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Intervertebral bridging ossification after kyphoplasty in a Parkinson’s patient with Kummell’s disease:A case report

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World Journal of Clinical Cases 2022年第2期10卷 677-684页

作者： Jie Li Yun Liu Lei Peng Jian Liu Zhi-Dong Cao Miao He Department of Orthopaedic Surgery Chongqing Emergency Medical Center(Chongqing University Central Hospital)Chongqing 400010China Department of Radiology Chongqing Emergency Medical Center(Chongqing University Central Hospital)Chongqing 400010China

BACKGROUND The short-term therapeutic efficacy of kyphoplasty on Kummell’s disease is ***,postoperative refracture and adjacent vertebral fracture occur occasionally and are difficult to ***'s disease(PD)is a pathological disorder associated with heterotopic *** a patient with PD,an intervertebral bridge was formed in a short period of time after postoperative refracture and adjacent vertebral fracture,providing new *** SUMMARY A 78-year-old woman had been suffering from PD for more than 10 *** months before operation,she developed lower back pain and *** visual analog scale(VAS)score was 9 *** magnetic resonance imaging indicated collapse of the L2 *** was performed and significantly decreased the severity of intractable *** patient’s VAS score for pain improved from 9 to *** days postoperatively,the patient suddenly developed severe back pain,and the VAS score was 9 points.X-ray showed L2 vertebral body collapse,slight forward bone cement displacement,L1 vertebral compression fracture,and severe L1 *** patient was given calcium acetate capsules 0.6 g po qd and alfacalcidol 0.5ug po qd,and bed rest and brace protection were *** conservative treatment for 2 mo,the patient's back pain was alleviated,and the VAS score improved from 9 to *** tomography at the 7-mo follow-up indicated extensive callus formation around the T12-L2 vertebrae and intervertebral bridging ossification,providing new *** kyphoplasty is currently a conventional treatment for Kummell's disease,with definite short-term ***,complications still occur in the long term,and these complications are difficult to address;thus,the treatment needs to be selected *** avoid refracture,an interlaced structure of bone cement with trabeculae should be created to the greatest extent possible during the injection of bone *** interven

关键词： Kummell's disease Parkinson's disease kyphoplasty Refracture Heterotopic ossification Case report

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Pedicle Screw Fixation with kyphoplasty Decreases the Fracture Risk of the Treated and Adjacent Non-treated Vertebral Bodies:a Finite Element Analysis

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2016年第6期36卷 887-894页

作者： Pan YANG Ying ZHANG Huan-wen DING Jian LIU Lin-qiang YE Jin XIAO Qiang TU Tao YANG Fei WANG Guo-gang SUN Orthopedic Hospital Guangzhou General Hospital of People＇s Liberation Army Guangzhou 510010 China Department of Orthopedics Chongqing Traditional Chinese Medicine Hospital （the First People＇s Hospital of Chongqing） Chongqing 400011 China Department of Spinal Surgery the First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou 510006 China Department of Anatomy Southwest Medical University Luzhou 646000 China

Adjacent vertebral fractures are common in patients with osteoporotic vertebral compression fractures（OVCFs） after *** finite element study was to examine whether short segment pedicle screw fixation（PSF） with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae after kyphoplasty for *** simulating cement augmentation with or without short segment pedicle screw fixation（PSF）,two tridimensional,anatomically detailed finite element models of the T10–L2 functional spinal junction were *** insertion of pedicle screws into the intact vertebra apparently decreased the stress distribution of the treated vertebra in vertical compression and other load *** stress distribution in the bone structures of the intact vertebra adjacent to the intact-screwed vertebra was much less than that in the one adjacent to the treated *** insertion of pedicle screws into the intact vertebra greatly decreased the maximum displacement of the cortical bones and cancellous bones of the *** results indicated that short segment PSF with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae in the management of OVCFs.

关键词： finite element analysis osteoporotic vertebral compression fractures kyphoplasty biomechanics pedicle screw fixation

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Clinical efficacy and safety of kyphoplasty for the treatment of osteoporotic vertebral compression fractures at different surgical timings based on the theory of“dynamic-static integration”

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Journal of Traditional Chinese Medical Sciences 2024年第1期11卷 86-92页

作者： Zunwang Li Jiang Chen Dekui Li Jiayu Yang Jiaqi Qin Yuqing Guan Dongzhimen Hospital Beijing University of Chinese MedicineBeijing 100700China

Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-static integration”.Methods:Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A,B,and C for those undergoing surgery within 7,7—21,and>21 days of fracture *** variations in the amount of bone cement injected,pre-and post-operative pain levels,functional activity,deformity correction of the injured vertebrae,bone cement leakage,and vertebral body height loss were compared among the three ***:Regarding pain relief and functional activity,the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly ***,the deformities of the injured vertebrae in the three groups were significantly corrected,with Groups A and B exhibiting superior correction compared to Group ***,the bone cement leakage rates in groups A and C were higher than that in Group *** the 3-month follow-up,the loss of vertebral height in Group C was significantly higher than those in groups A and ***:kyphoplasty is effective for OVCF *** surgery can effectively restore the vertebral height of the injured vertebra,reduce kyphosis,and reduce height loss of the injured vertebra after surgery;nevertheless,treatment within 1—3 weeks of the fracture can reduce the occurrence of bone cement leakage,making the surgery ***,surgical treatment within 1—3 weeks of fracture is safer and can achieve satisfactory therapeutic *** the perspective of traditional Chinese medicine,PKP surgery can transform the fracture end from a micromotion state to a fixed state,which fully embodies the theory of“dynamic-static integration”.

关键词： kyphoplasty Operation timing Bone cement leakage Lost height of injured vertebra

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kyphoplasty versus vertebroplasty for the treatment of malignant vertebral compression fractures caused by metastases： a retrospective study

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Chinese Medical Journal 2014年第8期127卷 1493-1496页

作者： Li Zhi Ni Caifang Chen Long Sun Zhiyong Yang Chao Zhao Xin Wang Yanwei Department of Interventional Radiology the First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China Department of Orthopaedic Surgery the First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China Department of General Surgery the First Affiliated Hospital of Soochow University Suzhou Jiangsu 215006 China

Background There are few comparative studies regarding kyphoplasty （KP） and vertebroplasty （VP） for the treatment of painful vertebral compression fractures （VCF） in patients with cancer. The purpose of this study is to retrospectively compare KP with VP in pain improvement, cement leakage incidence, and the cost of treatment of malignant VCE Methods We performed a retrospective study of clinical data for 80 patients with multiple spinal metastases, treated with KP in 42 cases and VP in 38. Visual analog scale （VAS） scores were collected pre-operatively, post-operatively, at 1 month, 6 months, and 1 year after treatment. Cement leakage was identified using fluoroscopy and CT scan. Total cost per patient was also collected. Results There was a significant difference between the pre- and post-operative VAS scores （7.4＋2.0 to 3.8＋1.6, P 〈0.001 in the KP group; 6.7＋2.4 to 3.7＋1.4, P 〈0.001 in the VP group）, and was maintained at 1-year follow-up （3.2＋1.4 in the KP group, 3.1＋1.3 in the VP group）. However, the difference in VAS score between these two groups was insignificant at baseline and every follow-up assessment post-operatively （P 〉0.05）. The incidence of cement leakage in the KP group was lower than that of the VP group （16.9% （14/83） vs 30.3% （23/76）, P 〈0.05）. However, none of the patients developed any symptoms. The length of postoperative hospital stay in the VP group was shorter than that of the KP group （（2.4＋1.3） vs （5.3＋1.9） days, P 〈0.05）. Total hospital cost in the KP group was much higher than that of the VP group （RMB Yuan 8 492_＋3 332 vs RMB Yuan 3 173~1 341, P〈0.01）. Conclusions VP and KP are both effective in providing pain relief for patients with cancer-related VCF. KP provides no greater degree of pain improvement. KP is associated with a lower rate of cement leakage compared with VP. VP is associated with lower cost and shorter postoperative hospital stay in China.

关键词： spinal metastases vertebral compression fractures kyphoplasty vertebroplasty

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Vertebral fracture assessment:Current research status and application in patients with kyphoplasty

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World Journal of Orthopedics 2015年第9期6卷 680-687页

作者： Efstathios Drampalos Konstantinos Nikolopoulos Christos Baltas Alexia Balanika Antonis Galanos Nikolaos Papaioannou Spyros Pneumaticos Laboratory for the Research of the Musculoskeletal System (LRMS) Faculty of MedicineUniversity of Athens Center for Hip Surgery Wrightington Hospital C’ Orthopedic Department University of Athens"K.A.T" Hospital

Imaging of the spine is of paramount importance for the recognition of osteoporotic vertebral fractures(VFs), and standard radiography(SR) of the spine is the suggested diagnostic method but is not routinely used because of the cost and radiation exposure considerations. VF assessment(VFA) is an efficient, low radiation method for identifying VFs at the time of bone mineral density(BMD) measurement. Prediction models used to indicate the need for VFA may have little predictive power in subspecialty referral populations such as rheumatologic patients or patients who underwent kyphoplasty. Rheumatologic patients are frequently at increased risk for VFs, and VFA should be performed on an individual basis, also taking in account the guidelines for the general population. kyphoplasty is a new minimal invasive procedure for the treatment of VFs and is being performed with increasing frequency. Following kyphoplasty, there may be a risk of new VFs in adjacent vertebrae. The assessment and follow-up of patients who underwent kyphoplasty requires repetitive X-ray imaging with the known limitations of SR. Thus, VFA may facilitate the evaluation of VFs in these patients because most of the kyphoplasty patients would fulfill the criteria. In a pilot study, we measured the BMD and performed VFA in 28 patients treated with kyphoplasty. Ratios of anterior to posterior(A/P) and middle to posterior(M/P) height were measured, and Genant's method was used to classify vertebrae accordingly. Intraobserver and interobserver reliability for A/P, M/P and the Genant's method were determined. Only 1 patient did not meet the criteria for VFA. Of the 364 available vertebrae, 295 could be analyzed. Most missing data(concerning 69 vertebrae) occurred in the upper thoracic region. Three of the 69 non-eligible vertebrae were lumbar vertebrae with cement leakage from the kyphoplasty procedure. In our hands, VFA was highly reproducible, demonstrating very good agreement in terms of intraobserver and

关键词： Vertebral fracture assessment Current research kyphoplasty Guideline

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Biomechanical assessment of new surgical method instead of kyphoplasty to improve the mechanical behavior of the vertebra:Micro finite element study

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World Journal of Orthopedics 2017年第11期8卷 829-835页

作者： Seyed Aref Hosseini Faradonbeh Nima Jamshidi Department of Biomedical Engineering Faculty of Engineering University of Isfahan

AIM To reduce post treatments of kyphoplasty, as a common treatment for osteoporotic *** This study suggests a new method for treating vertebrae by setting the hexagonal porous structure instead of the rigid bone cement mass in the kyphoplasty(KP). The KP procedure was performed on the fresh ovine vertebra of the level L1. Micro finite element modeling was performed based on micro computed tomography of ovine trabecular cube. The hexagonal porous structure was set on one cube instead of the bone cement mass. For the implant designing, two geometrical parameters were considered: Spacing diameter and *** The results of micro finite element analyses indicated the improvement in the mechanical behavior of the vertebra treated by the hexagonal porous structures, as compared to those treated by vertebroplasty(VP) and KP under static loading. The improvement in the mechanical behavior of the vertebra, was observed as 54% decrease in the amount of maximum Von Misses stress(improvement of stress distribution), in trabecular cube with embedded hexagonal structure, as compared to VP and KP. This is comparable to the results of the experimental study already performed; it was shown that the improvement of mechanical behavior of the vertebra was observed as: 83% increase in the range of displacements before getting to the ultimate strength(increasing the toughness) after setting hexagonal pearls inside vertebrae. Both the material and geometry of implant influenced the amount of Von Mises stress in the *** The new proposed method can be offered as a substitute for the KP. The implant geometry had a more obvious effect on the amount of Von Mises stress, as compared to the implant material.

关键词： Vertebroplasty kyphoplasty Micro finite element modeling Hexagonal porous structure Von mises stress

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Preliminary study on a single balloon cross-midline expansion via unipedicular approach in kyphoplasty

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Chinese Medical Journal 2008年第18期121卷 1811-1814页

作者： SUN Gang JIN Peng LI Fan-dong LIU Xun-wei HAO Run-song YI Yu-hai XIE Zhi-yong Department of Medical Imaging Jinan Military General Hospital of People's Liberation Army Jinan Shandong 250031 China

Background Recently, bilateral transpedicular kyphoplasty with a single balloon was performed for osteoporotic vertebral body compression fractures （OVCFs） to reduce the fees of the operation, but the time of operation and radiation exposure are longer. The aim of this study was to determine the safety and effectiveness of a single balloon cross-midline expansion via unipedicular approach in kyphoplasty for OVCFs. Methods Thirty-six patients with painful OVCFs （61 vertebrae） were enrolled in this research. Unilateral transpedicular puncture was performed under the fluoroscopy monitoring of an oblique angle down the pedicle. A single balloon was introduced through unipedicular approach, The final balloon position was in the midline of the vertebral body with the balloon cross-midline expansion and bone cement filled. Clinical outcomes were determined by comparison of the preoperative and postoperative visual analogue scale （VAS） and Oswestry disability index （ODI）. Radiographic assessment included restoration of vertebral height and correction of kyphosis. Follow-up was conducted for 6-12 months （mean 9.2 months）. Results Thirty-six consecutive patients with 61 vertebrae were successfully operated on with a mean operation time of 37.4 minutes per vertebra. All patients had dramatic pain relief and functional recovery within 96 hours after the procedure with no surgery or device-related complications. VAS score improved from 7.27±1.02 preoperatively to 2.71±0.75 postoperatively （P 〈0.01）. ODI score was decreased from （71.14±10.94）% preoperatively to （26.56±6.35）% postoperatively. The average loss of anterior body height was （14.33±2.76） mm before procedure and （10.03±1.83） mm after procedure （P 〈0.01）, while the average loss of middle body height was （10.15±2.70） mm before procedure and （5.89±1.83） mm after procedure （P 〈0.01）. The kyphotic deformity was corrected from （23.43±5.00） degree to （16.16±2.77） degree （P 〈0.01）. The pain relief and functional recovery were s

关键词： radiology, interventional kyphoplasty osteoporosis spinal fractures

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Depression of the Thoracolumbar Posterior Vertebral Body on the Estimation of Cement Leakage in Vertebroplasty and kyphoplasty Operations

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Chinese Medical Journal 2015年第23期128卷 3158-3162页

作者： Hao Chen Pu Jia Li Bao Fei Feng He Yang Jin-Jun Li Hai Tang Department of Orthopaedics Beijing Friendship Hospital Capital Medical University Beijing 100050 China

Background： The cross-section ofthoracolumbar vertebral body is kidney-shaped with depressed posterior boundary. The anterior wall of the vertebral canal is separated from the posterior wall of the vertebral body on the lateral X-ray image. This study was designed to determine the sagittal distance between the anterior border of the vertebral canal and the posterior border of the vertebral body （DBCV） and to analyze the potential role of DBCV in the estimation of cement leakage during percutaneous vertebroplasty （PVP） or percutaneous kyphoplasty （PKP）. Methods： We retrospectively recruited 233 patients who had osteoporotic vertebral compression fractures and were treated with PVP or PKP. Computed tomography images of T11-L2 normal vertebrae were measured to obtain DBCV. The distance from cement to the posterior wall of the vertebral body （DCPW） of thoracolumbar vertebrae was measured from C-arm images. The selected vertebrae were divided into two groups according to DCPW, with the fracture levels, fracture grades and leakage rates of the two groups compared. A relative operating characteristic （ROC） curve was applied to determine whether the DCPW difference can be used to estimate the degree of cement leakage. The data were processed by statistical software SPSS version 21.0 using independent sample t-test and Chi-square tests. Results： The maximum DBCV was 6.40 mm and the average DBCV was 3.74 ± 0.95 mm. DBCV appeared to be longer in males than in females, but the difference was not statistically significant. The average DCPW of type-B leakage vertebrae （2.59 ±1.20 ram） was shorter than that of other vertebrae （7.83 ±2.38 mm, P 〈 0.001）. The leakage rate of group DCPW ≤6.40 mm was lower than that of group DCPW 〉6.40 mm for type-C and type-S, but much higher for type-B. ROC curve revealed that DCPW only has a predictive value for type-B leakage （area under the curve： 0.98, 95% confidence interval： 0.95-0.99, P 〈 0.001）, and when the cut-ott＇value was 4.05 mm, the di

关键词： C-arm Image Complications kyphoplasty Vertebrae Vertebroplasty

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Preliminary clinical outcomes of percutaneous kyphoplasty with Sky-bone expander

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Chinese Medical Journal 2007年第9期120卷 761-766页

作者： ZHENG Zhao-min KUANG Guan-ming DONG Zhi-yong K.M.C. Cheung William W. Lu LI Fo-bao Department of Spine Surgery First Affiliated Hospital of Sun Yat-sen University Guangzhou 510080 China Department of Orthopaedics and Traumatology University of Hong Kong Hong Kong China

Background Percutaneous kyphoplasty （PKP） using balloon expander has been proved to be effective in the treatment of painful vertebral compression fractures. Recently, Sky-bone expander, an alternative bone expander for PKP has been developed. The purpose of this study was to show our preliminary clinical outcomes of PKP with Sky-bone expander. Methods PKP with Sky-bone expander was performed in 25 patients （30 vertebrae）. The operation time, bleeding volume, cement volume injected were recorded. The pain and functional activities of the patients before and after the operation were compared using Wilcoxon signed-rank test. The cement distribution in the vertebrae, vertebral height restoration, and kyphosis correction after the procedure were evaluated by radiography. The pre- and post-operative absolute values of the vertebral height and kyphotic angle were compared by paired-sample t test. All the patients were followed up by telephone or clinic consulting after being discharged from our hospital. Results The procedure was performed successfully in all the patients. Bipedicular injection was used in 2 of the patients, and unipedicular injection was made in the others. The operation time ranged from 25 to 120 minutes （45 minutes per vertebra on average）. The average bleeding volume was about 20 ml. Polymethylmethacrylate 1.5-5.0 ml （mean, （3.15±0.78） ml） was injected through each pedicle into all the patients except one, who received calcium sulphate 3.5 ml instead. The patients were followed up for 12-15 months （13.5 months on average）. The mean visual analogue scale （VAS） score, Oswestry Disability Index, anterior, midline, and posterior vertebral height, and kyphotic angle of the patients were improved significantly at the end of the follow-up compared with those before the operation. （2.5± 1.3, 35.1%, （20.94±6.15） mm, （20.26±4.59） mm, （26.72±3.49） mm, and 8.2 degrees vs. 8.5±1.9, 61.2%, （19.11±6.72） mm, （15.88±5.73） mm, （25.78±3.67） mm, and 17.3 degrees; all

关键词： kyphoplasty fracture, compression osteoporosis

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Treatment of osteoporotic vertebral compressive fractures with percutaneous kyphoplasty and oral Zishengukang

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Journal of Traditional Chinese Medicine 2012年第4期32卷 561-564页

作者： Zhenjun Huang Lijian Zhang Rehabilitation Centre of the 309th Hospital of the People's Liberation Army of China

OBJECTIVE:To observe the therapeutic effect of percutaneous kyphoplasty(PKP) and oral Zishengukang(ZSGK) for the treatment of osteoporotic vertebral compression fractures(OVCFs).METHODS:Seventy patients were randomly divided into a control group(PKP group) and an experimental group(PKP plus ZSGK group).The 35 patients in the experimental group were prescribed 6 g oral ZSGK three times a day for 90 days after *** analog pain scale(VAS),Oswestry functional score,vertebral height and Cobb's angle were recorded and compared before treatment and at one week,one month and three months after ***:Vertebral height and Cobb's angle significantly improved and VAS and Oswestry functional score were significantly lower in both groups after PKP than pre-operatively(P0.05).CONCLUSION:PKP combined with oral ZSGK provide superior short-term and long-term symptom control after OVCF than PKP alone.

关键词： Osteoporosis Fractures, Compression kyphoplasty Zishengukang pill

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