Liu, Hai-Xiao
(Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University)
,
Xu, Cong
(Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University)
,
Shang, Ping
(Department of Rehabilitation, Second Affiliated Hospital of Wenzhou Medical University)
,
Shen, Yue
(Department of Orthopaedic Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine)
,
Xu, Hua-Zi
(Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University)
Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral ...
Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. Results : Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and $5.34^{\circ}$ compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by $8.32^{\circ}$ (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). Conclusion : In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.
Objective : To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction. Methods : A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group. Results : Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and $5.34^{\circ}$ compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by $8.32^{\circ}$ (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05). Conclusion : In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.
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문제 정의
The aim of the present study is to evaluate whether balloon inflation restores sagittal alignment after postural correction in acute OVCFs. This study also tests the hypothesis that the degree of deformity correction is related to BMD in the patients with OVCFs.
The aim of the present study is to evaluate whether balloon inflation restores sagittal alignment after postural correction in acute OVCFs. This study also tests the hypothesis that the degree of deformity correction is related to BMD in the patients with OVCFs.
제안 방법
The fracture was detected in preoperative standing anteroposterior and lateral radiographs. Further examinations were performed to provide an evidence of edema in the fractured vertebral body on T2-weighted images and to evaluate the phenomenon of intravertebral vacuum cleft by magnetic resonance imaging (MRI) scan in all patients.
We evaluated the effect of postural correction on height restoration and sagittal realignment in the osteopenia and osteoporosis groups, respectively (Table 1). In both groups, postural correction improved Ha, Hm, Hp, Kyphotic angle and Cobb angle significantly (each p<0.
데이터처리
Comparisons between different time points were performed using a paired sample t-test. Comparisons between different groups were performed using the independent sample t-test or chi-square test. Differences were considered as statistically significant with a p value of less than 0.
To test for precision in measurements, we used the intraclass correlation. Comparisons between different time points were performed using a paired sample t-test. Comparisons between different groups were performed using the independent sample t-test or chi-square test.
For numeric data, mean±SD were calculated. To test for precision in measurements, we used the intraclass correlation. Comparisons between different time points were performed using a paired sample t-test.
성능/효과
2) suggested that postural correction rather than balloon inflation led to a significant restoration of vertebral height which was in conflict with several other studies. In his study, the mild and moderate OVCFs were in the majority with preoperative compression ratio of 72%. We also found that the treated vertebra reached maximal restoration after intra-operative postural reduction and little height restoration was observed by subsequently using balloon kyphoplasty in mild or moderate OVCFs.
Moreover, postural correction led to greater improvements of Ha, Hm, Kyphotic angle and Cobb angle in osteoporosis group compared with osteopenia group (each p<0.05).
참고문헌 (24)
1 Boonen S Van Meirhaeghe J Bastian L Cummings SR Ranstam J Tillman JB Balloon kyphoplasty for the treatment of acute vertebral compression fractures : 2-year results from a randomized trial J Bone Miner Res 2011 26 1627 1637 21337428
2 Cawley DT Sexton P Murphy T McCabe JP Optimal patient positioning for ligamentotaxis during balloon kyphoplasty of the thoracolumbar and lumbar spine J Clin Neurosci 2011 18 834 836 21489799
3 Chen YJ Lo DF Chang CH Chen HT Hsu HC The value of dynamic radiographs in diagnosing painful vertebrae in osteoporotic compression fractures AJNR Am J Neuroradiol 2011 32 121 124 20930002
4 Crandall D Slaughter D Hankins PJ Moore C Jerman J Acute versus chronic vertebral compression fractures treated with kyphoplasty : early results Spine J 2004 4 418 424 15246303
5 Faciszewski T McKiernan F Calling all vertebral fractures classification of vertebral compression fractures : a consensus for comparison of treatment and outcome J Bone Miner Res 2002 17 185 191 11811548
6 Feltes C Fountas KN Machinis T Nikolakakos LG Dimopoulos V Davydov R Immediate and early postoperative pain relief after kyphoplasty without significant restoration of vertebral body height in acute osteoporotic vertebral fractures Neurosurg Focus 2005 18 e5 15771395
7 Gaitanis IN Hadjipavlou AG Katonis PG Tzermiadianos MN Pasku DS Patwardhan AG Balloon kyphoplasty for the treatment of pathological vertebral compressive fractures Eur Spine J 2005 14 250 260 15480827
8 Genant HK Wu CY van Kuijk C Nevitt MC Vertebral fracture assessment using a semiquantitative technique J Bone Miner Res 1993 8 1137 1148 8237484
9 Hiwatashi A Westesson PL Yoshiura T Nuguchi T Toqao O Yamashita K Kyphoplasty and vertebroplasty produce the same degree of height restoration AJNR Am J Neuroradiol 2009 30 669 673 19131409
10 Jager PL Jonkman S Koolhaas W Stiekema A Wolffenbuttel BH Slart RH Combined vertebral fracture assessment and bone mineral density measurement : a new standard in the diagnosis of osteoporosis in academic populations Osteoporos Int 2011 22 1059 1068 20571773
11 Kim HS Ju CI Kim SW Lee SM Shin H Balloon kyphoplasty in severe osteoporotic compression fracture : is it a contraindication? Neurosurgery 2007 60 1 6
12 Lane JM Girardi F Parvaianen H Preliminary outcomes of the first 226 consecutive kyphoplasties for the fixation of painful osteoporotic vertebral compression fractures Osteoporosis Int 2002 11 Suppl S206
13 Ledlie JT Renfro MB Kyphoplasty treatment of vertebral fractures : 2-year outcomes show sustained benefits Spine (Phila Pa 1976) 2006 31 57 64 16395177
14 Lee JH Kwon JT Kim YB Suk JS Segmental deformity correction after balloon kyphoplasty in the osteoporotic vertebral compression fracture J Korean Neurosurg Soc 2007 42 371 376 19096572
15 Lieberman IH Dudeney S Reinhardt MK Bell G Initial outcome and efficacy of "kyphoplasty" in the treatment of painful osteoporotic vertebral compression fractures Spine (Phila Pa 1976) 2001 26 1631 1638 11464159
16 Masala S Fiori R Massari F Cantonetti M Postorino M Simonetti G Percutaneous kyphoplasty : indications and technique in the treatment of vertebral fractures from myeloma Tumori 2004 90 22 26 15143966
18 Phillips FM Ho E Campbell-Hupp M McNally T Todd Wetzel F Gupta P Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures Spine (Phila Pa 1976) 2003 28 2260 2265 discussion 2265-2267 14520041
19 Shindle MK Gardner MJ Koob J Bukata S Cabin JA Lane JM Vertebral height restoration in osteoporotic compression fractures : kyphoplasty balloon tamp is superior to postural correction alone Osteoporos Int 2006 17 1815 1819 16983458
20 Siris ES Miller PD Barrett-Connor E Faulkner KG Wehren LE Abbott TA Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women : results from the National Osteoporosis Risk Assessment JAMA 2001 286 2815 2822 11735756
21 Teng MM Wei CJ Wei LC Luo CB Lirng JF Chang FC Kyphosis correction and height restoration effects of percutaneous vertebroplasty AJNR Am J Neuroradiol 2003 24 1893 1900 14561624
22 Theodorou DJ Theodorou SJ Duncan TD Garfin SR Wong WH Percutaneous balloon kyphoplasty for the correction of spinal deformity in painful vertebral body compression fractures Clin Imaging 2002 26 1 5 11814744
23 Voggenreiter G Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures Spine (Phila Pa 1976) 2005 30 2806 2812 16371909
24 Voggenreiter G Lenz E Obertacke U Effectiveness of vertebroplasty and kyphoplasty in height restoration of osteoporotic vertebral compression fractures Akt Traumatol 2006 36 1 5
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