Vertebroplasty for osteoporotic vertebral compression fractures: missed diagnosis, severe vertebral compression, bone cement leakage and recurrent fractures in 225 cases

doi:10.3969/j.issn.2095-4344.2016.35.013

Abstract

Abstract:

BACKGROUND: Percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures has achieved very good results.

OBJECTIVE: To discuss and resolve some problems related to thoracic and lumbar vertebroplasty.

METHODS: 225 patients (78 males and 147 females) aged 53 to 92 years old were included in this study. They all accepted percutaneous vertebrolplasty and we observed and made a record about some questions related this surgery during perioperative period.

RESULTS AND CONCLUSION: Six cases (2.7%) missed diagnosis. More than two-third of the compression degree were found in sixteen cases (7.1%). Forty-five (12.8%) vertebrae suffered from bone cement leakage in twenty-nine cases (12.9%). Recurrent fractures appeared in ten cases (4.4%). Multiple vertebrae fractures appeared in seventy-nine cases (35.1%). (1) Strategies for missed diagnosis: conduct preoperative physical examination carefully; avoid missing the point of pain; increase MRI scanning when necessary. (2) Coping strategies for severe vertebral fractures: place the needle into the parallel endplates as far as possibly; puncture along the lumbar spine pedicle base and the lateral thoracic pedicle. (3) Coping strategies for cement leakage: when cement leakage over the lower edge of the end plate occurred in operation, we should immediately put the C-arm X-ray machine into anteroposterior position to determine the orientation of the leakage and stop injecting; we should continue to inject the bone cement into the no leak-side to ensure the filling amount of vertebral bone cement. (4) Coping strategies for recurrent fractures: reoperation. (5) Coping strategies for multiple fractures: patients with multiple fractures often have a feature of poor constitution and more complications. So, it is necessary to shorten the operation time, and determine unilateral or bilateral puncture ways depending on the degree of vertebral compression to save operation time.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Vertebroplasty, Osteoporotic Fractures, Tissue Engineering

CLC Number:

R318

Zhang Hui, Gao Zhong-yu, Xu Cai-yuan, Zhang Tong-xing, Zhang Tao. Vertebroplasty for osteoporotic vertebral compression fractures: missed diagnosis, severe vertebral compression, bone cement leakage and recurrent fractures in 225 cases[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(35): 5256-5262.

Figures/Tables 2

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