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Clinical Outcomes of Patients Undergoing Kyphoplasty due to Vertebral Compression Fracture: A Retrospective Examination of 52 Patients

Year 2020, Volume: 6 Issue: 2, 183 - 189, 31.08.2020

Ramazan Paşahan Emek Güldoğan

https://doi.org/10.19127/mbsjohs.750579

Abstract

Objective: Osteoporosis, vertebral colon hemangiomata and metastatic tumors are among the causes of vertebral fractures. When treating vertebral fractures, the patient is rested, analgesic anti-inflammatory therapy and kyphoplasty are performed, and if there is an unstable fracture and/or neurological deficit, spinal cord decompression and stabilization are performed. Kyphoplasty is an effective method in stable fractures of the vertebrae ensuring minimal trauma, short surgical operation time and reduced pain in the early stages. In this study, clinical outcomes of 52 patients who underwent kyphoplasty at the Neurosurgery Clinic of Inonu University due to osteoporosis, vertebral hemangioma and spinal colon metastatic malignancies were discussed and presented along with the literature.
Method: In our study, quantitative data are presented with medians (minimums and maximums) or averages (standard deviations), and qualitative data are presented with counts (percentages). The assumption of normality was checked by using the Shapiro-Wilk test. Because the DEXA variable had a normal distribution (p > 0.05), one-way analysis of variance was utilized to analyze the difference between fracture types. The variables of age and Visual Analog Scale (VAS) were not normally distributed (p < 0.05), so the Kruskal Wallis H test was utilized to analyze the differences between fracture types. Pearson’s chi-squared test was used to investigate how fracture sites were related to age groups and gender. p < .05 was considered statistically significant.
Results: A total of 52 patients who did not require surgery at the Neurosurgery Clinic of Inonu University but underwent kyphoplasty between January 1, 2010 and April 1, 2020 were included in the study. Of these patients, 45 underwent kyphoplasty due to osteoporotic vertebral fractures, 3 due to vertebral hemangioma, and 4 due to spinal metastasis. All patients were compared in terms of age, gender, fracture sites, DEXA, preoperative VAS scores and VAS scores on day 20.
Conclusion: Kyphoplasty is an effective method for the treatment of stable vertebral fractures caused by osteoporosis, spinal metastases and vertebral hemangiomata

Keywords

Kyphoplasty Vertebral metastasis Hemangioma,

References

  • Acosta Jr, F. L., C. F. Dowd, C. Chin, T. Tihan, C. P. Ames & P. R. Weinstein. Current treatment strategies and outcomes in the management of symptomatic vertebral hemangiomas. Neurosurgery; 2006;58(2):287-295.
  • Berenson, J., R. Pflugmacher, P. Jarzem, J. Zonder, K. Schechtman, J. B. Tillman, L. Bastian, T. Ashraf, F. Vrionis & C. P. F. E. Investigators. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. The lancet oncology; 2011;12(3):225-235.
  • Bolat, E. S. & S. Mıstık. Yerleşmiş Osteoporozda Teriparatid Tedavisinin Spinal Deformite İndeksi Üzerine Etkisi. Turk J Osteoporos; 2019;25:6-11.
  • Cakir, B., C. Carazzo, R. Schmidt, T. Mattes, H. Reichel & W. Käfer. Adjacent segment mobility after rigid and semirigid instrumentation of the lumbar spine. Spine; 2009;34(12):1287-1291.
  • Chen, C., P. Fan, X. Xie & Y. Wang. Risk Factors for Cement Leakage and Adjacent Vertebral Fractures in Kyphoplasty for Osteoporotic Vertebral Fractures. Clinical Spine Surgery; 2020;33(6):E251-E255.
  • Chi, J. H., G. T. Manley & D. Chou. Pregnancy-related vertebral hemangioma: case report, review of the literature, and management algorithm. Neurosurgical focus; 2005;19(3):1-7.
  • Choi, S. H., D.-Y. Kim, J. W. Koo, S. G. Lee, S.-Y. Jeong & C.-N. Kang. Incidence and management trends of osteoporotic vertebral compression fractures in South Korea: a nationwide population-based study. Asian Spine Journal; 2020;14(2):220.
  • Georgy, B. A. Vertebroplasty technique in metastatic disease. Neuroimaging Clinics; 2010;20(2):169-177.
  • Gerszten, P. C. & W. C. Welch. Current surgical management of metastatic spinal disease. 2000.
  • Hernlund, E., A. Svedbom, M. Ivergård, J. Compston, C. Cooper, J. Stenmark, E. V. McCloskey, B. Jönsson & J. A. Kanis. Osteoporosis in the European Union: medical management, epidemiology and economic burden. Archives of osteoporosis; 2013;8(1-2):136.
  • Itagaki, M. W., A. D. Talenfeld, S. W. Kwan, J. W. Brunner, K. E. Mortell & M. C. Brunner. Percutaneous vertebroplasty and kyphoplasty for pathologic vertebral fractures in the Medicare population: safer and less expensive than open surgery. Journal of Vascular and Interventional Radiology; 2012;23(11):1423-1429.
  • Kan, S.-L., Z.-F. Yuan, L.-X. Chen, J.-C. Sun, G.-Z. Ning & S.-Q. Feng. Which is best for osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty or non-surgical treatment? A study protocol for a Bayesian network meta-analysis. BMJ open; 2017;7:e012937.
  • Kanis, J., O. Johnell, A. Odén, C. De Laet & D. Mellstrom. Epidemiology of osteoporosis and fracture in men. Calcified tissue international; 2004;75(2):90-99.
  • Koyuncu, H., S. Karamehmetoğlu, C. Bahadır & K. Akgün. Postmenopozal vertebral kompresyon fraktürü sıklığı: Yaş, boy, kilo, boy/kulaç, menopoz süresi ilişkisinin değerlendirilmesi. Osteoporoz Dünyasından; 1996;2:81-84.
  • Liu, Q., J. Cao & J. Kong. Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture. Nigerian journal of clinical practice; 2019;22(3):289.
  • Liu, Y., Y. Wang, L. Zhao, R. Song, H. Tan & L. Wang. Effectiveness and safety of percutaneous vertebroplasty in the treatment of spinal metastatic tumor. Pakistan journal of medical sciences; 2017; 33(3):675.
  • Movrin, I. Adjacent level fracture after osteoporotic vertebral compression fracture: a nonrandomized prospective study comparing balloon kyphoplasty with conservative therapy. Wiener Klinische Wochenschrift;2012;124(9-10):304-311.
  • Nigro, L. Algorithm of treatment for extensive vertebral hemangiomas according to Tomita classification of vertebral tumors. Journal of Neurology and Neuroscience;2017;8(02).
  • Peh, W. C., L. A. Gilula & D. D. Peck. Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology; 2002; 223(1):121-126.
  • Pflugmacher, R., F. Kandziora, R.-J. Schroeder, I. Melcher, N. Haas & C. Klostermann. Percutaneous balloon kyphoplasty in the treatment of pathological vertebral body fracture and deformity in multiple myeloma: a one-year follow-up. Acta Radiologica; 2006;47(4):369-376.
  • Saracen, A. & Z. Kotwica. Vertebroplasty (PVP) is effective in the treatment of painful vertebral hemangiomas. Acta Orthopædica Belgica; 2018;84:105-107.
  • Siris, E., Y. Chen & T. Abbott a, Barrett-Connor E, Miller PD, Wehren LE, Berger ML. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med.; 2004;164(10):1108–1112.
  • Uei, H. & Y. Tokuhashi. Prognostic factors in patients with metastatic spine tumors derived from lung cancer—a novel scoring system for predicting life expectancy. World journal of surgical oncology;2018;16(1):131.
  • Wang, Y., H. Liu, B. Pi, H. Yang, Z. Qian & X. Zhu. Clinical evaluation of percutaneous kyphoplasty in the treatment of osteolytic and osteoblastic metastatic vertebral lesions. International Journal of Surgery; 2016;30:161-165.
  • Zhang, H.-T., G.-D. Chen, H.-L. Yang & Z.-P. Luo. Percutaneous kyphoplasty in the treatment of osteoblastic-related spinal metastases. Clinical spine surgery; 2017;30(2):80-84.
  • Zhang, Y.-L., L.-T. Shi, P.-F. Tang, Z.-J. Sun & Y.-H. Wang. Correlation analysis of osteoporotic vertebral compression fractures and spinal sagittal imbalance. Der Orthopäde; 2017;46(3):249-255.
  • Zhou, Z., Y. Wang, Z. Sun & Z. Qian. Safety of Cement Distribution Patterns in Metastatic Vertebral Tumors: A Retrospective Study. Medical science monitor: international medical journal of experimental and clinical research; 2019; 25:7228.
  • Zhu, K., C. Zhang & C. Shao. Research progress of secondary fracture of adjacent vertebral body after percutaneous vertebroplasty and percutaneous kyphoplasty. Zhongguo xiu fu chong jian wai ke za zhi= Zhongguo xiufu chongjian waike zazhi= Chinese journal of reparative and reconstructive surgery; 2013;27(3):369-373.
  • Zuo, X.-H., X.-P. Zhu, H.-G. Bao, C.-J. Xu, H. Chen, X.-Z. Gao & Q.-X. Zhang. Network meta-analysis of percutaneous vertebroplasty, percutaneous kyphoplasty, nerve block, and conservative treatment for nonsurgery options of acute/subacute and chronic osteoporotic vertebral compression fractures (OVCFs) in short-term and long-term effects. Medicine; 2018;97(29).

Year 2020, Volume: 6 Issue: 2, 183 - 189, 31.08.2020

Ramazan Paşahan Emek Güldoğan

https://doi.org/10.19127/mbsjohs.750579

Abstract

References

  • Acosta Jr, F. L., C. F. Dowd, C. Chin, T. Tihan, C. P. Ames & P. R. Weinstein. Current treatment strategies and outcomes in the management of symptomatic vertebral hemangiomas. Neurosurgery; 2006;58(2):287-295.
  • Berenson, J., R. Pflugmacher, P. Jarzem, J. Zonder, K. Schechtman, J. B. Tillman, L. Bastian, T. Ashraf, F. Vrionis & C. P. F. E. Investigators. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. The lancet oncology; 2011;12(3):225-235.
  • Bolat, E. S. & S. Mıstık. Yerleşmiş Osteoporozda Teriparatid Tedavisinin Spinal Deformite İndeksi Üzerine Etkisi. Turk J Osteoporos; 2019;25:6-11.
  • Cakir, B., C. Carazzo, R. Schmidt, T. Mattes, H. Reichel & W. Käfer. Adjacent segment mobility after rigid and semirigid instrumentation of the lumbar spine. Spine; 2009;34(12):1287-1291.
  • Chen, C., P. Fan, X. Xie & Y. Wang. Risk Factors for Cement Leakage and Adjacent Vertebral Fractures in Kyphoplasty for Osteoporotic Vertebral Fractures. Clinical Spine Surgery; 2020;33(6):E251-E255.
  • Chi, J. H., G. T. Manley & D. Chou. Pregnancy-related vertebral hemangioma: case report, review of the literature, and management algorithm. Neurosurgical focus; 2005;19(3):1-7.
  • Choi, S. H., D.-Y. Kim, J. W. Koo, S. G. Lee, S.-Y. Jeong & C.-N. Kang. Incidence and management trends of osteoporotic vertebral compression fractures in South Korea: a nationwide population-based study. Asian Spine Journal; 2020;14(2):220.
  • Georgy, B. A. Vertebroplasty technique in metastatic disease. Neuroimaging Clinics; 2010;20(2):169-177.
  • Gerszten, P. C. & W. C. Welch. Current surgical management of metastatic spinal disease. 2000.
  • Hernlund, E., A. Svedbom, M. Ivergård, J. Compston, C. Cooper, J. Stenmark, E. V. McCloskey, B. Jönsson & J. A. Kanis. Osteoporosis in the European Union: medical management, epidemiology and economic burden. Archives of osteoporosis; 2013;8(1-2):136.
  • Itagaki, M. W., A. D. Talenfeld, S. W. Kwan, J. W. Brunner, K. E. Mortell & M. C. Brunner. Percutaneous vertebroplasty and kyphoplasty for pathologic vertebral fractures in the Medicare population: safer and less expensive than open surgery. Journal of Vascular and Interventional Radiology; 2012;23(11):1423-1429.
  • Kan, S.-L., Z.-F. Yuan, L.-X. Chen, J.-C. Sun, G.-Z. Ning & S.-Q. Feng. Which is best for osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty or non-surgical treatment? A study protocol for a Bayesian network meta-analysis. BMJ open; 2017;7:e012937.
  • Kanis, J., O. Johnell, A. Odén, C. De Laet & D. Mellstrom. Epidemiology of osteoporosis and fracture in men. Calcified tissue international; 2004;75(2):90-99.
  • Koyuncu, H., S. Karamehmetoğlu, C. Bahadır & K. Akgün. Postmenopozal vertebral kompresyon fraktürü sıklığı: Yaş, boy, kilo, boy/kulaç, menopoz süresi ilişkisinin değerlendirilmesi. Osteoporoz Dünyasından; 1996;2:81-84.
  • Liu, Q., J. Cao & J. Kong. Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture. Nigerian journal of clinical practice; 2019;22(3):289.
  • Liu, Y., Y. Wang, L. Zhao, R. Song, H. Tan & L. Wang. Effectiveness and safety of percutaneous vertebroplasty in the treatment of spinal metastatic tumor. Pakistan journal of medical sciences; 2017; 33(3):675.
  • Movrin, I. Adjacent level fracture after osteoporotic vertebral compression fracture: a nonrandomized prospective study comparing balloon kyphoplasty with conservative therapy. Wiener Klinische Wochenschrift;2012;124(9-10):304-311.
  • Nigro, L. Algorithm of treatment for extensive vertebral hemangiomas according to Tomita classification of vertebral tumors. Journal of Neurology and Neuroscience;2017;8(02).
  • Peh, W. C., L. A. Gilula & D. D. Peck. Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology; 2002; 223(1):121-126.
  • Pflugmacher, R., F. Kandziora, R.-J. Schroeder, I. Melcher, N. Haas & C. Klostermann. Percutaneous balloon kyphoplasty in the treatment of pathological vertebral body fracture and deformity in multiple myeloma: a one-year follow-up. Acta Radiologica; 2006;47(4):369-376.
  • Saracen, A. & Z. Kotwica. Vertebroplasty (PVP) is effective in the treatment of painful vertebral hemangiomas. Acta Orthopædica Belgica; 2018;84:105-107.
  • Siris, E., Y. Chen & T. Abbott a, Barrett-Connor E, Miller PD, Wehren LE, Berger ML. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med.; 2004;164(10):1108–1112.
  • Uei, H. & Y. Tokuhashi. Prognostic factors in patients with metastatic spine tumors derived from lung cancer—a novel scoring system for predicting life expectancy. World journal of surgical oncology;2018;16(1):131.
  • Wang, Y., H. Liu, B. Pi, H. Yang, Z. Qian & X. Zhu. Clinical evaluation of percutaneous kyphoplasty in the treatment of osteolytic and osteoblastic metastatic vertebral lesions. International Journal of Surgery; 2016;30:161-165.
  • Zhang, H.-T., G.-D. Chen, H.-L. Yang & Z.-P. Luo. Percutaneous kyphoplasty in the treatment of osteoblastic-related spinal metastases. Clinical spine surgery; 2017;30(2):80-84.
  • Zhang, Y.-L., L.-T. Shi, P.-F. Tang, Z.-J. Sun & Y.-H. Wang. Correlation analysis of osteoporotic vertebral compression fractures and spinal sagittal imbalance. Der Orthopäde; 2017;46(3):249-255.
  • Zhou, Z., Y. Wang, Z. Sun & Z. Qian. Safety of Cement Distribution Patterns in Metastatic Vertebral Tumors: A Retrospective Study. Medical science monitor: international medical journal of experimental and clinical research; 2019; 25:7228.
  • Zhu, K., C. Zhang & C. Shao. Research progress of secondary fracture of adjacent vertebral body after percutaneous vertebroplasty and percutaneous kyphoplasty. Zhongguo xiu fu chong jian wai ke za zhi= Zhongguo xiufu chongjian waike zazhi= Chinese journal of reparative and reconstructive surgery; 2013;27(3):369-373.
  • Zuo, X.-H., X.-P. Zhu, H.-G. Bao, C.-J. Xu, H. Chen, X.-Z. Gao & Q.-X. Zhang. Network meta-analysis of percutaneous vertebroplasty, percutaneous kyphoplasty, nerve block, and conservative treatment for nonsurgery options of acute/subacute and chronic osteoporotic vertebral compression fractures (OVCFs) in short-term and long-term effects. Medicine; 2018;97(29).
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case reports
Authors

Ramazan Paşahan 0000-0002-3221-1422

Emek Güldoğan 0000-0002-5436-8164

Publication Date August 31, 2020
Published in Issue Year 2020 Volume: 6 Issue: 2

Cite

Vancouver Paşahan R, Güldoğan E. Clinical Outcomes of Patients Undergoing Kyphoplasty due to Vertebral Compression Fracture: A Retrospective Examination of 52 Patients. Mid Blac Sea J Health Sci. 2020;6(2):183-9.
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