Creation of a planned or central-clefted puncture combined with a second puncture during vertebroplasty to treat osteoporotic vertebral compression fractures with large clefts
| Autor: | Zheng-mao Zhang, Minyu Zhu, Yu Wang, Yang Zhou, Chi Li, Honglin Teng, Jing Wang |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors lcsh:Diseases of the musculoskeletal system Visual analogue scale Osteoporotic fractures Punctures Spinal Puncture 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine lcsh:Orthopedic surgery Recurrence Fractures Compression medicine Humans Orthopedics and Sports Medicine Aged Retrospective Studies Vas score Vertebroplasty business.industry Bone Cements Osteonecrosis Middle Aged Compression (physics) Surgery lcsh:RD701-811 Treatment Outcome Orthopedic surgery Osteoporosis Spinal Fractures Female lcsh:RC925-935 business 030217 neurology & neurosurgery Follow-Up Studies Research Article Cement leakage |
| Zdroj: | Journal of Orthopaedic Surgery and Research, Vol 15, Iss 1, Pp 1-8 (2020) Journal of Orthopaedic Surgery and Research |
| ISSN: | 1749-799X |
| DOI: | 10.1186/s13018-020-02048-z |
| Popis: | Background Cemented vertebrae frequently re-fracture after vertebroplasty to treat osteoporotic vertebral compression fractures (OVCFs) with large clefts. We compared the efficacy of planned and central-clefted puncture, both followed by a second puncture, as treatments for OVCFs with large clefts. Methods We retrospectively studied 38 patients. 18 of whom underwent planned puncture (group A) and 20 central-clefted puncture (group B). A second puncture was performed when the initially injected cement was restricted to the cleft. We recorded a visual analog scale (VAS) pain scores, vertebral kyphotic angles (KAs), and compression ratios (CRs) preoperatively and at 2 days and 6 months postoperatively. We recorded the cement dispersion patterns and complications. Results Second punctures succeeded in 15/18 and 7/20 patients of groups A and B, respectively. At 2 days postoperatively, the VAS score, KA, and CR were significantly better than the preoperative values (P < 0.01); no significant difference was found between the two groups (P > 0.05). At the 6-month follow-up, all scores were poorer than at 2 days postoperatively (all P < 0.05), significantly more so in group B than group A (P < 0.05). Significant differences in terms of the cement dispersion patterns, and the cemented vertebral re-fracture and cement leakage rates, were observed between the two groups (all P < 0.05). Conclusion The two-puncture techniques were initially effective when treating large-clefted OVCFs. However, compared to the central-clefted puncture, the planned puncture improved the success rate of the second puncture, allowed better cement dispersion, and reduced the incidence of vertebral re-fracture during follow-up. |
| Databáze: | OpenAIRE |
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