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Fu Y, Yan YC, Ru XL, Qu HB. [Effect of acrylic bone cement mixed with calcium sulfate combined with percutaneous kyphoplasty in the treatment of osteoporotic fractures]. Zhongguo Gu Shang 2023; 36:896-900. [PMID: 37735085 DOI: 10.12200/j.issn.1003-0034.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
OBJECTIVE To investigate the clinical efficacy of acrylic cement (PMMA) mixed with calcium sulfate combined with percutaneous kyphoplasty (PKP) in the treatment of osteoporotic fracture (OVCF). METHODS The clinical data of 191 patients with OVCF treated with PKP from January 2020 to March 2021 were retrospectively analyzed. Among them, 82 patients with 94 vertebral bodies were treated with PMMA mixed with calcium sulfate as the observation group, and 109 patients with 125 vertebral bodies were treated with pure PMMA as the control group. Among the 82 patients in the observation group, there were 16 males and 66 females, with a mean age of (75.35±11.22) years old, including 36 thoracic vertebrae and 58 lumbar vertebrae. In the control group, there were 109 patients, 22 males and 87 females, with an average age of (74.51±9.21) years old, including 63 thoracic vertebrae and 62 lumbar vertebrae. The visual analog scale (VAS) before operation and 1 day, 3 months and 1 year after operation were calculated. The Oswestry disability index (ODI), Cobb's angle, vertebral body height and the probability of postoperative bone cement leakage were used to analyze the efficacy of the two groups. RESULTS All the patients were followed up for more than one year. Compared with the control group, there was no significant difference in operation time, bleeding volume and bone cement injection volume between the two groups(P>0.05), while the leakage rate of bone cement was significantly lower in the observation group (P<0.05). In addition, there was no significant difference in VAS, ODI, Cobb angle, and vertebral body height between the two groups before operation, and 1 day, 3 months, and 1 year after operation (P>0.05), but each index was improved compared with that before operation (P<0.05). CONCLUSION PMMA mixed with calcium sulfate has equivalent efficacy in treating OVCF than PMMA alone, but can effectively reduce the probability of cement leakage.
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Affiliation(s)
- Yang Fu
- Department of Orthopaedics, Zhejiang Hospital, Hangzhou 310000, Zhejiang, China
| | - Ying-Chao Yan
- Department of Orthopaedics, Zhejiang Hospital, Hangzhou 310000, Zhejiang, China
| | - Xuan-Liang Ru
- Department of Orthopaedics, Zhejiang Hospital, Hangzhou 310000, Zhejiang, China
| | - Hang-Bo Qu
- Department of Orthopaedics, Zhejiang Hospital, Hangzhou 310000, Zhejiang, China
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Yao SQ, Wu R, Zhou JP, Yang YJ, Tan YC, Yang K, Li JJ, Jiang ZW, Liu B. [Comparison of vesselplasty and percutanous kyphoplasty in the treatment of Kümmell disease]. Zhongguo Gu Shang 2022; 35:429-434. [PMID: 35535530 DOI: 10.12200/j.issn.1003-0034.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare the efficacy between vesselplasty and percutanous kyphoplasty (PKP) in the treatment of Kümmell disease. METHODS The clinical data of patients with Kümmell disease from July 2018 to December 2019 were retrospectively analyzed. According to the different therapeutic methods, the patients were divided into vesselplasty group and PKP group. There were 20 patients in vesselplasty group, including 2 males and 18 females, aged from 54 to 83 years with an average of (67.40±7.44)years, 1 case of T10 fracture, 3 cases of T12 fracture, 9 cases of L1 fractures, 5 cases of L2 fractures and 2 cases of L3 fractures. There were 20 patients in PKP group, including 3 males and 17 females, aged from 56 to 81 with an average of(67.20±7.01) years, 2 cases of T10 fracture, 1 case of T11 fracture, 6 cases of T12 fracture, 10 cases of L1 fracture and 1 case of L3 fracture. Visual analogue scale(VAS), Cobb angle, anterior vertebral height were recorded before operation, 1 day after operation and 1 year after operation. Oswestry Disability Index(ODI) was recorded before operation, 1 month after operation and 1 year after operation. And bone cement leakage rate was compared between two groups after operation. RESULTS All the patient were followed up for more than 1 year. In vesselplasty group, VAS score was 1.20±0.41, ODI was(13.50±3.10)%, Cobb angle was(17.20±3.12)° and anterior vertebral height was(20.20±1.35) mm at 1 year after operation. In PKP group, VAS score was 1.15±0.40, ODI was (13.20±3.00)%, Cobb angle was (17.10±3.19)° and anterior vertebral height was (20.10±1.37) mm at 1 year after operation. These index was significantly better than pre-operation through intra-group comparison(P<0.05), and there was no statistically difference between the two groups(P>0.05). There were 20 cases (20 vertebrae) in vesselplasty group, of which 1 case had bone cement leakage at the upper endplate, with a leakage rate of 5%(1/20). In PKP group, there were 20 cases (20 vertebrae), 3 cases of upward endplate leakage(3/7), 1 case of downward endplate leakage(1/7), 1 case of leakage to the front of the vertebral body(1/7), 2 cases of leakage to the side of the vertebral body(2/7), with a leakage rate of 35% (7/20). The difference between two groups was statistically significant(P<0.05). CONCLUSION Vesselplasty in the treatment of Kümmell disease can better reduce leakage rate of bone cement and reduce complications.
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Affiliation(s)
- Shu-Qiang Yao
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Rui Wu
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Ji-Ping Zhou
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Yong-Jun Yang
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Yuan-Chao Tan
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Kai Yang
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Jia-Jia Li
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Ze-Wei Jiang
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
| | - Bin Liu
- No.1 Ward of Spine, Shandong Wendeng Osteopathic Hospital, Wendeng 264400, Shandong, China
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Xu XY, Luo DM, Liu SL, Shen XT, Zhou ZY, Yuan GD. [Treatment of severely osteoporotic vertebral compression fractures with the vertebral body stent system and percutanous kyphoplasty combined with zoledronic acid]. Zhongguo Gu Shang 2020; 33:827-30. [PMID: 32959569 DOI: 10.12200/j.issn.1003-0034.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs). METHODS The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed, including 13 males and 35 females, aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery, and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI, the height of diseasedvertebral lost were compared before operation, 3 d and half a year after operation, and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed. RESULTS Before operation, 3 d and half a year after operation, VAS scores were 7.60±0.12, 3.00±0.46, 1.20±0.23, ODI were(82.00±0.32)%, (30.00±1.50) %, (18.00±0.16) %, the height of diseased vertebral lost were (12.00±0.43) mm, (3.00± 0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score, ODI, the height of diseased vertebral lost were obviously improved (P<0.05), and there was no significant difference between 3 d and half a year after operation (P>0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation, and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up. CONCLUSION VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back, improve the mobility of the thoracolumbar, but also can restore the height of the vertebral body to the maximum extent, and prevent the re-fracture of the affected vertebrae and adjacent vertebrae, which is worthy to spread in clinic.
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Affiliation(s)
- Xiang-Yang Xu
- Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China
| | - De-Min Luo
- Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China
| | - Shang-Li Liu
- Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China
| | - Xiao-Tao Shen
- Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China
| | - Zu-Yan Zhou
- Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China
| | - Guo-Dong Yuan
- Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China
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Deng XG, Xiong XM, Cui W, Gu T, Wan D, Shi HG, Chen X, Song SM, Hou W, Mei GL, Jiang WB. [Preliminary application of CPC/PMMA composite bone cement in kyphoplasty for the elderly]. Zhongguo Gu Shang 2020; 33:831-6. [PMID: 32959570 DOI: 10.12200/j.issn.1003-0034.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE From the perspective of clinical application to analyze the effectiveness and reliability of CPC/PMMA bone cement in percutaneous kyphoplasty (PKP) for the treatment of elderly patients with osteoporotic thoracolumbar fractures. METHODS A retrospective analysis was performed on 62 patients with osteoporotic compression fracture of single-vertebral thoracic or lumbar segment who underwent PKP surgery and had a bone density less than or equal to -3.0 SD from February 2016 to December 2016. Among them, 23 patients were in CPC/PMMA group, with an average age of (77.6±2.2) years old, 39 patients in PMMA group, with an average age of (77.1±1.1) years old. The indexes between two groups were compared, including the visual analogue scale (VAS), height ratio of anterior vertebra (AVHR), local Cobb angle, cement leakage, new adjacent vertebral fracture(NAVF). RESULTS There were no significant difference in gender, age, follow-up time and preoperative VAS, AVHR, local Cobb angle between two groups (P>0.05), at the 1 day after operation, VAS, AVHR, local Cobb angle in all patients got obvious improvement (P<0.05), which was no significant difference at 1 day after operation and final follow-up (P>0.05). At the same time, there was no statistically significant difference in the incidence of new adjacent vertebral fracture and cement leakage (P>0.05). The pain in both groups continued to improve at follow up after operation (P<0.05), the local Cobb angle increased (P<0.05) and AVHR decreased slightly (P<0.05). However, the images of conventional methods (X-ray or CT) could not find signs about CPC degeneration and new bone ingrowth. CONCLUSION CPC/PMMA composite bone cement is safe and reliablein PKP for treatment of elderly patients with osteoporotic thoracolumbar fractures, which can effectively relieve pain and maintain vertebral body stability. It has the same curative effect as PMMA bone cement. It was worthy to research more in future, although no direct evidences support the CPC/PMMA composite bone cement can reduce the incidence of adjacent vertebral fracture, CPC degeneration or new bone ingrowth.
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Affiliation(s)
- Xuan-Geng Deng
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Xiao-Ming Xiong
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Wei Cui
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Tao Gu
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Dun Wan
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Hua-Gang Shi
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Xing Chen
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Si-Mao Song
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Wei Hou
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Guo-Long Mei
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
| | - Wen-Bing Jiang
- Department of Spine, Sichuan Orthopedic Hospital, Chengdu 610041, Sichuan, China
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