Abstract
Background: Percutaneous vertebroplasty (PVP) has been gradually used for osteoporotic vertebral compression fracture (OVCF) treatment, but severe osteoporotic vertebral body compression fractures (sOVCFs) due to the difficulty in performing a puncture and the characteristics of the fractured vertebrae, it has been considered as a contraindication to PVP. The aim of the following study was to evaluate the feasibility of a unilateral, three-dimensional (3D), accurate puncture in percutaneous vertebroplasty (PVP) for a single, severely osteoporotic vertebral body compression fracture (ssOVCFs).
Materials and Methods: 57 patients received PVP in the current study. Feasibility of a unilateral approach was judged before surgery using the 64-slice helical computed tomography (CT) multiplanar reconstruction technique, a 3D accurate puncture plan was then determined. The skin bone distance, puncture angle and needle insertion depth were recorded during surgery. 2D CT rechecking was performed for any complication at day 1 after operation. Preoperative and postoperative numerical data were compared.
Results: The procedure was completed smoothly in all patients. 2D CT scanning at day 1 after operation did not show any puncture related complications. Visual analog scoring (VAS) showed that the score at day 3 after surgery was reduced to 1.7 ± 0.4 (0–2.9 scale) from the preoperative 7.9 ± 2.1 (6.1–9.5 scale). No significant differences in measure numerical data were found before and after the surgery. At 12 months followup three patients presented with nonadjacent level fractures, VAS for other patients were 1.2 ± 0.3 (0–2.1 scale).
Conclusions: Application of CT scanning for a unilateral 3D puncture design helps realize an accurate puncture in PVP. It is a safe and effective method for ssOVCFs treatment.
Similar content being viewed by others
References
Gangi A, Kastler BA, Dietemann JL. Percutaneous vertebroplasty guided by a combination of CT and fluoroscopy. AJNR Am J Neuroradiol 1994;15:83–6.
Galibert P, Deramond H, Rosat P, Le Gars D. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty. Neurochirurgie 1987;33:166–8.
Deramond H, Darrasson R, Galibert P. Percutaneous vertebroplasty with acrytic cement in the treatment of aggressive spinal angiomas. Rachis 1989;1:143–53.
He SC, Teng GJ, Deng G, Fang W, G JH, Zhu GY, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fractures with intraosseous cystic cavitary phenomena. J Intervent Radiol 2005;14:256–60.
Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: Technical aspects. AJNR Am J Neuroradiol 1997;18:1897–904.
Mathis JM, Petri M, Naff N. Percutaneous vertebroplasty treatment of steroid-induced osteoporotic compression fractures. Arthritis Rheum 1998;41:171–5.
Cyteval C, Sarrabère MP, Roux JO, Thomas E, Jorgensen C, Blotman F, et al. Acute osteoporotic vertebral collapse: Open study on percutaneous injection of acrylic surgical cement in 20 patients. AJR Am J Roentgenol 1999; 173:1685–90.
Cortet B, Cotten A, Boutry N, Flipo RM, Duquesnoy B, Chastanet P, et al. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: An open prospective study. J Rheumatol 1999;26:2222–8.
Ploeg WT, Veldhuizen AG, The B, Sietsma MS. Percutaneous vertebroplasty as a treatment for osteoporotic vertebral compression fractures: A systematic review. Eur Spine J 2006;15:1749–58.
Winking M, Stahl JP, Oertel M, Schnettler R, Böker DK. Treatment of pain from osteoporotic vertebral collapse by percutaneous PMMA vertebroplasty. Acta Neurochir (Wien) 2004; 146:469–76.
Evans AJ, Jensen ME, Kip KE, DeNardo AJ, Lawler GJ, Negin GA, et al. Vertebral compression fractures: Pain reduction and improvement in functional mobility after percutaneous polymethylmethacrylate vertebroplasty retrospective report of 245 cases. Radiology 2003;226:366–72.
Muijs SP, Nieuwenhuijse MJ, Van Erkel AR, Dijkstra PD. Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures: Evaluation after 36 months. J Bone Joint Surg Br 2009;91:379–84.
DePalma MJ, Ketchum JM, Frankel BM, Frey ME. Percutaneous vertebroplasty for osteoporotic vertebral compression fractures in the nonagenarians: A prospective study evaluating pain reduction and new symptomatic fracture rate. Spine (Phila Pa 1976) 2011;36:277–82.
Nieuwenhuijse MJ, van Erkel AR, Dijkstra PD. Percutaneous vertebroplasty in very severe osteoporotic vertebral compression fractures: Feasible and beneficial. J Vase Interv Radiol 2011;22:1017–23.
Peh WC, Gilula LA. Percutaneous vertebroplasty: Indications, contraindications, and technique. Br J Radiol 2003;76:69–75.
Peh WC, Gilula LA, Peck DD. Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures. Radiology 2002;223:121–6.
Rad AE, Gray LA, Kallmes DF. Significance and targeting of small, central clefts in severe fractures treated with vertebroplasty. AJNR Am J Neuroradiol 2008;29:1285–7.
O’Brien JP, Sims JT, Evans AJ. Vertebroplasty in patients with severe vertebral compression fractures: A technical report. AJNR Am J Neuroradiol 2000;21:1555–8.
Hentschel SJ, Rhines LD, Shah HN, Burton AW, Mendel E. Percutaneous vertebroplasty in vertebra plana secondary to metastasis. J Spinal Disord Tech 2004;17:554–7.
Kobayashi K, Takizawa K, Koyama M, Yoshimatsu M, Sakaino S, Nakajima Y. Unilateral transpedicular percutaneous vertebroplasty using puncture simulation. Radiat Med 2006;24:187–94.
Weill A, Chiras J, Simon JM, Rose M, Sola-Martinez T, Enkaoua E. Spinal metastases: Indications for and results of percutaneous injection of acrylic surgical cement. Radiology 1996;199:241–7.
Deramond H, Depriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results. Radiol Clin North Am 1998;36:533–46.
Cotten A, Boutry N, Cortet B, Assaker R, Demondion X, Leblond D, et al. Percutaneous vertebroplasty: State of the art. Radiographics 1998;18:311–20.
Zhang QW, Chen ZQ, Xue QY, Sun. Characters and clinical value of MRI signal changes in osteoporotic vertebral compressive fracture (OVCF) in kyphoplasty. Bone Tumor Dis China 2010;9:80–3.
Guo XD, Yuan JH, Hang XJ. Impact of endplate facture on prognosis of thoracolumbar fracture. Orthop J China 2010;18:1153–6.
Kim AK, Jensen ME, Dion JE, Schweickert PA, Kaufmann TJ, Kallmes DF. Unilateral transpedicular percutaneous vertebroplasty: Initial experience. Radiology 2002;222:737–41.
Yang XM, Wu TL, Xu HG, Wang H, Liu P, Wang LT, et al. Modified unilateral transpedicular percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures. Orthop J China 2011;3:247–52.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Li, HD., Xu, CJ., Wang, H. et al. Percutaneous vertebroplasty for single osteoporotic vertebral body compression fracture. IJOO 49, 245–250 (2015). https://doi.org/10.4103/0019-5413.152514
Published:
Issue Date:
DOI: https://doi.org/10.4103/0019-5413.152514
Key words
- Percutaneous vertebroplasty
- severe vertebral body compression fractures
- three-dimensional accurate puncture