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[PMID]:29390489
[Au] Autor:Li HK; Hao DJ; Yang JS; Huang DG; Yu CC; Zhang JN; Gao L; Li H; Qian B
[Ad] Endereço:Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
[Ti] Título:Percutaneous kyphoplasty versus posterior spinal fixation with vertebroplasty for treatment of Kümmell disease: A case-control study with minimal 2-year follow-up.
[So] Source:Medicine (Baltimore);96(51):e9287, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This is a retrospective case-control study.The aim of this study was to compare the surgical results of percutaneous kyphoplasty (KP) and posterior spinal fixation with vertebroplasty (PSF+VP) for treatment of Kümmell disease (KD).KD is rare form of post-traumatic delayed avascular necrosis of the vertebral body. It is reported that KP is an effect measure for treatment of KD. Some studies have recommended posterior spinal fixation with vertebroplasty for KD.A total of 100 patients with KD who underwent spinal surgery at our hospital were enrolled from January 2008 to December 2013. The inclusion criteria were monosegment lesion without neurological deficit; the segments are restricted to T11-L2; conservative treatment is invalid. The exclusion criteria were metastatic spinal tumors, infection, primary bone tumor, and multiple myeloma; bisegments and multi-segments; patients with neurological symptoms; the defect of posterior wall of vertebral body; the occupying of vertebral canal. The symptomatic vertebrae were restricted to T11-L2. Patients who were followed-up for less than 2 years after surgery were excluded. Finally, there are 25 patients in the KP group and 21 in the PSF+VP group. There were no significant differences in patient age, disease duration, or the length of follow-up between the 2 groups.Operative time (43.2 ±â€Š21.8 vs 230.6 ±â€Š87.1 minutes) was significantly longer and bleeding volume (5.3 ±â€Š3.1 vs 215.0 ±â€Š170.2 mL) significantly greater in the PSF+VP group. No significant difference between the 2 groups was observed in Visual analog scale score (VAS) (1.3 ±â€Š0.9 vs 1.2 ±â€Š0.9), Oswestry disability index score (ODI) (27.2 ±â€Š9.0 vs 26.0 ±â€Š6.3), and Cobb angle (17.0 ±â€Š7.2 vs 16.5 ±â€Š2.8). KP resulted in a shorter operation time, less bleeding volume, and fewer postoperative complications than PSF+VP.This study shows that both treatments KP and PSF+VP for KD can be safe and effective for the patients with monosegment lesion and without neurological deficit. However, KP show the advantages in a shorter surgical duration, less blood loss, and fewer postoperative complications.
[Mh] Termos MeSH primário: Cifoplastia/métodos
Osteonecrose/diagnóstico por imagem
Osteonecrose/cirurgia
Doenças da Coluna Vertebral/diagnóstico por imagem
Doenças da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Perda Sanguínea Cirúrgica
Estudos de Casos e Controles
Distribuição de Qui-Quadrado
Bases de Dados Factuais
Feminino
Seguimentos
Seres Humanos
Cifoplastia/efeitos adversos
Masculino
Meia-Idade
Duração da Cirurgia
Osteonecrose/fisiopatologia
Medição da Dor
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/fisiopatologia
Estudos Retrospectivos
Índice de Gravidade de Doença
Doenças da Coluna Vertebral/fisiopatologia
Fatores de Tempo
Tomografia Computadorizada por Raios X/métodos
Resultado do Tratamento
Vertebroplastia/efeitos adversos
Vertebroplastia/métodos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009287


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[PMID]:29382020
[Au] Autor:Zhang C; Wang G; Liu X; Li Y; Sun J
[Ad] Endereço:Department of Spine, Shandong Provincial Hospital Affiliated to Shandong University,Shandong Province.
[Ti] Título:Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review.
[So] Source:Medicine (Baltimore);96(47):e8895, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Albeit it is rare, the authors report a stage 3 Kummell disease case. It is diagnosed by dynamic thoracic magnetic resonance imaging (MRI). Because there is no established strategy on stage 3 Kummell disease, we performed percutaneous kyphoplasty at first, but unfortunately made a revision surgery to remove the polymethylmethacrylate (PMMA) cement after the failure of percutaneous kyphoplasty. PATIENT CONCERNS: A 73-year-old lady with severe back pain due to osteoporosis vertebral fracture was admitted to our hospital on June 23, 2016. She underwent percutaneous kyphoplasty with the back pain improved shortly. Unfortunately, she went back to our hospital due to aggravated back pain and partial paralysis on July 25, 2016. DIAGNOSES: Kummell disease, lumbar stenosis, lacunar infarction. OUTCOMES: Specially, the compression of spinal cord was obvious in the hyperflexion position on dynamic MRI. Even though there was no improvement in muscle strength, the patient was satisfied with the back pain relief after percutaneous kyphoplasty. But, the same back pain reappeared after about 1 month. Then, we took out the PMMA cement and performed posterior vertebral column resection. At last, the back pain was relieved again but the muscle strength was improved not obviously after operation. At the same time, the kyphosis was corrected and the intravertebral stability was achieved. LESSONS: Dynamic MRI is helpful in Kummell disease with neurologic symptoms, even if there is no obvious compression in the neutral position. Furthermore, the intravertebral instability is probably the main reason of the neurologic symptoms in this case. Percutaneous kyphoplasty could not reconstruct the intravertebral stability. Stage 3 Kummell disease with obvious intravertebral instability should be treated by open surgery.
[Mh] Termos MeSH primário: Cifoplastia/efeitos adversos
Cifose/cirurgia
Reoperação/métodos
Fraturas da Coluna Vertebral/complicações
[Mh] Termos MeSH secundário: Idoso
Cimentos para Ossos
Feminino
Seres Humanos
Cifoplastia/métodos
Cifose/etiologia
Fraturas por Osteoporose/complicações
Polimetil Metacrilato
Falha de Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Bone Cements); 9011-14-7 (Polymethyl Methacrylate)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008895


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[PMID]:29245267
[Au] Autor:Li X; Lu Y; Lin X
[Ad] Endereço:Department of Orthopaedic Surgery, The first affiliated hospital of Zhejiang University, Hangzhou, Zhejiang, China.
[Ti] Título:Refracture of osteoporotic vertebral body after treatment by balloon kyphoplasty: Three cases report.
[So] Source:Medicine (Baltimore);96(49):e8961, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Balloon kyphoplasty is a widely accepted treatment of osteoporotic vertebral compression fractures (OVCFs) with good results and a low risk for complications. A refracture of previously treated vertebra is a relatively rare condition. PATIENT CONCERNS: We reported our 3 cases and reviewed all relevant literatures of 11 cases with refracture of osteoporotic vertebral body after kyphoplasty. DIAGNOSES: Follow-up radiographs or magnetic resonance imaging examination confirmed refractures of previously treated vertebrae after kyphoplasty. INTERVENTIONS: One patient with 1 refracture of osteoporotic vertebral body after kyphoplasty was treated conservatively, but the other 2 patients were treated surgically because of multiple vertebral fractures or neurological deficits. OUTCOMES: The average age of the patients was 76.8 years (range, 63-86 years). All the patients had severe osteoporosis with a mean T-score of -3.46 (range -5.0 to -3.0). The sites of refractures are in the lumbar and thoracolumbar regions. Severe osteoporosis, the presence of intravertebral cleft, and a solid lump injection pattern of polymethylmethacrylate would result in insufficient strengthening effects of cement augmentation and therefore increased the likelihood of refractures of the kyphoplasty vertibrae. LESSONS: Patients with OVCFs and intravertebral cleft who did not obtain complete pain-relief at the treated vertebral level after kyphoplasty should be strictly followed up. Early finding of this condition and rapid intervention might contribute to avoiding the occurrence of the cemented vertebral refracture after kyphoplasty. Conservative treatments such as back brace and antiosteoporotic medications were strongly recommended.
[Mh] Termos MeSH primário: Fraturas por Compressão/cirurgia
Cifoplastia/métodos
Fraturas por Osteoporose/cirurgia
Fraturas da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Recidiva
Retratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171225
[Lr] Data última revisão:
171225
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008961


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[PMID]:28853606
[Au] Autor:Jamjoom B; Patel S; Bommireddy R; Klezl Z
[Ad] Endereço:Department of Trauma and Orthopaedics, Royal Derby Hospital , Derby , UK.
[Ti] Título:Impact of the quantity of intradiscal cement leak on the progression of intervertebral disc degeneration.
[So] Source:Ann R Coll Surg Engl;99(7):529-533, 2017 Sep.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Introduction We aim to assess the impact of the quantity of intradiscal cement leak during kyphoplasty on the rate of progression of degenerative changes in the affected disc. Methods Of 316 kyphoplasty procedures, we identified 32 episodes of intradiscal cement leak in 26 patients. The quantity of cement leaked was graded from I to IV. Disc degenerative changes were assessed at presentation and follow-up using radiographical scoring and magnetic resonance imaging (MRI) grading systems. Data for low-grade leaks (grade I) were compared with the medium- and high-grade leaks (grades II-IV) using a chi-squared test. Results Median follow-up radiographic and MRI assessments were made at 18 and 21 months, respectively. Medium- and high-grade leaks were associated with a significantly higher radiographic disc degeneration scores compared with low-grade leaks (P = 0.04295) but no difference was found in MRI disc degeneration grades and in adjacent vertebral fracture rates. Conclusions Our findings indicate that the quantity of cement leaking into the disc space significantly influences the rate of progression of disc degeneration.
[Mh] Termos MeSH primário: Degeneração do Disco Intervertebral/cirurgia
Cifoplastia/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cimentos para Ossos/uso terapêutico
Progressão da Doença
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico por imagem
Cifoplastia/métodos
Imagem por Ressonância Magnética
Meia-Idade
Complicações Pós-Operatórias/etiologia
Radiografia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170831
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0083


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[PMID]:28658144
[Au] Autor:Zhao S; Xu CY; Zhu AR; Ye L; Lv LL; Chen L; Huang Q; Niu F
[Ad] Endereço:aDepartment of Spine Surgery bMedical Record Department, The First Hospital of Jilin University, Changchun, Jilin, China.
[Ti] Título:Comparison of the efficacy and safety of 3 treatments for patients with osteoporotic vertebral compression fractures: A network meta-analysis.
[So] Source:Medicine (Baltimore);96(26):e7328, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) constitute an age-related health problem that affects approximately 200 million people worldwide. Currently, various treatments are performed with the goal of reducing pain, stabilizing the vertebrate, and restoring mobility. In this study, we aimed to assess the efficacy and safety of vertebroplasty (VP), kyphoplasty (KP), and conservative treatment (CT) for the treatment of OVCFs. METHODS: We performed a network meta-analysis. PubMed and Embase databases were searched to identify randomized controlled trials (RCTs) that contained at least one of the following outcomes: visual analog scale (VAS), Roland-Morris Disability Questionnaire (RDQ), European Quality of Life-5 Dimensions (EQ-5D), and new fractures. Odds ratios with 95% confidence intervals (CIs) were used to calculate the risk of new fractures, and mean differences (MDs) with 95% CIs were utilized to express RDQ, EQ-5D, and VAS outcomes. RESULTS: Sixteen RCTs with 2046 participants were included in this meta-analysis. Compared with CT, patients treated with VP had improved pain relief, daily function, and quality of life; however, no significant differences were found between VP and KP for these 3 outcomes. All treatment options were associated with comparable risk of new fractures. When the rank probability was assessed to distinguish subtle differences between the treatments, VP was the most effective treatment for pain relief, followed by KP and CT; conversely, KP was the most effective in improving daily function and quality of life and decreasing the incidence of new fractures, followed by VP and CT. CONCLUSION: VP might be the best option when pain relief is the principle aim of therapy, but KP was associated with the lowest risk of new fractures and might offer better outcomes in terms of daily function and quality of life.
[Mh] Termos MeSH primário: Tratamento Conservador
Fraturas por Compressão/terapia
Cifoplastia
Fraturas por Osteoporose/terapia
Fraturas da Coluna Vertebral/terapia
Vertebroplastia
[Mh] Termos MeSH secundário: Tratamento Conservador/efeitos adversos
Seres Humanos
Cifoplastia/efeitos adversos
Metanálise em Rede
Vertebroplastia/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007328


  6 / 623 MEDLINE  
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[PMID]:28640112
[Au] Autor:Liu T; Li Z; Su Q; Hai Y
[Ad] Endereço:Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China.
[Ti] Título:Cement leakage in osteoporotic vertebral compression fractures with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty surgery.
[So] Source:Medicine (Baltimore);96(25):e7216, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to investigate cement leakage (CL) in osteoporotic vertebral compression fractures (OVCFs) with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty (PKP) surgery.This study included a series of 77 patients (23 males, 54 females) with single level osteoporotic vertebral body fracture (OVCF) who underwent unilateral PKP in our hospital. Preoperative x-ray, computed tomography (CT) scan, and 3-dimensional reconstructions were studied. During the PKP procedure, needle was carefully put to avoid too near to the cortical defect according to CT image. High-viscosity bone cement was used via unilateral PKP. Radiographic outcomes were evaluated by assessment of vertebral body wall breakage, fracture type, and vertebral body change. The exact rate of CL was analyzed.A total of 77 patients with single-level OVCF were included in this study. The mean age of the patients was 74.8 ±â€Š8.0 years. Among these cases, 7 (9.1%) involved the thoracic spine (T3-T10), 60 (77.9%) involved the thoracolumbar spine (T10-L2), and 10 (13.0%) involved the lumbar spine (L3-L5). There were 27 vertebral bodies found posterior wall breakage, 51 vertebral bodies found endplate breakage, and 49 vertebral bodies found anterior-lateral wall breakage. CT scan was more efficient in detecting vertebral body wall breakage and CL than x-ray (P < .001). No neurological symptoms were found after surgery. Both cases with CL (CL group) and cases without cement leakage (NCL group) experienced vertebral height restoration (HR) with similar cement volume CV. There were no significant difference between the two groups about the parameter HR and CV. Severe vertebral body fracture and biconcave fracture had more CL than other groups. OVCF cases with cortical defect had more CL rate than those without cortical defect; however, no significant difference was found in the correlation between vertebral wall breakage and CL.Cortical defect remains a potential risk of CL during PKP surgery. Careful preoperative evaluation and using high-viscosity bone cement during the unilateral PKP procedure could prevent serious leakage and clinical symptoms.
[Mh] Termos MeSH primário: Cimentos para Ossos/efeitos adversos
Cimentos para Ossos/uso terapêutico
Fraturas por Compressão/cirurgia
Cifoplastia
Fraturas por Osteoporose/cirurgia
Fraturas da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Fraturas por Compressão/diagnóstico por imagem
Fraturas por Compressão/etiologia
Seres Humanos
Imagem Tridimensional
Cifoplastia/efeitos adversos
Cifoplastia/métodos
Vértebras Lombares/diagnóstico por imagem
Vértebras Lombares/lesões
Vértebras Lombares/cirurgia
Masculino
Osteoporose/complicações
Osteoporose/diagnóstico por imagem
Osteoporose/cirurgia
Fraturas por Osteoporose/diagnóstico por imagem
Complicações Pós-Operatórias/diagnóstico por imagem
Estudos Retrospectivos
Índice de Gravidade de Doença
Fraturas da Coluna Vertebral/diagnóstico por imagem
Fraturas da Coluna Vertebral/etiologia
Vértebras Torácicas/diagnóstico por imagem
Vértebras Torácicas/lesões
Vértebras Torácicas/cirurgia
Tomografia Computadorizada por Raios X
Falha de Tratamento
Viscosidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007216


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[PMID]:28640091
[Au] Autor:Feng L; Shen JM; Feng C; Chen J; Wu Y
[Ad] Endereço:aDepartment of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medicine University bThe Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
[Ti] Título:Comparison of radiofrequency kyphoplasty (RFK) and balloon kyphoplasty (BKP) in the treatment of vertebral compression fractures: A meta-analysis.
[So] Source:Medicine (Baltimore);96(25):e7150, 2017 Jun.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Balloon kyphoplasty (BKP) is a widely adopted minimally invasive treatment for vertebral compression fractures (VCFs), but leakage of cement is a main complication of BKP. A novel vertebral augmentation technique radiofrequency kyphoplasty (RFK) with high viscosity cement was developed in 2009. Here, we aim to evaluate whether RFK can relieve symptoms efficiently and reduce cement leakage. METHODS: A literature search was performed using Pubmed, Embase, and Cochrane CENTRAL until September 30, 2016. Both randomized controlled trial (RCT) and non-RCT studies comparing RFK and BKP were included. The main outcomes included pain relief (VAS), functionality improvement (ODI), operation time, reduction of deformity (vertebral height and kyphosis angle), and incidence of cement leakage. The origin of heterogeneity was further explored by subgroup stratification. RESULTS: A total of 6 studies involving 833 patients with VCFs were included. The reduction of VAS score in the RFK group was 3.96 points more than that in the BKP group (P  =  .0007) postoperatively, and the improvement persisted until 12 months after the surgery (P < .00001). The operation time was shorter in RFK group than that in BKP group (P  =  .01). The increase of anterior vertebral height shortly after the operation was 0.53 mm greater in RFK group (P  =  .01). The decrease of kyphotic angle after RFK was 0.63° and 0.92° greater than that after BKP, both immediately and 6 months after operation (P  =  .002 and P < .00001, respectively). There was no significant difference between the incidence of cement leakage after RFK and BKP (P  =  .06). Further subgroup analysis stratified by study design indicated that the incidence of leakage decreased 15% in RFK than BPK (P < .00001) in non-RCT subgroup, but RFK and BKP treatments were equivalent in the RCT studies (P  =  .86). CONCLUSION: RFK appears to be more effective and safer than BKP in the present meta-analysis. The incidence of cement leakage diverges in RCT and non-RCT studies, so large-sample multicentered RCT studies are required to validate this new surgery system.
[Mh] Termos MeSH primário: Fraturas por Compressão/cirurgia
Cifoplastia
Ondas de Rádio/uso terapêutico
Fraturas da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Cifoplastia/efeitos adversos
Ondas de Rádio/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007150


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[PMID]:28578121
[Au] Autor:Crespo-Sanjuán J; Ardura F; Hernández-Ramajo R; Noriega DC
[Ad] Endereço:Unidad de Columna, Servicio Cirugía Ortopédica, Hospital Clínico Universitario de Valladolid, Calle Ramón y Cajal, Valladolid, Spain.
[Ti] Título:Requirements for a Stable Long-Term Result in Surgical Reduction of Vertebral Fragility Fractures.
[So] Source:World Neurosurg;105:137-144, 2017 Sep.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Osteoporotic vertebral fractures are one of the major health problems in the world. Minimally invasive surgical treatment has great advantages compared with conservative treatment in treating these fractures, because it eliminates pain and functional disability. The percutaneous intravertebral expandable titanium device SpineJack (Vexim SA, Balma, France) is beneficial compared with other kyphoplasty devices, showing results that are maintained over time and a reduction in complications. However, controversy exists about the minimum amount of cement that should be used to achieve long-term restoration and which is essential to minimize complications. We reviewed publications studying the maintenance of long-term restoration using this percutaneous expandable titanium device in cadavers. In this study, we show the first long-term work with patients treated with percutaneous expandable titanium device, describing precise indications concerning the minimum amount of cement that should be used. METHODS: Results were evaluated from a clinical study including 178 patient outcomes with long-term follow-up results performed by our team. RESULTS: The mean total quantity of cement injected was 4.4 mL (25% vertebral body filling). The leakage rate was 12.9%, and all of these occurrences were asymptomatic. The mean follow-up time was 77 months (60-96 months). All clinical scales improved significantly after the procedure. A recollapse of the treated vertebra was observed in 3 cases (1.6%), and the adjacent fracture rate was 2.2%. CONCLUSIONS: From the results of our study and review of the literature, cement equivalent to 25% of the vertebral body filling volume, when combined with the titanium expandable device, seems to be sufficient to prevent recollapse in osteoporotic and type A.3 fractures.
[Mh] Termos MeSH primário: Fraturas da Coluna Vertebral/cirurgia
Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cimentos para Ossos/uso terapêutico
Feminino
Fraturas por Compressão/cirurgia
Seres Humanos
Cifoplastia/métodos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Osteoporose/complicações
Osteoporose/cirurgia
Fraturas por Osteoporose/cirurgia
Resultado do Tratamento
Vertebroplastia/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170605
[St] Status:MEDLINE


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[PMID]:28445294
[Au] Autor:Chang W; Zhang X; Jiao N; Yuwen P; Zhu Y; Zhang F; Chen W
[Ad] Endereço:aDepartment of Orthopaedic Surgery bDepartment of Radiology cDepartment of Pharmacy, the Third Hospital of Hebei Medical University, Shijiazhuang, P.R. China.
[Ti] Título:Unilateral versus bilateral percutaneous kyphoplasty for osteoporotic vertebral compression fractures: A meta-analysis.
[So] Source:Medicine (Baltimore);96(17):e6738, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The debate on the efficacy of unilateral percutaneous kyphoplasty (UPKP) and bilateral percutaneous kyphoplasty (BPKP) for the treatment of osteoporotic vertebral compression fractures (OVCFs) is ongoing.This meta-analysis aimed to evaluate the clinical results of UPKP and BPKP in the treatment of OVCFs. METHODS: Web of Science, PubMed, Embase, and the Chinese Biomedical Database publication databases were searched using a date range of January 2008 to November 2016, for studies comparing UPKP and BPKP for the treatment of OVCFs. The clinical effectiveness was assessed by comparing perioperative outcomes (surgery time, the volume of injected cement, X-ray exposure time, and kyphotic angle reduction), clinical outcomes (visual analogue scale [VAS] for pain relief and Oswestry Disability Index [ODI] for quality of life), and surgery-related complications (cement leakage and adjacent vertebral fractures). Data were analyzed using Stata/SE11.0 software. RESULTS: Fourteen trials with 1194 patients were retrieved. The pooled results showed significant differences in surgery time (weighted mean difference [WMD] -21.44, 95% confidence interval [CI] [-23.57 to -19.30]; P < .001); volume of injected cement [WMD -1.90, 95% CI [-2.26 to -1.54); P < .001); and X-ray exposure time (WMD -13.66, 95%CI [-19.59 to -7.72]; P < .001) between UPKP and BPKP treatments. However, the pooled results showed no significant differences in kyphotic angle reduction, VAS in the short-term, VAS in the long-term, ODI, cement leakage, or adjacent vertebral fractures between the 2 surgical procedures. Following a subgroup analysis, the results based on randomized controlled trials (RCTs) indicated that there were significant differences in surgery time (WMD -24.65, 95%CI [-26.53 to -22.77]; P < .001) and the volume of injected cement (WMD -1.66, 95%CI [-1.97 to -1.36]; P < .001) between UPKP and BPKP treatment procedures, respectively. The results based on RCTs indicated that there were no significant differences, either in kyphotic angle reduction or in X-ray exposure time, between the 2 surgical procedures. CONCLUSIONS: Compared to BPKP procedures, UPKP procedures may achieve similar clinical results in the treatment of OVCFs when assessed in terms of the pain relief, improvements in life quality, and surgery-related complications. However, UPKP procedures had a shorter operation time and volume of injected cement compared with BPKP procedures. Additional high quality and multicenter RCTs are needed to provide further robust evidence.
[Mh] Termos MeSH primário: Fraturas por Compressão/cirurgia
Cifoplastia/métodos
Fraturas por Osteoporose/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Cifoplastia/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006738


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[PMID]:28386056
[Au] Autor:Sun ZY; Li XF; Zhao H; Lin J; Qian ZL; Zhang ZM; Yang HL
[Ad] Endereço:Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland).
[Ti] Título:Percutaneous Balloon Kyphoplasty in Treatment of Painful Osteoporotic Occult Vertebral Fracture: A Retrospective Study of 89 Cases.
[So] Source:Med Sci Monit;23:1682-1690, 2017 Apr 07.
[Is] ISSN:1643-3750
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND The definition of a vertebral fracture is usually based on the presence of a deformation of the vertebral body and this can be misleading in the presence of a fracture without radiologic collapse with the definition of occult osteoporotic vertebral fractures (OOVFs). STIR sequence of MRI images showing hyperintensity signal was the most confirmative screening examination used to determine the presence of painful OOVFs. To date, clinical management of OOVFs has been rarely discussed. MATERIAL AND METHODS Between 2011 and 2013, 89 patients suffering from painful OOVFs underwent 142 percutaneous balloon kyphoplasty (PKP) procedures. Outcome data (mean variation of anterior and middle vertebral body height, visual analog scale [VAS] scores, Oswestry Disability Index [ODI] scores, and SF-36 scores) were recorded preoperatively, postoperatively, and at 1 month, 6 months, and 2 year after treatment, to evaluate the results. RESULTS We successfully treated 89 patients (142 vertebral bodies) with PKP. Cement leakages were observed in 12 (8.45%) treated vertebral bodies and there were 5 new adjacent vertebral fractures during the follow-up period. The mean variation of anterior and middle vertebral body height changed from 96.5±3.4% preoperatively to 97.2±2.5% postoperatively (p>0.05) and from 96.3±2.8% preoperatively to 97.9±3.1% postoperatively (p>0.05), respectively. The mean VAS scores were reduced significantly from pre-surgery to post-surgery (8.3±1.2 to 2.9±0.7; p<0.05), as was the ODI score (76.4±12.5 to 26.7±5.6; p<0.05). The SF-36 scores, including Bodily Pain (BF), Vitality (VT), Physical Function (PF), and Social Functioning (SF), all showed notable improvement (P<0.05). These variations were maintained during the 2-year follow-up period. CONCLUSIONS PKP is a safe and effective method in the treatment of painful OOVFs.
[Mh] Termos MeSH primário: Fraturas Fechadas/cirurgia
Cifoplastia/métodos
Fraturas por Osteoporose/cirurgia
[Mh] Termos MeSH secundário: Idoso
Cimentos para Ossos/uso terapêutico
Feminino
Fraturas Fechadas/diagnóstico por imagem
Fraturas por Compressão/diagnóstico por imagem
Fraturas por Compressão/cirurgia
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Osteoporose/tratamento farmacológico
Fraturas por Osteoporose/diagnóstico por imagem
Estudos Retrospectivos
Fraturas da Coluna Vertebral/cirurgia
Traumatismos da Coluna Vertebral/cirurgia
Coluna Vertebral/cirurgia
Resultado do Tratamento
Vertebroplastia/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE



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