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.	祝腾蛟, 田耘, 周方. 骨质疏松性椎体压缩骨折微创治疗的现状和进展. 中国微创外科杂志, 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.	马航展, 马金火, 褚学远, 等. 单侧入路椎体成形术治疗骨质疏松性胸腰椎骨折. 中国矫形外科杂志, 2019, 27(12): 1068-1072.
5.	刘爱华, 吴中学, 杨新健, 等. 单侧入路的椎体成形术治疗老年椎体压缩性骨折. 中国现代医学杂志, 2006, 16(17): 2623-2625, 2628.
6.	金成浩, 蔡迎, 钟杰林, 等. 单侧与双侧经皮后凸成形治疗骨质疏松性胸腰椎骨折. 中国矫形外科杂志, 2020, 28(18): 1712-1715.
7.	何仕诚, 滕皋军, 邓钢, 等. 椎体成形术治疗合并囊腔样变的骨质疏松性椎体压缩骨折. 介入放射学杂志, 2005, 14(3): 256-260.
8.	李哲, 苏庆军, 海涌. 伴有椎体内裂隙征的骨质疏松性椎体压缩骨折的诊治进展. 中国脊柱脊髓杂志, 2017, 27(7): 647-651.
9.	夏维财. 经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折. 中国微创外科杂志, 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.	沈凯, 张胜利, 谭祖键, 等. 经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折中骨水泥单侧与双侧弥散对疗效的影响. 中华创伤杂志, 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.	Zapałowicz 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.	赵继荣, 邓强, 王兴盛, 等. 老年骨质疏松性压缩骨折经皮穿刺椎体成形术后疗效不佳相关因素. 中国老年学杂志, 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.	陈亮, 杨惠林, 唐天驷. 后凸成形术治疗多椎体骨质疏松性压缩骨折的疗效分析. 中华骨科杂志, 2009, 29(4): 310-314.
21.	格日勒, 刘鑫, 杨鹏, 等. 经皮椎体成形和经皮椎体后凸成形治疗老年骨质疏松性椎体压缩性骨折的对比. 中国微创外科杂志, 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. 祝腾蛟, 田耘, 周方. 骨质疏松性椎体压缩骨折微创治疗的现状和进展. 中国微创外科杂志, 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. 马航展, 马金火, 褚学远, 等. 单侧入路椎体成形术治疗骨质疏松性胸腰椎骨折. 中国矫形外科杂志, 2019, 27(12): 1068-1072.
5. 刘爱华, 吴中学, 杨新健, 等. 单侧入路的椎体成形术治疗老年椎体压缩性骨折. 中国现代医学杂志, 2006, 16(17): 2623-2625, 2628.
6. 金成浩, 蔡迎, 钟杰林, 等. 单侧与双侧经皮后凸成形治疗骨质疏松性胸腰椎骨折. 中国矫形外科杂志, 2020, 28(18): 1712-1715.
7. 何仕诚, 滕皋军, 邓钢, 等. 椎体成形术治疗合并囊腔样变的骨质疏松性椎体压缩骨折. 介入放射学杂志, 2005, 14(3): 256-260.
8. 李哲, 苏庆军, 海涌. 伴有椎体内裂隙征的骨质疏松性椎体压缩骨折的诊治进展. 中国脊柱脊髓杂志, 2017, 27(7): 647-651.
9. 夏维财. 经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折. 中国微创外科杂志, 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. 沈凯, 张胜利, 谭祖键, 等. 经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折中骨水泥单侧与双侧弥散对疗效的影响. 中华创伤杂志, 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. Zapałowicz 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. 赵继荣, 邓强, 王兴盛, 等. 老年骨质疏松性压缩骨折经皮穿刺椎体成形术后疗效不佳相关因素. 中国老年学杂志, 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. 陈亮, 杨惠林, 唐天驷. 后凸成形术治疗多椎体骨质疏松性压缩骨折的疗效分析. 中华骨科杂志, 2009, 29(4): 310-314.
21. 格日勒, 刘鑫, 杨鹏, 等. 经皮椎体成形和经皮椎体后凸成形治疗老年骨质疏松性椎体压缩性骨折的对比. 中国微创外科杂志, 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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