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Trauma vertebroplasty

O Gonschorek, S Hauck, T Weiß, V Bühren
INTRODUCTION: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. METHODS: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated...
January 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Shant Aghyarian, Xiaobang Hu, Ram Haddas, Isador H Lieberman, Victor Kosmopoulos, Harry K W Kim, Danieli C Rodrigues
Vertebral compression fractures are caused by many factors including trauma and osteoporosis. Osteoporosis induced fractures are a result of loss in bone mass and quality that weaken the vertebral body. Vertebroplasty and kyphoplasty, involving cement augmentation of fractured vertebrae, show promise in restoring vertebral mechanical properties. Some complications however, are reported due to the performance characteristics of commercially available bone cements. In this study, the biomechanical performance characteristics of two novel composite (PMMA-CaP) bone cements were studied using an anatomically accurate human cadaveric vertebroplasty model...
November 27, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Hüseyin Balkarlı, Mesut Kılıç, İbrahim Öztürk
Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L1 vertebra due to trauma...
September 13, 2016: Revista Brasileira de Anestesiologia
William Clark, Paul Bird, Peter Gonski, Terrence H Diamond, Peter Smerdely, H Patrick McNeil, Glen Schlaphoff, Carl Bryant, Elizabeth Barnes, Val Gebski
BACKGROUND: We hypothesised that vertebroplasty provides effective analgesia for patients with poorly controlled pain and osteoporotic spinal fractures of less than 6 weeks' duration. The effectiveness of vertebroplasty, using an adequate vertebral fill technique, in fractures of less than 6 weeks' duration has not been specifically assessed by previously published masked trials. METHODS: This was a multicentre, randomised, double-blind, placebo-controlled trial of vertebroplasty in four hospitals in Sydney, Australia...
October 1, 2016: Lancet
Rahel Bornemann, Yorck Rommelspacher, Tom R Jansen, Kirsten Sander, Dieter C Wirtz, Robert Pflugmacher
BACKGROUND: Painful vertebral compression fractures (VCF) caused by osteoporosis are a common health problem in the elderly population. If conservative treatments are unsuccessful, surgical treatments like vertebroplasty or kyphoplasty are recommended. But the use of Polymethylmethacrylat (PMMA) bone cement for augmentation surgery is associated with risks. OBJECTIVES: Evaluation of the effectiveness and safety of a newly developed silicon polymer (VK100) that can be used instead of PMMA bone cement for kyphoplasty treatments...
July 2016: Pain Physician
Doniel Drazin, Miriam Nuno, Faris Shweikeh, Alexander R Vaccaro, Eli Baron, Terrence T Kim, J Patrick Johnson
Introduction. Operative treatment of lumbar spine compression fractures includes fusion and/or cement augmentation. Our aim was to evaluate postoperative differences in patients treated surgically with fusion, vertebroplasty, or kyphoplasty. Methods. The Nationwide Inpatient Sample Database search for adult vertebral compression fracture patients treated 2004-2011 identified 102,316 surgical patients: 30.6% underwent spinal fusion, 17.1% underwent kyphoplasty, and 49.9% underwent vertebroplasty. Univariate analysis of patient and hospital characteristics, by treatment, was performed...
2016: BioMed Research International
F Ahlhelm, R Omidi
CLINICAL ISSUE: Minimally invasive treatment of spinal fractures. STANDARD TREATMENT PROCEDURES: Conservative treatment versus spinal surgery. TREATMENT INNOVATIONS: Minimally invasive stabilization techniques, such as percutaneous (assisted) cementoplasty have been introduced as new procedures. DIAGNOSTIC WORK-UP: Magnetic resonance imaging (MRI), X‑rays and computed tomography (CT) are the imaging techniques of first choice...
August 2016: Der Radiologe
Matthias Bungartz, Stefan Maenz, Elke Kunisch, Victoria Horbert, Long Xin, Francesca Gunnella, Joerg Mika, Juliane Borowski, Sabine Bischoff, Harald Schubert, Andre Sachse, Bernhard Illerhaus, Jens Günster, Jörg Bossert, Klaus D Jandt, Raimund W Kinne, Olaf Brinkmann
BACKGROUND CONTEXT: Large animal models are highly recommended for meaningful preclinical studies, including the optimization of cement augmentation for vertebral body defects by vertebroplasty/kyphoplasty. PURPOSE: The aim of this study was to perform a systematic characterization of a strictly minimally invasive in vivo large animal model for lumbar ventrolateral vertebroplasty. STUDY DESIGN/ SETTING: This is a prospective experimental animal study...
June 23, 2016: Spine Journal: Official Journal of the North American Spine Society
Hiroyuki Aono, Hidekazu Tobimatsu, Kenta Ariga, Masayuki Kuroda, Yukitaka Nagamoto, Shota Takenaka, Masayuki Furuya, Motoki Iwasaki
BACKGROUND: Short-segment posterior spinal instrumentation for thoracolumbar burst fracture provides superior correction of kyphosis by an indirect reduction technique, but it has a high failure rate. We investigated the clinical and radiological results of temporary short-segment pedicle screw fixation without augmentation performed for thoracolumbar burst fractures with the goal of avoiding treatment failure by waiting to see if anterior reconstruction was necessary. METHODS: We studied 27 consecutive patients with thoracolumbar burst fracture who underwent short-segment posterior instrumentation using ligamentotaxis with Schanz screws and without augmentation...
June 2016: Injury
A El Saman, S Meier, A Sander, A Kelm, I Marzi, H Laurer
BACKGROUND: Therapy of vertebral fractures in the elderly is a growing challenge for surgeons. Within the last two decades, the use of polymethylmethacrylate (PMMA) in the treatment of osteoporotic vertebral fractures has been widely established. Besides vertebroplasty and kyphoplasty, the augmentation of pedicle screws with PMMA found widespread use to strengthen the implant-bone interface. Several studies showed an enhanced pullout strength of augmented screws compared to standard pedicle screws in osteoporotic bone models...
October 2013: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Rupert Schupfner, Herman J Stoevelaar, Thomas Blattert, Daniel Fagan, Patrick Fransen, Stefano Marcia, Frederic Schils, Mashood Ali Siddiqi, Giovanni Carlo Anselmetti
BACKGROUND: Appropriate treatment choice for osteoporotic vertebral compression fractures (OVCF) is challenging due to patient heterogeneity. Using the RAND/UCLA method, an international multidisciplinary expert panel established patient-specific criteria for the choice between non-surgical management (NSM), vertebroplasty (VP), and balloon kyphoplasty (BKP). OBJECTIVES: To assess the applicability of the appropriateness criteria in real-life practice. STUDY DESIGN: Prospective observational study...
January 2016: Pain Physician
Mario Muto, Gianluigi Guarnieri, Francesco Giurazza, Luigi Manfrè
Vertebral cementoplasty is a well-known mini-invasive treatment to obtain pain relief in patients affected by vertebral porotic fractures, primary or secondary spine lesions and spine trauma through intrametameric cement injection. Two major categories of treatment are included within the term vertebral cementoplasty: the first is vertebroplasty in which a simple cement injection in the vertebral body is performed; the second is assisted technique in which a device is positioned inside the metamer before the cement injection to restore vertebral height and allow a better cement distribution, reducing the kyphotic deformity of the spine, trying to obtain an almost normal spine biomechanics...
2016: British Journal of Radiology
Tae Seong Im, Joon Woo Lee, Eugene Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
OBJECTIVE: To evaluate the effects of facet joint injection (FJI) reducing the need for percutaneous vertebroplasty (PVP) in cases of vertebral compression fracture (VCF). MATERIALS AND METHODS: A total of 169 patients who were referred to the radiology department of our institution for PVP between January 2011 and December 2014 were retrospectively evaluated. The effectiveness of FJI was evaluated by the proportion of patients who cancelled PVP and who experienced reduced pain...
May 2016: Cardiovascular and Interventional Radiology
Shinji Tanishima, Chikako Takeda, Yuki Hamamoto, Yasumitsu Kondo, Hideki Nagashima
There is a possibility that the patients with diffuse idiopathic skeletal hyperostosis (DISH) increase with aging of the population and progressive lengthening of life expectancy in developed countries. In the patients with DISH, even a trivial vertebral fracture may actually turn out to be a three-column injury because mechanical stress is applied to the fracture site due to the lever arm effect. Under these circumstances, even a prolonged strict immobilization often results in failure. Recently, elderly people increasingly wish to maintain physical abilities...
November 2012: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Er-Zhu Yang, Jian-Guang Xu, Gao-Zhong Huang, Wen-Zhen Xiao, Xiao-Kang Liu, Bing-Fang Zeng, Xiao-Feng Lian
STUDY DESIGN: A prospective randomized clinical trial. OBJECTIVE: In this study, we determine whether percutaneous vertebroplasty (PVP) offers extra benefits to aged patients with acute osteoporotic vertebral compression fractures (OVCFs) over conservative therapy (CV). SUMMARY OF BACKGROUND DATA: OVCFs are common in the aged population with osteoporosis. While the optimal treatment of aged patients with acute OVCFs remains controversial, PVP, a minimally invasive procedure, is a treatment option to be considered...
April 2016: Spine
Mary Kristen Jesse, Brian Petersen, Deborah Glueck, Sarah Kriedler
BACKGROUND: The most widely researched risk/complication following vertebroplasty (VP) or kyphoplasty (KP) is that of adjacent level fracture (ALF). Current literature results regarding the effect of intradiscal extravasation of cement on the risk of ALF is conflicting with about half of the studies concluding there is no added risk with endplate extravasation and half of the studies reporting opposite conclusions. OBJECTIVE: The purpose of the study is to further stratify the data to determine whether specifically the location and extent of endplate cement extravasation more strongly affect ALF risk in osteoporotic patients following either VP or balloon KP...
September 2015: Pain Physician
Ethan A Winkler, John K Yue, Harjus Birk, Caitlin K Robinson, Geoffrey T Manley, Sanjay S Dhall, Phiroz E Tarapore
OBJECT Traumatic fractures of the thoracolumbar spine are common injuries, accounting for approximately 90% of all spinal trauma. Lumbar spine trauma in the elderly is a growing public health problem with relatively little evidence to guide clinical management. The authors sought to characterize the complications, morbidity, and mortality associated with surgical and nonsurgical management in elderly patients with traumatic fractures of the lumbar spine. METHODS Using the National Sample Program of the National Trauma Data Bank, the authors performed a retrospective analysis of patients ≥ 55 years of age who had traumatic fracture to the lumbar spine...
October 2015: Neurosurgical Focus
Tuluhan Yunus Emre, H Bahadır Gökcen, Zafer Atbaşı, Gülis Kavadar, Meriç Enercan, Cagatay Ozturk
Vertebroplasty is a minimally invasive procedure that may be performed under either local or general anesthesia. In this study, we aimed at assessing the outcomes of the vertebroplasty performed under local anesthesia in patients at high risk of general anesthesia. Vertebroplasty was performed under local anesthesia in the treatment of a total of 62 patients (68 vertebrae in total) with osteoporotic vertebral fractures between 2011 and 2013. None of the patients had a history of trauma. Patients who were classified as ASA III during the preoperative examinations were included in the study...
January 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Liang Chen, Renbin Dong, Yong Gu, Yu Feng
BACKGROUND: Kümmell's disease is a clinical syndrome characterized by a minor spinal trauma with a symptom-free period from months to years, followed by progressive painful kyphosis. Kyphoplasty and vertebroplasty have been introduced to treat Kümmell's disease, and obtained good clinical results. Recently, delayed cement displacement was reported for Kümmell's disease treated by cement augmentation alone. Some authors recommended internal fixation combined with cement injection for this particular condition...
July 2015: Pain Physician
Sang Moon Hong, Tae Wan Kim, Kwan Ho Park
Multiple myeloma is a B-cell origin tumor characterized by hypercalcemia, osteolytic bony lesions, and pathologic fractures. Back pain is one of the most common presenting symptoms of multiple myeloma and about 60% of patients have vertebral involvement at the time of diagnosis7). Minimally invasive surgeries such as vertebroplasty and kyphoplasty are effective to relieve pain and improve the quality of life when a compression fracture occurs in multiple myeloma patients. We report a case of continuous multiple compression fractures associated with multiple myeloma...
March 2012: Korean Journal of Spine
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