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Acta Neurochirurgica
Article . 2009 . Peer-reviewed
License: Springer TDM
Data sources: Crossref
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Percutaneous vertebroplasty for the treatment of osteoporotic burst fractures

Authors: Jun Jae, Shin; Dong Kyu, Chin; Young Sul, Yoon;

Percutaneous vertebroplasty for the treatment of osteoporotic burst fractures

Abstract

Vertebroplasty is a minimally invasive surgical procedure which involves injecting polymethylmethacrylate into the compressed vertebral body. At present the indications include the treatment of osteoporotic compression fractures, vertebral myeloma, and metastases. The value of vertebroplasty in osteoporotic compression fracture has been discussed comprehensively. The surgical operation for burst fractures without neurological deficit remains controversial. Some authors have asserted that vertebroplasty is contraindicated in patients with burst fracture. However, we performed the procedure, after considering the patents general condition, to reduce surgical risks and the duration of immobilisation. The purpose of this study is to investigate clinical outcomes, kyphosis correction, wedge angle, and height restoration of thoraco-lumbar osteoporotic burst fractures treated by percutaneous vertebroplasty.Twenty-five patients with osteoporotic burst fracture were treated with postural reduction followed by vertebroplasty. We measured the kyphosis, wedge angle, spinal canal compromise and the height of the fractured vertebral body initially, after postural reduction, and after vertebroplasty.The average height of the collapsed vertebral bodies was 24.8% of the original height. Average kyphosis angle was 19.4 degrees and average wedge angle was 19.8 degrees at first. Mean canal encroachment was initially 25.1%. Kyphosis angle, wedge angle, and anterior, middle, and posterior height improved significantly after the procedure. The mean amelioration of the spinal canal encroachment after vertebroplasty was 23.3%. The average increase in anterior vertebral body height was 7.5 mm, central was 5.8 mm, and posterior was 0.9 mm. The mean reduction in kyphosis angle was 6.8 degrees and the mean reduction in wedge angle was 9.7 degrees .Although vertebroplasty has been considered as contraindicated in thoraco-lumbar burst fractures, we successfully used the procedure as a safe treatment in patients with osteoporotic burst fracture without neurologic deficit. This method could eliminate the need for and risks of major spinal surgery. We would like to offer it as a relatively safe and effective methods of management in thoraco-lumbar burst fractures.

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Keywords

Male, Thoracic Vertebrae/diagnostic imaging, Minimally Invasive Surgical Procedures/methods, Percutaneous vertebroplasty, Postural reduction, Kyphosis/surgery, Spinal Stenosis, Spinal Stenosis/etiology, Lumbar Vertebrae/surgery*, Vertebroplasty/methods*, Spinal Fractures/diagnostic imaging, Tomography, Lumbar Vertebrae, Age Factors, Thoracic Vertebrae/surgery*, Spinal Fractures/pathology, Back Pain/surgery, Magnetic Resonance Imaging, X-Ray Computed, Treatment Outcome, Spinal Stenosis/surgery, Burst fracture, Spinal Fractures, Female, Kyphosis/pathology, Thoraco-lumbar spine, Lumbar Vertebrae/diagnostic imaging, 610, Thoracic Vertebrae, Back Pain/physiopathology, Lumbar Vertebrae/pathology, Spinal Stenosis/pathology, Osteoporosis/complications*, Minimally Invasive Surgical Procedures/statistics & numerical data, Humans, Minimally Invasive Surgical Procedures, Kyphosis, Spinal Fractures/surgery*, Aged, Vertebroplasty/statistics & numerical data, Vertebroplasty, Kyphosis/etiology, Back Pain/etiology, Back Pain, Osteoporosis, Thoracic Vertebrae/pathology, Tomography, X-Ray Computed

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
27
Top 10%
Top 10%
Top 10%
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