Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation
Background: To evaluate the safety and efficacy of vertebroplasty with short segmented cement augmented pedicle screws fixation for severe osteoporotic vertebral compression fractures (OVCF) with posterior/anterior wall fracture patients. Methods: A retrospective study of 48 patients of DGOU type-4...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | North American Spine Society Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666548422000142 |
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| author | Deepak Joshi, M.S Orthopaedics, Mch, FISS Ghanshyam Kakadiya, M.S Orthopaedics, DNB, MNAMS, FISS Umair Attar, DNB Orthopaedics |
| author_facet | Deepak Joshi, M.S Orthopaedics, Mch, FISS Ghanshyam Kakadiya, M.S Orthopaedics, DNB, MNAMS, FISS Umair Attar, DNB Orthopaedics |
| author_sort | Deepak Joshi, M.S Orthopaedics, Mch, FISS |
| collection | DOAJ |
| description | Background: To evaluate the safety and efficacy of vertebroplasty with short segmented cement augmented pedicle screws fixation for severe osteoporotic vertebral compression fractures (OVCF) with posterior/anterior wall fracture patients. Methods: A retrospective study of 48 patients of DGOU type-4 (vertebra plana) OVCF with posterior/anterior wall fracture, were treated by vertebroplasty and short segment PMMA cement augmented pedicle screws fixation. Radiological parameters (kyphosis angle and compression ratio) and clinical parameters Visual analogue scale (VAS) and Oswestry disability index (ODI) were analysed. Results: A significant improvement was noted in VAS (preoperative, 7.90±0.60; final follow-up 2.90±0.54) and ODI (77.10±6.96 to 21.30±6.70), (P<0.05). Neurological improvement was noted in all patients. Kyphosis corrected significantly from preoperative 23.20±5.90 to 5.30±1.40 postoperative with 5% (3.30±2.95) loss of correction at final follow-up. Anterior vertebral height restored significantly from 55.80±11.9% to 87.6±13.1% postoperative with 4.5±4.0% loss at final follow-up. Two cases of cement leakage were found, but both patients were asymptomatic. One patient had implant backout, one had Screw breakage and two had proximal junction kyphosis at final follow-up. No iatrogenic dural or nerve injury. Conclusions: Treatment with vertebroplasty with cement augmented screw fixation and direct decompression is a great option in treating such a complex situation in fragile age with fragile bones because. Vertebroplasty is a viable option for restoring vertebral anterior columns in patients who are considered as contraindications for vertebroplasty, like DGOU-4. It provides anterior support avoiding corpectomy, minimise blood loss, and also the duration of surgery. The addition of short segment fixation gives adequate support with less stress risers at the junctional area. |
| first_indexed | 2024-12-12T07:35:36Z |
| format | Article |
| id | doaj.art-b4cf790e116d4e5aabf50b8e6773e0b6 |
| institution | Directory Open Access Journal |
| issn | 2666-5484 |
| language | English |
| last_indexed | 2024-12-12T07:35:36Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | North American Spine Society Journal |
| spelling | doaj.art-b4cf790e116d4e5aabf50b8e6773e0b62022-12-22T00:32:56ZengElsevierNorth American Spine Society Journal2666-54842022-06-0110100111Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixationDeepak Joshi, M.S Orthopaedics, Mch, FISS0Ghanshyam Kakadiya, M.S Orthopaedics, DNB, MNAMS, FISS1Umair Attar, DNB Orthopaedics2Spine Surgeon, Department of Spine Surgery, Fortis Hospital, Sector 63, Mohali, IndiaSpine Surgeon, Department of Spine Surgery, Fortis Hospital, Sector 63, Mohali, India; Corresponding author.Spine Surgeon, Department of Spine Surgery, Fortis Hospital, Sector 63, Mohali, India; Orthopaedic Surgeon, Fortis Hospital, Sector 63, Mohali, IndiaBackground: To evaluate the safety and efficacy of vertebroplasty with short segmented cement augmented pedicle screws fixation for severe osteoporotic vertebral compression fractures (OVCF) with posterior/anterior wall fracture patients. Methods: A retrospective study of 48 patients of DGOU type-4 (vertebra plana) OVCF with posterior/anterior wall fracture, were treated by vertebroplasty and short segment PMMA cement augmented pedicle screws fixation. Radiological parameters (kyphosis angle and compression ratio) and clinical parameters Visual analogue scale (VAS) and Oswestry disability index (ODI) were analysed. Results: A significant improvement was noted in VAS (preoperative, 7.90±0.60; final follow-up 2.90±0.54) and ODI (77.10±6.96 to 21.30±6.70), (P<0.05). Neurological improvement was noted in all patients. Kyphosis corrected significantly from preoperative 23.20±5.90 to 5.30±1.40 postoperative with 5% (3.30±2.95) loss of correction at final follow-up. Anterior vertebral height restored significantly from 55.80±11.9% to 87.6±13.1% postoperative with 4.5±4.0% loss at final follow-up. Two cases of cement leakage were found, but both patients were asymptomatic. One patient had implant backout, one had Screw breakage and two had proximal junction kyphosis at final follow-up. No iatrogenic dural or nerve injury. Conclusions: Treatment with vertebroplasty with cement augmented screw fixation and direct decompression is a great option in treating such a complex situation in fragile age with fragile bones because. Vertebroplasty is a viable option for restoring vertebral anterior columns in patients who are considered as contraindications for vertebroplasty, like DGOU-4. It provides anterior support avoiding corpectomy, minimise blood loss, and also the duration of surgery. The addition of short segment fixation gives adequate support with less stress risers at the junctional area.http://www.sciencedirect.com/science/article/pii/S2666548422000142OsteoporosisVertebra planaPedicle screwPosterior fixationVertebroplastyPosterior wall fracture |
| spellingShingle | Deepak Joshi, M.S Orthopaedics, Mch, FISS Ghanshyam Kakadiya, M.S Orthopaedics, DNB, MNAMS, FISS Umair Attar, DNB Orthopaedics Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation North American Spine Society Journal Osteoporosis Vertebra plana Pedicle screw Posterior fixation Vertebroplasty Posterior wall fracture |
| title | Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation |
| title_full | Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation |
| title_fullStr | Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation |
| title_full_unstemmed | Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation |
| title_short | Time to revisit contraindications of vertebroplasty- A retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation |
| title_sort | time to revisit contraindications of vertebroplasty a retrospective study of osteoporotic burst fracture operated with vertebroplasty and short segment fixation |
| topic | Osteoporosis Vertebra plana Pedicle screw Posterior fixation Vertebroplasty Posterior wall fracture |
| url | http://www.sciencedirect.com/science/article/pii/S2666548422000142 |
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