Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective Analysis
Study Design Retrospective case-control study. Purpose To evaluate the primary outcomes and radiographic results of percutaneous vertebroplasty (PVP) in patients with singlelevel osteoporotic vertebral fracture (OVF) with intravertebral cleft (IVC) to identify the risk factors for cement loosening a...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2018-10-01
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| Series: | Asian Spine Journal |
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| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2018-12-5-935.pdf |
| _version_ | 1819267198923833344 |
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| author | Toshio Nakamae Kiyotaka Yamada Yasuyuki Tsuchida Orso Lorenzo Osti Nobuo Adachi Yoshinori Fujimoto |
| author_facet | Toshio Nakamae Kiyotaka Yamada Yasuyuki Tsuchida Orso Lorenzo Osti Nobuo Adachi Yoshinori Fujimoto |
| author_sort | Toshio Nakamae |
| collection | DOAJ |
| description | Study Design Retrospective case-control study. Purpose To evaluate the primary outcomes and radiographic results of percutaneous vertebroplasty (PVP) in patients with singlelevel osteoporotic vertebral fracture (OVF) with intravertebral cleft (IVC) to identify the risk factors for cement loosening after PVP. Overview of Literature PVP is a widely accepted method for managing painful OVF; however, cement loosening occasionally occurs with poor outcomes. Methods This retrospective study involved 195 patients treated with PVP for single-level OVF with IVC. Six months thereafter, the primary outcomes were evaluated using the Visual Analog Scale (VAS) for back pain and the modified Oswestry Disability Index. Computed tomography was conducted to detect cement loosening. Possible risk factors, such as age, sex, wedging angle, intravertebral instability, Parkinson’s disease, spinous process fracture, ankylosing spinal hyperostosis, split vertebrae, and adjacent intervertebral vacuum, were assessed. Results Forty-nine patients (25%) experienced cement loosening 6 months after PVP. The mean VAS scores were significantly higher in patients with cement loosening than in those without (50 vs. 26 mm, respectively; p <0.01). Cement loosening was closely associated with intravertebral instability (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04–1.40; p =0.015), Parkinson’s disease (OR, 54.31; 95% CI, 4.47–659.53; p =0.002), spinous process fracture (OR, 7.11; 95% CI, 1.65–30.60; p =0.009), and split vertebrae (OR, 11.59; 95% CI, 1.64–82.02; p =0.014). Conclusions Patients with cement loosening experienced worse back pain than those without cement loosening. The important risk factors that influenced cement loosening after PVP were high intravertebral instability, Parkinson’s disease, spinous process fracture, and split vertebrae. |
| first_indexed | 2024-12-23T21:13:22Z |
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| id | doaj.art-d986f040acfe484fbada2510dafc6952 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-23T21:13:22Z |
| publishDate | 2018-10-01 |
| publisher | Korean Spine Society |
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| series | Asian Spine Journal |
| spelling | doaj.art-d986f040acfe484fbada2510dafc69522022-12-21T17:30:59ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462018-10-0112593594210.31616/asj.2018.12.5.935951Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective AnalysisToshio Nakamae0Kiyotaka Yamada1Yasuyuki Tsuchida2Orso Lorenzo Osti3Nobuo Adachi4Yoshinori Fujimoto5 Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, Japan Department of Radiology, JA Hiroshima General Hospital, Hiroshima, Japan Spinal Service, Calvary Health Care, North Adelaide Campus, North Adelaide, SA, Australia Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan Department of Orthopaedic Surgery, JA Hiroshima General Hospital, Hiroshima, JapanStudy Design Retrospective case-control study. Purpose To evaluate the primary outcomes and radiographic results of percutaneous vertebroplasty (PVP) in patients with singlelevel osteoporotic vertebral fracture (OVF) with intravertebral cleft (IVC) to identify the risk factors for cement loosening after PVP. Overview of Literature PVP is a widely accepted method for managing painful OVF; however, cement loosening occasionally occurs with poor outcomes. Methods This retrospective study involved 195 patients treated with PVP for single-level OVF with IVC. Six months thereafter, the primary outcomes were evaluated using the Visual Analog Scale (VAS) for back pain and the modified Oswestry Disability Index. Computed tomography was conducted to detect cement loosening. Possible risk factors, such as age, sex, wedging angle, intravertebral instability, Parkinson’s disease, spinous process fracture, ankylosing spinal hyperostosis, split vertebrae, and adjacent intervertebral vacuum, were assessed. Results Forty-nine patients (25%) experienced cement loosening 6 months after PVP. The mean VAS scores were significantly higher in patients with cement loosening than in those without (50 vs. 26 mm, respectively; p <0.01). Cement loosening was closely associated with intravertebral instability (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.04–1.40; p =0.015), Parkinson’s disease (OR, 54.31; 95% CI, 4.47–659.53; p =0.002), spinous process fracture (OR, 7.11; 95% CI, 1.65–30.60; p =0.009), and split vertebrae (OR, 11.59; 95% CI, 1.64–82.02; p =0.014). Conclusions Patients with cement loosening experienced worse back pain than those without cement loosening. The important risk factors that influenced cement loosening after PVP were high intravertebral instability, Parkinson’s disease, spinous process fracture, and split vertebrae.http://www.asianspinejournal.org/upload/pdf/asj-2018-12-5-935.pdfPercutaneous vertebroplastyOsteoporotic vertebral fractureCement looseningIntravertebral cleftSpinous process fracture |
| spellingShingle | Toshio Nakamae Kiyotaka Yamada Yasuyuki Tsuchida Orso Lorenzo Osti Nobuo Adachi Yoshinori Fujimoto Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective Analysis Asian Spine Journal Percutaneous vertebroplasty Osteoporotic vertebral fracture Cement loosening Intravertebral cleft Spinous process fracture |
| title | Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective Analysis |
| title_full | Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective Analysis |
| title_fullStr | Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective Analysis |
| title_full_unstemmed | Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective Analysis |
| title_short | Risk Factors for Cement Loosening after Vertebroplasty for Osteoporotic Vertebral Fracture with Intravertebral Cleft: A Retrospective Analysis |
| title_sort | risk factors for cement loosening after vertebroplasty for osteoporotic vertebral fracture with intravertebral cleft a retrospective analysis |
| topic | Percutaneous vertebroplasty Osteoporotic vertebral fracture Cement loosening Intravertebral cleft Spinous process fracture |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2018-12-5-935.pdf |
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