Application of improved injecting tube in percutaneous kyphoplasty through unipedicular puncturing_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 YANGDeshun , LEIBingjun , LIAOLiang , WANGKaiming , ZHANGQing , YANGZhiyong

Department of Orthopedics, the Third People’ s Hospital of Bengbu, Bengbu Anhui, 233000, P.R.China;

Corresponding author：

YANGDeshun, Email: yangdeshun1974@126.com

Keywords：

Bone cement; percutaneous kyphoplasty; osteoporotic vertebral compression fracture; improved injecting tube

DOI：

10.7507/1002-1892.201610022

Video：

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Objective To research the feasibility and effectiveness of percutaneous kyphoplasty (PKP) by improved injecting tube through unipedicular puncturing. Methods Between January 2012 and Junuary 2016, 60 cases (68 vertebrae) of osteoporotic vertebral compression fractures (OVCF) were treated. PKP was performed through unipedicular puncturing with routine injecting tube in 30 cases (34 vertebrae, routine group), and with improved injecting tube in 30 cases (34 vertebrae, improved group). There was no significant difference in age, gender, disease duration, fracture level, preoperative visual analogue scale (VAS), or vertebral height between 2 groups (P>0.05). The operation time, the volume of bone cement injected, preoperative and postoperative VAS, and preoperative and postoperative vertebral height, and postoperative distribution coefficient of bone cement were recorded and compared between 2 groups. Results Good healing of puncture points was achieved in 2 groups after PKP, and no serious complication occurred. There was no significant difference in operation time and the volum of bone cement injected between 2 groups (t=0.851,P=0.399;t=1.672,P=0.101). Bone cement leakage was observed in 2 cases of 2 groups respectively. The distribution coefficient of bone cement in routine group was significantly less than that in improved group (t=13.049,P=0.000). All patients were followed up 12-36 months (mean, 19 months). The postoperative VAS and vertebral height were significantly improved when compared with preoperative ones in 2 groups (P<0.05), but there was no significant difference in VAS between at 2 days after operation and at last follow-up, in vertebral height between at 2 days after operation and at 1 year after operation, and between 2 groups after operation (P>0.05). X-ray films showed vertebral compression fractures in 6 cases of routine group and in 1 case of improved group during follow-up. Conclusion PKP by improved injecting tube through unipedicular puncturing can improve the distribution of bone cement, restore the height and strength of vertebral body, and reduce the incidence of re-fracture.

Citation： YANGDeshun, LEIBinjun, LIAOLiang, WANGKaiming, ZHANGQin, YANGZhiyong. Application of improved injecting tube in percutaneous kyphoplasty through unipedicular puncturing. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(2): 197-202. doi: 10.7507/1002-1892.201610022 Copy

1.	余伟波, 梁德, 江小兵, 等. 经皮椎体成形术和经皮椎体后凸成形术治疗伴椎体内真空裂隙的骨质疏松椎体压缩骨折的比较研究. 中国修复重建外科杂志, 2016, 30(9): 1104-1110.
2.	潘爱星, 杨晋才, 海涌, 等. 单侧与双侧穿刺经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的对比研究. 中国骨与关节杂志, 2016, 5(1): 44-47.
3.	He D, Wu L, Sheng X, et al. Internal fixation with percutaneous kyphoplasty compared with simple percutaneous kyphoplasty for thoracolumbar burst fractures in elderly patients: a prospective randomized controlled trial. Eur Spine J, 2013, 22(10): 2256-2263.
4.	Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine, 2001, 26(14): 1631-1638.
5.	徐耀宁, 郑秋坚, 尹东, 等. 经皮椎体后凸成形术治疗陈旧性骨质疏松椎体压缩性骨折的疗效研究. 中华创伤骨科杂志, 2014, 16(9): 770-775.
6.	Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine (Phila Pa 1976), 2001, 26(14): 1547-1554.
7.	Rousing R, Andersen MO, Jespersen SM, et al. Percutaneous veterbroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-month follow-up in a clinical randomized study. Spine, 2009, 34(13): 1348-1354.
8.	Li D, Wu Y, Huang Y, et al. Risk factors of recompression of cemented vertebrae after kyphoplasty for osteoporotic vertebral compression fractures. Int Orthop, 2016, 40(6): 1285-1290.
9.	Niu J, Zhou H, Meng Q, et al. Factors affecting recompression of augmented vertebrae after successful percutaneous ballon kyphoplasty: a retrospective analysis. Acta Radiologica, 2015, 56(11): 1380-1387.
10.	印飞, 孙振中, 宋升, 等. 单双侧经皮椎体后凸成形术治疗中位胸椎骨质疏松性压缩骨折对比研究. 中国修复重建外科杂志, 2016, 30(1): 77-81.
11.	钟远鸣, 苏之盟, 覃海飚, 等. 椎体成形术骨水泥弥散情况对再发骨折的影响. 重庆医学, 2016, 45(6): 752-759.
12.	陈柏龄, 谢登辉, 黎艺强, 等. 单侧PKP骨水泥注射过中线分布对压缩性骨折椎体两侧刚度的影响. 中国脊柱脊髓杂志, 2011, 21(2): 118-121.
13.	Mroz TE, Yamashita T, Davros WJ, et al. Radiation exposure to the surgeon and the patient during kyphoplasty. J Spinal Disord Tech, 2008, 21(2): 96-100.
14.	李玉伟, 严晓云, 王海蛟, 等. 应用高黏度骨水泥单侧穿刺经皮椎体成形术治疗新鲜椎体骨折. 中国修复重建外科杂志, 2015, 29(7): 845-848.
15.	贺宝荣, 许正伟, 郝定均, 等. 骨水泥在骨质疏松性骨折椎体内分布状态与生物力学性能的关系. 中华骨科杂志, 2012, 32(8): 768-773.
16.	李健, 吴溢峰, 杨波, 等. 双侧双平面与单侧经椎弓根椎体成形术疗效比较. 中国矫形外科杂志, 2011, 19(2): 91-95.
17.	王想福, 范有福, 石瑞芳, 等. 单侧穿刺椎体后凸成形术骨水泥分布与穿刺角度的关系. 中国骨伤, 2015, 28(8): 704-707.
18.	金志辉, 张贵林. 单双侧椎体后凸成形术治疗骨质疏松性胸腰椎压缩骨折的疗效分析. 中国骨与关节损伤杂志, 2015, 30(1): 35-38.
19.	Georgy BA. Comparison between radiofrequency targeted vertebral augmentation and ballon kyphoplasty in the treatment of vertebral compression fractures: addressing factors that affect cement extravasation and distribution. Pain Physician, 2013, 16(5): E513-518.
20.	晏雄伟, 张洪燕. 椎体后凸成形治疗骨质疏松性脊柱骨折: 注入骨水泥的要点. 中国组织工程研究, 2014, 18(9): 1471-1476.

1. 余伟波, 梁德, 江小兵, 等. 经皮椎体成形术和经皮椎体后凸成形术治疗伴椎体内真空裂隙的骨质疏松椎体压缩骨折的比较研究. 中国修复重建外科杂志, 2016, 30(9): 1104-1110.
2. 潘爱星, 杨晋才, 海涌, 等. 单侧与双侧穿刺经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的对比研究. 中国骨与关节杂志, 2016, 5(1): 44-47.
3. He D, Wu L, Sheng X, et al. Internal fixation with percutaneous kyphoplasty compared with simple percutaneous kyphoplasty for thoracolumbar burst fractures in elderly patients: a prospective randomized controlled trial. Eur Spine J, 2013, 22(10): 2256-2263.
4. Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine, 2001, 26(14): 1631-1638.
5. 徐耀宁, 郑秋坚, 尹东, 等. 经皮椎体后凸成形术治疗陈旧性骨质疏松椎体压缩性骨折的疗效研究. 中华创伤骨科杂志, 2014, 16(9): 770-775.
6. Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine (Phila Pa 1976), 2001, 26(14): 1547-1554.
7. Rousing R, Andersen MO, Jespersen SM, et al. Percutaneous veterbroplasty compared to conservative treatment in patients with painful acute or subacute osteoporotic vertebral fractures: three-month follow-up in a clinical randomized study. Spine, 2009, 34(13): 1348-1354.
8. Li D, Wu Y, Huang Y, et al. Risk factors of recompression of cemented vertebrae after kyphoplasty for osteoporotic vertebral compression fractures. Int Orthop, 2016, 40(6): 1285-1290.
9. Niu J, Zhou H, Meng Q, et al. Factors affecting recompression of augmented vertebrae after successful percutaneous ballon kyphoplasty: a retrospective analysis. Acta Radiologica, 2015, 56(11): 1380-1387.
10. 印飞, 孙振中, 宋升, 等. 单双侧经皮椎体后凸成形术治疗中位胸椎骨质疏松性压缩骨折对比研究. 中国修复重建外科杂志, 2016, 30(1): 77-81.
11. 钟远鸣, 苏之盟, 覃海飚, 等. 椎体成形术骨水泥弥散情况对再发骨折的影响. 重庆医学, 2016, 45(6): 752-759.
12. 陈柏龄, 谢登辉, 黎艺强, 等. 单侧PKP骨水泥注射过中线分布对压缩性骨折椎体两侧刚度的影响. 中国脊柱脊髓杂志, 2011, 21(2): 118-121.
13. Mroz TE, Yamashita T, Davros WJ, et al. Radiation exposure to the surgeon and the patient during kyphoplasty. J Spinal Disord Tech, 2008, 21(2): 96-100.
14. 李玉伟, 严晓云, 王海蛟, 等. 应用高黏度骨水泥单侧穿刺经皮椎体成形术治疗新鲜椎体骨折. 中国修复重建外科杂志, 2015, 29(7): 845-848.
15. 贺宝荣, 许正伟, 郝定均, 等. 骨水泥在骨质疏松性骨折椎体内分布状态与生物力学性能的关系. 中华骨科杂志, 2012, 32(8): 768-773.
16. 李健, 吴溢峰, 杨波, 等. 双侧双平面与单侧经椎弓根椎体成形术疗效比较. 中国矫形外科杂志, 2011, 19(2): 91-95.
17. 王想福, 范有福, 石瑞芳, 等. 单侧穿刺椎体后凸成形术骨水泥分布与穿刺角度的关系. 中国骨伤, 2015, 28(8): 704-707.
18. 金志辉, 张贵林. 单双侧椎体后凸成形术治疗骨质疏松性胸腰椎压缩骨折的疗效分析. 中国骨与关节损伤杂志, 2015, 30(1): 35-38.
19. Georgy BA. Comparison between radiofrequency targeted vertebral augmentation and ballon kyphoplasty in the treatment of vertebral compression fractures: addressing factors that affect cement extravasation and distribution. Pain Physician, 2013, 16(5): E513-518.
20. 晏雄伟, 张洪燕. 椎体后凸成形治疗骨质疏松性脊柱骨折: 注入骨水泥的要点. 中国组织工程研究, 2014, 18(9): 1471-1476.

Chinese Journal of Reparative and Reconstructive Surgery

Application of improved injecting tube in percutaneous kyphoplasty through unipedicular puncturing

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