Effectiveness of synchronous unilateral percutaneous kyphoplasty in the treatment of double noncontiguous thoracolumbar osteoporotic vertebral compression fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

JIANG Weili ,  NIU Guoqi , ZHOU Gong , LIU Tao , ZHANG Qingbo , LIU Lutan , CHENG Jiawei

Department of Spinal Surgery, the Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233002, P.R.China;

Corresponding?author：

NIU Guoqi, Email: ssngq@163.com

Keywords：

Percutaneous kyphoplasty; unilateral puncture; osteoporotic vertebral compression fracture

DOI：

10.7507/1002-1892.202103018

Video：

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Objective To investigate the effectiveness of synchronous unilateral percutaneous kyphoplasty (PKP) in the treatment of double noncontiguous thoracolumbar osteoporotic vertebral compression fracture (OVCF). Methods Between December 2018 and September 2020, 27 patients with double noncontiguous thoracolumbar OVCF were treated by synchronous unilateral PKP. There were 11 males and 16 females, with an average age of 75.4 years (range, 66-92 years). The fractures were caused by falls in 22 cases and sprains in 5 cases. The time from injury to hospital admission was 0.5-7.0 days, with an average of 2.1 days. The fractured vertebrae located at T₉ in 2 cases, T₁₀ in 3 cases, T₁₁ in 10 cases, T₁₂ in 15 cases, L₁ in 12 cases, L₂ in 6 cases, L₃ in 4 cases, and L₄ in 2 cases. The volume of bone cement injected into each vertebral body, operation time, and intraoperative fluoroscopy times were recorded. Anteroposterior and lateral X-ray films of thoracolumbar spine were taken to observe the anterior height of the injured vertebra, the Cobb angle of kyphosis, and the diffusion and good distribution rate of bone cement in the thoracolumbar spine. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the pain and functional improvement. Results All operations completed successfully. The operation time was 34-70 minutes, with an average of 45.4 minutes. The intraoperative fluoroscopy was 21- 60 times, with an average of 38.6 times. The volume of bone cement injected into each vertebral body was 2-9 mL, with an average of 4.3 mL. All patients were followed up 6-21 months, with an average of 11.3 months. X-ray film reexamination showed that the anterior height of the injured vertebra and Cobb angle at each time point after operation were significantly improved than those before operation (P<0.05), and there was no significant difference between different time points after operation (P>0.05). The distribution of bone cement was excellent in 40 vertebral bodies, good in 13 vertebral bodies, and poor in 1 vertebral body, and the excellent and good rate was 98.1% (53/54). The pain of all patients significantly relieved or disappeared, and the function improved. The VAS score and ODI at each time point after operation were significantly lower than those before operation (P<0.05), and there was no significant difference between different time points after operation (P>0.05).Conclusion For the double noncontiguous thoracolumbar OVCF, the synchronous unilateral PKP has the advantages of simple puncture, less trauma, less intraoperative fluoroscopy, shorter operation time, satisfactory distribution of bone cement, etc. It can restore the height of the vertebral body, correct the kyphotic angle, significantly alleviate the pain, and improve the function.

Citation： JIANG Weili, NIU Guoqi, ZHOU Gong, LIU Tao, ZHANG Qingbo, LIU Lutan, CHENG Jiawei. Effectiveness of synchronous unilateral percutaneous kyphoplasty in the treatment of double noncontiguous thoracolumbar osteoporotic vertebral compression fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(9): 1155-1160. doi: 10.7507/1002-1892.202103018 Copy

1.	Alvarez L, Pérez-Higueras A, Granizo JJ, et al. Predictors of outcomes of percutaneous vertebroplasty for osteoporotic vertebral fractures. Spine (Phila Pa 1976), 2005, 30(1): 87-92.
2.	祝騰蛟, 田耘, 周方. 骨質疏松性椎體壓縮骨折微創治療的現狀和進展. 中國微創外科雜志, 2015, 15(12): 1121-1124.
3.	Wasfie T, Jackson A, Brock C, et al. Does a fracture liaison service program minimize recurrent fragility fractures in the elderly with osteoporotic vertebral compression fractures? Am J Surg, 2019, 217(3): 557-560.
4.	馬航展, 馬金火, 褚學遠, 等. 單側入路椎體成形術治療骨質疏松性胸腰椎骨折. 中國矯形外科雜志, 2019, 27(12): 1068-1072.
5.	劉愛華, 吳中學, 楊新健, 等. 單側入路的椎體成形術治療老年椎體壓縮性骨折. 中國現代醫學雜志, 2006, 16(17): 2623-2625, 2628.
6.	金成浩, 蔡迎, 鐘杰林, 等. 單側與雙側經皮后凸成形治療骨質疏松性胸腰椎骨折. 中國矯形外科雜志, 2020, 28(18): 1712-1715.
7.	何仕誠, 滕皋軍, 鄧鋼, 等. 椎體成形術治療合并囊腔樣變的骨質疏松性椎體壓縮骨折. 介入放射學雜志, 2005, 14(3): 256-260.
8.	李哲, 蘇慶軍, 海涌. 伴有椎體內裂隙征的骨質疏松性椎體壓縮骨折的診治進展. 中國脊柱脊髓雜志, 2017, 27(7): 647-651.
9.	夏維財. 經皮椎體后凸成形術治療老年骨質疏松性椎體壓縮骨折. 中國微創外科雜志, 2015, 15(3): 280-281, 288.
10.	El-Fiki M. Vertebroplasty, kyphoplasty, lordoplasty, expandable devices, and current treatment of painful osteoporotic vertebral fractures. World Neurosurg, 2016, 91(1): 628-632.
11.	沈凱, 張勝利, 譚祖鍵, 等. 經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折中骨水泥單側與雙側彌散對療效的影響. 中華創傷雜志, 2018, 34(6): 527-533.
12.	Ma X, Xing D, Ma J, et al. Risk factors for new vertebral compression fractures after percutaneous vertebroplasty: qualitative evidence synthesized from a systematic review. Spine (Phila Pa 1976), 2013, 38(12): E713-E722.
13.	Linville DA. Vertebroplasty and kyphoplasty. South Med J, 2002, 95(6): 583-587.
14.	Zapa?owicz K, Radek M. Percutaneous balloon kyphoplasty in the treatment of painful vertebral compression fractures: effect on local kyphosis and one-year outcomes in pain and disability. Neurol Neurochir Pol, 2015, 49(1): 11-15.
15.	Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976), 2001, 26(14): 1631-1638.
16.	Khairallah A. Descemet stripping automated endothelialkeratoplasty (DSAEK) versus repeat penetrating keratoplasty (PKP) to manage eyes with failed corneal graft. Ann Saudi Med, 2018, 38(1): 36-41.
17.	趙繼榮, 鄧強, 王興盛, 等. 老年骨質疏松性壓縮骨折經皮穿刺椎體成形術后療效不佳相關因素. 中國老年學雜志, 2018, 38(19): 4678-4680.
18.	Zhang L, Liu Z, Wang J, et al. Unipedicular versus bipedicular percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a prospective randomized study. BMC Musculoskelet Disord, 2015, 16: 145. doi: 10.1186/s12891-015-0590-6.
19.	Hu KZ, Chen SC, Xu L. Comparison of percutaneous balloon dilation kyphoplasty and percutaneous vertebroplasty in treatment for thoracolumbar vertebral compression fractures. Eur Rev Med Pharmacol Sci, 2018, 22(1 Suppl): 96-102.
20.	陳亮, 楊惠林, 唐天駟. 后凸成形術治療多椎體骨質疏松性壓縮骨折的療效分析. 中華骨科雜志, 2009, 29(4): 310-314.
21.	格日勒, 劉鑫, 楊鵬, 等. 經皮椎體成形和經皮椎體后凸成形治療老年骨質疏松性椎體壓縮性骨折的對比. 中國微創外科雜志, 2019, 19(12): 1084-1087.

1. Alvarez L, Pérez-Higueras A, Granizo JJ, et al. Predictors of outcomes of percutaneous vertebroplasty for osteoporotic vertebral fractures. Spine (Phila Pa 1976), 2005, 30(1): 87-92.
2. 祝騰蛟, 田耘, 周方. 骨質疏松性椎體壓縮骨折微創治療的現狀和進展. 中國微創外科雜志, 2015, 15(12): 1121-1124.
3. Wasfie T, Jackson A, Brock C, et al. Does a fracture liaison service program minimize recurrent fragility fractures in the elderly with osteoporotic vertebral compression fractures? Am J Surg, 2019, 217(3): 557-560.
4. 馬航展, 馬金火, 褚學遠, 等. 單側入路椎體成形術治療骨質疏松性胸腰椎骨折. 中國矯形外科雜志, 2019, 27(12): 1068-1072.
5. 劉愛華, 吳中學, 楊新健, 等. 單側入路的椎體成形術治療老年椎體壓縮性骨折. 中國現代醫學雜志, 2006, 16(17): 2623-2625, 2628.
6. 金成浩, 蔡迎, 鐘杰林, 等. 單側與雙側經皮后凸成形治療骨質疏松性胸腰椎骨折. 中國矯形外科雜志, 2020, 28(18): 1712-1715.
7. 何仕誠, 滕皋軍, 鄧鋼, 等. 椎體成形術治療合并囊腔樣變的骨質疏松性椎體壓縮骨折. 介入放射學雜志, 2005, 14(3): 256-260.
8. 李哲, 蘇慶軍, 海涌. 伴有椎體內裂隙征的骨質疏松性椎體壓縮骨折的診治進展. 中國脊柱脊髓雜志, 2017, 27(7): 647-651.
9. 夏維財. 經皮椎體后凸成形術治療老年骨質疏松性椎體壓縮骨折. 中國微創外科雜志, 2015, 15(3): 280-281, 288.
10. El-Fiki M. Vertebroplasty, kyphoplasty, lordoplasty, expandable devices, and current treatment of painful osteoporotic vertebral fractures. World Neurosurg, 2016, 91(1): 628-632.
11. 沈凱, 張勝利, 譚祖鍵, 等. 經皮椎體后凸成形術治療骨質疏松性椎體壓縮骨折中骨水泥單側與雙側彌散對療效的影響. 中華創傷雜志, 2018, 34(6): 527-533.
12. Ma X, Xing D, Ma J, et al. Risk factors for new vertebral compression fractures after percutaneous vertebroplasty: qualitative evidence synthesized from a systematic review. Spine (Phila Pa 1976), 2013, 38(12): E713-E722.
13. Linville DA. Vertebroplasty and kyphoplasty. South Med J, 2002, 95(6): 583-587.
14. Zapa?owicz K, Radek M. Percutaneous balloon kyphoplasty in the treatment of painful vertebral compression fractures: effect on local kyphosis and one-year outcomes in pain and disability. Neurol Neurochir Pol, 2015, 49(1): 11-15.
15. Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976), 2001, 26(14): 1631-1638.
16. Khairallah A. Descemet stripping automated endothelialkeratoplasty (DSAEK) versus repeat penetrating keratoplasty (PKP) to manage eyes with failed corneal graft. Ann Saudi Med, 2018, 38(1): 36-41.
17. 趙繼榮, 鄧強, 王興盛, 等. 老年骨質疏松性壓縮骨折經皮穿刺椎體成形術后療效不佳相關因素. 中國老年學雜志, 2018, 38(19): 4678-4680.
18. Zhang L, Liu Z, Wang J, et al. Unipedicular versus bipedicular percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a prospective randomized study. BMC Musculoskelet Disord, 2015, 16: 145. doi: 10.1186/s12891-015-0590-6.
19. Hu KZ, Chen SC, Xu L. Comparison of percutaneous balloon dilation kyphoplasty and percutaneous vertebroplasty in treatment for thoracolumbar vertebral compression fractures. Eur Rev Med Pharmacol Sci, 2018, 22(1 Suppl): 96-102.
20. 陳亮, 楊惠林, 唐天駟. 后凸成形術治療多椎體骨質疏松性壓縮骨折的療效分析. 中華骨科雜志, 2009, 29(4): 310-314.
21. 格日勒, 劉鑫, 楊鵬, 等. 經皮椎體成形和經皮椎體后凸成形治療老年骨質疏松性椎體壓縮性骨折的對比. 中國微創外科雜志, 2019, 19(12): 1084-1087.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of synchronous unilateral percutaneous kyphoplasty in the treatment of double noncontiguous thoracolumbar osteoporotic vertebral compression fractures

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