[Retrospective study on volume of bone cement injection for concurrent of fracture after thoracolumbar vertebraes kyphoplasty].

OBJECTIVE: To explore relationship between volume of bone cement injection and concurrent of fracture after thoracolumbar osteoporotic vertebral fracture treated by percutaneous kyphoplasty (PKP). METHODS: From January 2006 to December 2008,68 patients with thoracolumbar osteoporotic vertebral fracture treated by PKP were retrospectively analyzed. Among them, 30 patients with less than 3 ml bone cement injection (mean 2.5 ml, low group), including 11 males and 19 females, with an average age of (85.0 +/- 8.5) years (ranging for 60 to 91); 38 cases with over 4 ml bone cement injection (mean 4.5 ml, large group), including 15 males and 23 females,with an average age of (86.0 +/- 9.2) years (ranging for 60 to 93). Factors of concurrent vertebral fractures were observed during follow-up. RESULTS: All patients were followed up from 3.4 to 5.1 years with an average of 3.8 years. Thirteen patients (43.3%) co-occurred fracture in low group,among which strengthened concurrent vertebral fracture occurred in 1 case,upper and lower section adjacent vertebral fracture in 8 cases,distal segment of vertebral fracture in 4 cases; while 18 patients (47.3%) co-occurred fracture in large group,among which strengthened concurrent vertebral fracture occurred in 2 cases, upper and lower section adjacent vertebral fracture in 10 cases,distal segment of vertebral fracture in 6 cases. No significant difference between two groups (P > 0.05). CONCLUSION: Bone cement injection is not main influence factors for treating concurrent of fracture after thoracolumbar osteoporotic vertebral fracture by PKP. Concurrent fracture mainly relates with progress of osteoporosis, the volume of injection volume may appropriately over the volume of balloon.

[Clinical observation of effects and complications of the mid-stage in treating osteoporotic vertebral compression fracture with percutaneous kyphoplasty].

OBJECTIVE: To observe the clinical effects and complications in treating osteoporotic vertebral fractures with percutaneous kyphoplasty (PKP) and in order to found the cause and countermeasures of the complications. METHODS: From March 2006 to March 2007, 31 patients with osteoporotic vertebral fractures were treated with unilateral percutaneous kyphoplasty. There were 11 males and 20 females, ranging in age from 54 to 91 years with the mean of 81 years. All patients were followed up for more than three years. At pre-treatment and postoperatively immediately, 1, 2, 3 years after PKP, the height of anterior vertebral body and thoracic-lumbar and back pain were respectively analyzed by imaging data and VAS scoring. RESULTS: At pre-treatment and postoperatively immediately, 1, 2, 3 years after PKP, the height of anterior vertebral body were (0.9 +/- 0.2), (2.6 +/- 0.3), (2.6 +/- 0.2), (2.5 +/- 0.7), (2.5 +/- 0.4) cm, respectively; the VAS soring were (7.6 +/- 1.4), (2.3 +/- 0.7), (2.4 +/- 0.5), (2.8 +/- 0.3), (3.1 +/- 0.2) scores, respectively. The height of anterior vertebral body recoveried obviously after PKP (P < 0.05); following prolongation of time, the height of anterior vertebral body gradually reduced (P > 0.05). The thoracic-lumbar and back pain relieved obviously after PKP (P < 0.05); following prolongation of time, the pain gradually aggratated, but there was no significant difference (P > 0.05). At final follow up, reinforced vertebral re-fractures was found in 2 cases, adjacent vertebral fractures in 6 cases, distal vertebral fractures in 2 cases, asymptomatic degeneration of adjacent intervertebral in 5 cases. CONCLUSION: PKP have definite and early effects in treating osteoporotic vertebral fractures. But in mid-stage after PKP, the height of anterior vertebral body reduce and the pain aggravate gradually, especially degenerative adjacent vertebral fracture advent. Strict choosing the candidate of the precedure, improvement of materials of perfusion and reducing of volume of bone cement maybe can decrease incidence rate of complications.