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Chang-Hoon Jeon, Nam-Su Chung, Jae-Heon Lee, Han-Dong Lee
Bleeding and hematoma formation is rarely reported in percutaneous vertebroplasty procedure. An 84 year old male presented with a large paraspinal muscle hematoma after a percutaneous vertebroplasty. The patient had neither any prior bleeding disorder nor any anticoagulant treatment. Vital signs of the patient were unstable, and his hemoglobin level decreased daily. After a month of conservative treatment, including transfusion, cryotherapy, pain control and bed rest, his hemoglobin level remained stable and he showed relief from pain...
September 2016: Indian Journal of Orthopaedics
Olivier Lamy, Elena Gonzalez-Rodriguez, Delphine Stoll, Didier Hans, Bérengère Aubry-Rozier
CONTEXT: Denosumab inhibits bone resorption, increases bone mineral density (BMD), and reduces fracture risk. Denosumab was approved for the treatment of osteoporosis and the prevention of bone loss in some oncologic situations. Denosumab discontinuation is associated with a severe bone turnover rebound (BTR) and a rapid loss of BMD. The clinical consequences of the BTR observed after denosumab discontinuation are not known. Cases description: We report 9 women who presented 50 rebound-associated vertebral fractures (RAVFs) after denosumab discontinuation...
October 12, 2016: Journal of Clinical Endocrinology and Metabolism
Ivan Zderic, Philipp Steinmetz, Markus Windolf, R Geoff Richards, Andreas Boger, Boyko Gueorguiev
Cement leakage is a serious adverse event potentially occurring during vertebroplasty. Pre-operative in-silico planning of the cement filling process can help reducing complication rates related to leakage. This requires a better understanding of the cement flow along the whole injection path. Therefore, the aim of the present study was to analyze bone cement flow behavior by stepwise injections through medical cannulas. Sixteen cannulas were assigned to four groups for stepwise injection of differently colored cement portions of 1ml volume...
October 7, 2016: Medical Engineering & Physics
Mehmet Nuri Erdem, Sinan Karaca, Seckin Sarı, Feridun Yumrukcal, Ruhat Tanli, Mehmet Aydogan
BACKGROUND CONTEXT: Application of pedicle screws with cement in order to strengthen the fixation of the osteoporotic spine has increasingly gained popularity. However, the technique has also led to an increase in cement-related complications. PURPOSE: The aim of this study was to compare the clinical and radiological results of the patients with degenerative spinal pathologies who were treated with pedicle screws and cement injections on all segments versus those who were treated with cement injections only on the strategic vertebrae selected...
October 5, 2016: Spine Journal: Official Journal of the North American Spine Society
Kunio Yokoyama, Masahiro Kawanishi, Makoto Yamada, Hidekazu Tanaka, Yutaka Ito, Toshihiko Kuroiwa
As a treatment for painful vertebral compression fractures (VCFs), vertebral perforation does not require bone cement infusion. Here, we retrospectively assessed the long-term therapeutic effects of vertebroplasty in a comparison with those of vertebral perforation. The subjects were 64 patients who underwent percutaneous vertebroplasty (PVP group) and 67 patients who underwent vertebral perforation (Perforation group) between 2006 and 2011 at Takeda general hospital. We compared the analgesic effects of the treatments and the incidences of new VCFs between the groups at 15 months postsurgery...
October 4, 2016: British Journal of Neurosurgery
Eelin Tan, Tian Wang, Matthew H Pelletier, William R Walsh
BACKGROUND: Studies on the effects of cement augmentation or vertebroplasty on multi-level spine after vertebral compression fractures are lacking. This paper seeks to establish a 3-vertebrae ovine model to determine the impact of compression fracture on spine biomechanics, and to discover if cement augmentation can restore mechanical stability to fractured spine. METHODS: Five lumbar spine segments (L1-L3) were obtained from 5-year-old female Merino sheep. Standardized wedge-compression fractures were generated in each L2 vertebra, and then augmented with polymethyl methacrylate (PMMA) cement mixed with 30% barium sulphate powder...
June 2016: J Spine Surg
Daniele Vanni, Renato Galzio, Anna Kazakova, Andrea Pantalone, Giovanni Grillea, Marcello Bartolo, Vincenzo Salini, Vincenzo Magliani
Currently, there is no general consensus about the management of osteoporotic vertebral fractures (OVF). In the past, conservative treatment for at least one month was deemed appropriate for the majority of vertebral fractures. When pain persisted after conservative treatment, it was necessary to consider surgical interventions including: vertebroplasty for vertebral fractures with less than 30% loss of height of the affected vertebral body and kyphoplasty for vertebral fractures with greater than 30% loss of height...
March 2016: J Spine Surg
Bartosz Polis, Jacek Krawczyk, Lech Polis, Emilia Nowosławska
PURPOSE: The aim of the article is to present the new extrapedicular percutaneous technique for posttraumatic vertebral column fracture. METHODS: A 15-year-old boy needed a surgical Th8 posttraumatic vertebral body (VB) compressive fracture reduction due to insufficient conservative treatment and consistent severe clinical symptoms. After 6 months of external Jevett long-roll brace stabilization, progressive sagittal balance disturbance of thoracic kyphosis was measured and persistent clinical symptoms were observed...
September 26, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Stephen Lutz, Tracy Balboni, Joshua Jones, Simon Lo, Joshua Petit, Shayna E Rich, Rebecca Wong, Carol Hahn
PURPOSE: The purpose is to provide an update the Bone Metastases Guideline published in 2011 based on evidence complemented by expert opinion. The update will discuss new high-quality literature for the 8 key questions from the original guideline and implications for practice. METHODS AND MATERIALS: A systematic PubMed search from the last date included in the original Guideline yielded 414 relevant articles. Ultimately, 20 randomized controlled trials, 32 prospective nonrandomized studies, and 4 meta-analyses/pooled analyses were selected and abstracted into evidence tables...
August 5, 2016: Practical Radiation Oncology
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
Valentina Danesi, Gianluca Tozzi, Luca Cristofolini
BACKGROUND: Prophylactic augmentation is meant to reinforce the vertebral body, but in some cases it is suspected to actually weaken it. Past studies only investigated structural failure and the surface strain distribution. To elucidate the failure mechanism of the augmented vertebra, more information is needed about the internal strain distribution. This study aims to measure, for the first time, the full-field three-dimensional strain distribution inside augmented vertebrae in the elastic regime and to failure...
July 27, 2016: Clinical Biomechanics
Kaan Yaltirik, Ahmed M Ashour, Conner R Reis, Selçuk Özdoğan, Başar Atalay
BACKGROUND AND CONTEXT: Minimally invasive percutaneous vertebral augmentation techniques; vertebroplasty, and kyphoplasty have been treatment choices for vertebral compression fractures (VCFs). The purpose of this study is to evaluate the outcomes of the patients who underwent vertebroplasty or kyphoplasty regarding complications, correction of vertebral body height, kyphosis angle and pain relief assessment using visual analog score (VAS) for pain. MATERIALS AND METHODS: A retrospective review of the hospital records for 100 consecutive patients treated with kyphoplasty or vertebroplasty in our department database...
July 2016: Journal of Craniovertebral Junction and Spine
Mara Bozza Stephenson, Bryan Glaenzer, Angelo Malamis
Spinal metastases are a common and morbid condition in America. Of the 1.6 million new cases of cancer estimated to be diagnosed in the USA in 2015, approximately 5-10 % will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with osteolytic spinal metastases experience severe and often debilitating pain, which significantly reduces quality of life. Due to the morbidity of open surgery, particularly in oncologic patients, the treatment paradigm has shifted towards minimally invasive therapy...
November 2016: Current Treatment Options in Oncology
J C Faivre, J F Py, G Vogin, G Martinage, J Salleron, P Royer, N Grandgirard, D Pasquier, S Thureau
Analgesic external beam radiation therapy is a standard of care for patients with uncomplicated painful bone metastases and/or prevention of bone complications. In case of fracture risk, radiation therapy is performed after surgery in a consolidation of an analgesic purpose and stabilizing osteosynthesis. Radiotherapy is mandatory after vertebroplasty or kyphoplasty. Spinal cord compression - the only emergency in radiation therapy - is indicated postoperatively either exclusively for non surgical indication...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Jing Xiao, Xiaobin Wang, Xiaoju Tan
OBJECTIVE: To verify whether the procedure of posterior instrumentation and vertebroplasty for treatment of thoracolumbar burst fracture in youth and middle-aged patients is safe, practical and effective in short- and long-term.
 METHODS: A total of 50 patients aged 30-55 years old who suffered from thoracolumbar burst fracture complicated with incomplete paralysis or without neurologic symptom received surgery by using pedicle-screw implantation, reduction and bone cement filling through the unilateral or bilateral pedicles...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Hui Jing Qiu, Roderich Rietig, Volker Steger, Angela Lehn-Stefan, Dominik Ketelsen, Bernd Balletshofer, Elko Randrianarisoa
HISTORY AND ADMISSION FINDINGS: We report on a patient with acute dyspnea after several vertebral body interventions, among others a kyphoplasty, that was performed a few days earlier. INVESTIGATIONS: In the computed tomography we prove a bilateral pulmonary embolism (cement and thrombus). There is no right heart failure. A deep vein thrombosis can be excluded by color-coded vascular ultrasound. DIAGNOSIS, TREATMENT AND COURSE: The pulmonary embolism is due to bone cement...
September 2016: Deutsche Medizinische Wochenschrift
Hyeun-Sung Kim, Dong-Hwa Heo
Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed...
2016: BioMed Research International
Hsin-Yao Chen, Chiu-Liang Chen, Wei-Liang Chen
BACKGROUND: Pedicle screw instrumentation for treating spinal disorder is becoming increasingly widespread. Many studies have advocated its use to facilitate rigid fixation for spine; however, adjacent segmental disease is a known complication. Instrumented fusion for osteoporotic spines remains a significant challenge for spine surgeons. Prophylactic vertebroplasty for adjacent vertebra has been reported to reduce the complications of junctional compression fractures but has raised a new problem of vertebral subluxation...
2016: Therapeutics and Clinical Risk Management
Eric Bonnard, Pauline Foti, Adrian Kastler, Nicolas Amoretti
OBJECTIVE: Evaluate patients' intraoperative experience of percutaneous vertebroplasty (PV) performed without general anaesthesia in order to assess the feasibility of local anaesthesia and simple analgesic medication as pain control protocol. METHODS: Ninety-five patients who underwent single-site PV were consecutively included in the study between 2011 and 2013. Each procedure was achieved under local anaesthesia and perfusion of paracetamol, tramadol and dolasetron, with combined CT and fluoroscopy guidance...
August 23, 2016: European Radiology
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