072794
DOI: No ID Found -
Scientific Reports Feb 2021Severe osteoporotic vertebral compression fractures (OVCFs) were considered as relative or even absolute contraindication for vertebroplasty and kyphoplasty and these...
Severe osteoporotic vertebral compression fractures (OVCFs) were considered as relative or even absolute contraindication for vertebroplasty and kyphoplasty and these relevant reports are very limited. This study aimed to evaluate and compare the efficacy of vertebroplasty with high-viscosity cement and conventional kyphoplasty in managing severe OVCFs. 37 patients of severe OVCFs experiencing vertebroplasty or kyphoplasty were reviewed and divided into two groups, according to the procedural technique, 18 in high-viscosity cement percutaneous vertebroplasty (hPVP) group and 19 in conventional percutaneous kyphoplasty (cPKP) group. The operative time, and injected bone cement volume were recorded. Anterior vertebral height (AVH), Cobb angle and cement leakage were also evaluated in the radiograph. The rate of cement leakage was lower in hPVP group, compared with cPKP group (16.7% vs 47.4%, P = 0.046). The patients in cPKP group achieved more improvement in AVH and Cobb angle than those in hPVP group postoperatively (37.2 ± 7.9% vs 43.0 ± 8.9% for AVH, P = 0.044; 15.5 ± 4.7 vs 12.7 ± 3.3, for Cobb angle, P = 0.042). At one year postoperatively, there was difference observed in AVH between two groups (34.1 ± 7.4 vs 40.5 ± 8.7 for hPVP and cPKP groups, P = 0.021), but no difference was found in Cobb angle (16.6 ± 5.0 vs 13.8 ± 3.8, P = 0.068). Similar cement volume was injected in two groups (2.9 ± 0.5 ml vs 2.8 ± 0.6 ml, P = 0.511). However, the operative time was 37.8 ± 6.8 min in the hPVP group, which was shorter than that in the cPKP group (43.8 ± 8.2 min, P = 0.021). In conclusion, conventional PKP achieved better in restoring anterior vertebral height and improving kyphotic angle, but PVP with high-viscosity cement had lower rate of cement leakage and shorter operative time with similar volume of injected cement.
Topics: Aged; Aged, 80 and over; Bone Cements; Female; Fractures, Compression; Humans; Kyphoplasty; Lumbar Vertebrae; Male; Operative Time; Osteoporotic Fractures; Retrospective Studies; Spinal Fractures; Thoracic Vertebrae; Vertebroplasty; Viscosity
PubMed: 33633366
DOI: 10.1038/s41598-021-84314-6 -
International Journal of Surgery... Nov 2017This meta-analysis of Randomized Controlled Trials (RCTs) aims to evaluate the efficacy and safety in percutaneous vertebroplasty (PVP) and conservative treatment (CT)... (Comparative Study)
Comparative Study Meta-Analysis Review
Percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: An updated meta-analysis of prospective randomized controlled trials.
BACKGROUND
This meta-analysis of Randomized Controlled Trials (RCTs) aims to evaluate the efficacy and safety in percutaneous vertebroplasty (PVP) and conservative treatment (CT) for osteoporotic vertebral compression fractures (OVCFs).
METHODS
The authors searched RCTs in electronic databases (Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Medline, Embase, Springer Link, Web of Knowledge, OVID and Google Scholar) in a timeframe from their establishment to Feb 2017. We also manually searched the reference lists of reports and reviews for possible relevant studies. Researches on PVP versus CT in OVCFs were selected in this meta-analysis. The quality of all studies was assessed and effective data were pooled for this meta-analysis. The outcomes were measured by pain relief (one week, one month, three months and six months), quality of life (RDQ, ED-5Q and QUALEFFO) and the rate of adjacent vertebral fracture. Publication bias assessment was also performed, respectively. The meta-analysis was performed using RevMan 5.1.
RESULTS
13 reports (12 RCTs) with a total 1231 patients (623 in the PVP and 608 in the CT) met inclusion criteria. Patients were followed up for at least 2 weeks in all the studies. Statistical differences were found between pain relief (one week (MD 1.36, 95% CI (0.55, 2.17)), one month (MD 1.56, 95% CI (0.43, 2.70)) and six months (MD -1.59, 95% CI (-2.9, -0.27))) and QUALEFFO (MD -5.03 95%CI (-7.94, -2.12)). No statistical differences were found between pain relief (three months (MD -0.28, 95% CI (-1.46, 0.90))), RDQ (MD -0.59, 95% CI (-1.31, 0.13)), ED-5Q (MD 0.10, 95% CI (-0.01, 0.22)) and the rate of adjacent vertebral fracture (RR 1.21, 95% CI (0.89, 1.62)).
CONCLUSIONS
PVP is associated with higher pain relief than CT in the early period. Furthermore, PVP did not increase the rate of adjacent vertebral fracture. The results indicate that it is a safe and effective treatment for OVCFs. Because of some limitations, these findings should be interpreted with caution. Additional studies are needed. Large, definitive RCTs are needed.
Topics: Conservative Treatment; Fractures, Compression; Humans; Osteoporotic Fractures; Pain Management; Prospective Studies; Randomized Controlled Trials as Topic; Spinal Fractures; Vertebroplasty
PubMed: 28939236
DOI: 10.1016/j.ijsu.2017.09.021 -
Blood Cancer Journal Feb 2019Multiple myeloma (MM) represents approximately 15% of haematological malignancies and most of the patients present with bone involvement. Focal or diffuse spinal...
The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG).
Multiple myeloma (MM) represents approximately 15% of haematological malignancies and most of the patients present with bone involvement. Focal or diffuse spinal osteolysis may result in significant morbidity by causing painful progressive vertebral compression fractures (VCFs) and deformities. Advances in the systemic treatment of myeloma have achieved high response rates and prolonged the survival significantly. Early diagnosis and management of skeletal events contribute to improving the prognosis and quality of life of MM patients. The management of patients with significant pain due to VCFs in the acute phase is not standardised. While some patients are successfully treated conservatively, and pain relief is achieved within a few weeks, a large percentage has disabling pain and morbidity and hence they are considered for surgical intervention. Balloon kyphoplasty and percutaneous vertebroplasty are minimally invasive procedures which have been shown to relieve pain and restore function. Despite increasing positive evidence for the use of these procedures, the indications, timing, efficacy, safety and their role in the treatment algorithm of myeloma spinal disease are yet to be elucidated. This paper reports an update of the consensus statement from the International Myeloma Working Group on the role of cement augmentation in myeloma patients with VCFs.
Topics: Bone Cements; Clinical Decision-Making; Decision Trees; Disease Management; Female; Fractures, Compression; Humans; Kyphoplasty; Male; Multiple Myeloma; Spinal Fractures; Treatment Outcome; Vertebroplasty
PubMed: 30808868
DOI: 10.1038/s41408-019-0187-7 -
A second puncture and injection technique for treating osteoporotic vertebral compression fractures.Journal of Orthopaedic Surgery and... Dec 2019To evaluate the clinical effect of the second puncture and injection technique during a percutaneous vertebroplasty (PVP) procedure.
OBJECTIVE
To evaluate the clinical effect of the second puncture and injection technique during a percutaneous vertebroplasty (PVP) procedure.
METHODS
Patients treated with a second puncture and injection (group A) or a single puncture and injection (group B) during PVP at our institution during 2010-2017 were reviewed. Vertebral height loss, visual analogue scale (VAS) score, Oswestry disability index (ODI), adjacent vertebral fractures, and cement leakage were compared between the groups.
RESULTS
A total of 193 patients were enrolled (86 cases in group A, 107 cases in group B). The follow-up period was 15.64 (12-20) months. The loss of anterior (group A 0.01 ± 0.03; group B 0.14 ± 0.17) and middle (group A 0.13 ± 0.12; group B 0.16 ± 0.11) vertebral height in group B was significantly higher than that in group A (P < 0.05). The VAS score and ODI were also significantly higher in group B than in group A at the final follow-up; the VAS score and ODI in group B were 1.65 ± 0.70 and 14.50 ± 4.16, respectively, and those in group A were 1.00 ± 0.74 and 12.81 ± 4.02, respectively (P < 0.05). Three patients in group A and two in group B experienced adjacent vertebral fractures. Regarding mild, moderate, and severe cement leakage, there were 25 (29%), 5 (5%), and 0 cases, respectively, in group A and 28 (26%), 3 (2.8%), and 1 (0.009%) case, respectively, in group B (P > 0.05).
CONCLUSIONS
The second puncture and injection technique may effectively increase the dispersion of cement, thus preventing recompression of the cemented vertebral body, and it does not increase the risk of cement leakage or adjacent vertebral fracture.
Topics: Aged; Aged, 80 and over; Bone Cements; Female; Follow-Up Studies; Fractures, Compression; Humans; Injections; Lumbar Vertebrae; Male; Middle Aged; Osteoporotic Fractures; Punctures; Retrospective Studies; Spinal Fractures; Thoracic Vertebrae; Vertebroplasty
PubMed: 31806033
DOI: 10.1186/s13018-019-1498-x