AI Chat Paper
Note: Please note that the following content is generated by AMiner AI. SciOpen does not take any responsibility related to this content.
{{lang === 'zh_CN' ? '文章概述' : 'Summary'}}
{{lang === 'en_US' ? '中' : 'Eng'}}
Chat more with AI
PDF (925.7 KB)
Collect
AI Chat Paper
Show Outline
Outline
Show full outline
Hide outline
Outline
Show full outline
Hide outline
Original Article | Open Access

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”

Zunwang Li1Jiang Chen1Dekui Li( )Jiayu YangJiaqi QinYuqing Guan
Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China

1 These authors have contributed equally to this work.

Peer review under responsibility of Beijing University of Chinese Medicine.

Show Author Information

Abstract

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 occurrence. The 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 groups.

Results

Regarding pain relief and functional activity, the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved. Furthermore, the deformities of the injured vertebrae in the three groups were significantly corrected, with Groups A and B exhibiting superior correction compared to Group C. Moreover, the bone cement leakage rates in groups A and C were higher than that in Group B. At the 3-month follow-up, the loss of vertebral height in Group C was significantly higher than those in groups A and B.

Conclusion

Kyphoplasty is effective for OVCF treatment. Early 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 safer. Therefore, surgical treatment within 1–3 weeks of fracture is safer and can achieve satisfactory therapeutic effects. From 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”.

References

1

Prost S, Pesenti S, Fuentes S, et al. Treatment of osteoporotic vertebral fractures. Orthop Traumatol Surg Res. 2021;107(1S):102779.

2

Ballane G, Cauley JA, Luckey MM, et al. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int. 2017;5:1531-1542.

3

Kim HJ, Zuckerman SL, Cerpa M, et al. Incidence and risk factors for complications and mortality after vertebroplasty or kyphoplasty in the osteoporotic vertebral compression fracture-analysis of 1932 cases from the American college of surgeons national surgical quality improvement. Global Spine J. 2022;12(6):1125-1134.

4

Cui L, Chen L, Xia W, et al. Vertebral fracture in postmenopausal Chinese women: a population-based study. Osteoporos Int. 2017;28(9):2583 -2590.

5

Yu F, Xia W. The epidemiology of osteoporosis, associated fragility fractures, and management gap in China. Arch Osteoporosis. 2019;14(1):32.

6

Si L, Winzenberg TM, Jiang Q, et al. Projection of osteoporosis-related fractures and costs in China: 2010-2050. Osteoporos Int. 2015;26(7):1929-1937.

7

Kutsal FY, Ergin Ergani GO. Vertebral compression fractures: still an unpredictable aspect of osteoporosis. Turk J Med. 2021;51(2):393-399.

8

Alsoof D, Anderson G, McDonald CL, et al. Diagnosis and management of vertebral compression fracture. Am J Med. 2022;135(7):815-821.

9

Sui T, Chen J, Huang ZF, et al. Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients. Chin J Traumatol. 2022;38(12):1057-1066 [Chinese].

10

Lems WF, Dreinhöfer KE, Bischoff-Ferrari H, et al. EULAR/EFORT recommendations for management of patients older than 50 years with a fragility fracture and prevention of subsequent fractures. Ann Rheum Dis. 2017;76(5):802-810.

11

Zhang J, He X, Fan Y, et al. Risk factors for conservative treatment failure in acute osteoporotic vertebral compression fractures. Arch Osteoporosis. 2019;14(1):24.

12

Martikos K, Greggi T, Faldini C, et al. Osteoporotic thoracolumbar compression fractures: long-term retrospective comparison between vertebroplasty and conservative treatment. Eur Spine J. 2018;27(S2):244-247.

13

Liu Q, Cao J, Kong JJ. Clinical effect of balloon kyphoplasty in elderly patients with multiple osteoporotic vertebral fracture. Niger J Clin Pract. 2019;22(3):289-292.

14

Denaro L, Longo UG, Denaro V. Vertebroplasty and kyphoplasty: reasons for concern? Orthop Clin N Am. 2009;40(4):465-471.

15

Colangelo D, Nasto LA, Genitiempo M, et al. Kyphoplasty vs. conservative treatment: a case-control study in 110 post-menopausal women population. Is kyphoplasty better than conservative treatment? Eur Rev Med Pharmacol. 2015;19(21):3998-4003.

16

Belkoff SM, Mathis JM, Erbe EM, et al. Biomechanical evaluation of a new bone cement for use in vertebroplasty. Spine. 2000;25(9):1061-1064.

17

Hadley C, Awan OA, Zoarski GH. Biomechanics of vertebral bone augmentation. Neuroimaging Clin. 2010;20(2):159-167.

18

Tolba R, Bolash RB, Shroll J, et al. Kyphoplasty increases vertebral height, decreases both pain score and opiate requirements while improving functional status. Pain Pract. 2014;14(3):E91-E97.

19

Bai M, Yin H, Zhao J, et al. Application of PMMA bone cement composited with bone-mineralized collagen in percutaneous kyphoplasty. Regen Biomater. 2017;4(4):251-255.

20

Lai PL, Chen LH, Chen WJ, et al. Chemical and physical properties of bone cement for vertebroplasty. Biomed J. 2013;36(4):162-167.

21

Wang F, Wang LF, Miao DC, et al. Which one is more effective for the treatment of very severe osteoporotic vertebral compression fractures: PVP or PKP? J Pain Res. 2018;11:2625-2631.

22

Daher M, Kreichati G, Kharrat K, et al. Vertebroplasty versus Kyphoplasty in the Treatment of osteoporotic vertebral compression fractures: a meta-analysis. World Neurosurg. 2023;171:65-71.

23

Zhao DH, Chen K, Zhu J, et al. Postoperative functional evaluation of percutaneous vertebroplasty compared with percutaneous Kyphoplasty for vertebral compression fractures. Am J Therapeut. 2016;23(6):e1381-e1390.

24

Zhang HW, Li YZ, Wang ZP, et al. Correlation discussion on TCM theory of “dynamic-static integration” and mechanism of adaptive remodeling of bone load. Chin J Inf Tradit Chin Med. 2021;28(4):17-20 [Chinese].

25

Yeom JS, Kim WJ, Choy WS, et al. Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures. J Bone Joint Surg Br. 2003;85(1):83-89.

26

Baker CE, Moore-Lotridge SN, Hysong AA, et al. Bone fracture acute phase response-a unifying theory of fracture repair: clinical and scientific implications. Clin Rev Bone Miner Metabol. 2018;16(4):142-158.

27

Bahney CS, Zondervan RL, Allison P, et al. Cellular biology of fracture healing. J Orthop Res. 2019;37(1):35-50.

28

Wang X, Friis T, Glatt V, et al. Structural properties of fracture haematoma: current status and future clinical implications. J Tissue Eng Regen Med. 2017;11(10):2864-2875.

29

Krüger A, Oberkircher L, Kratz M, et al. Cement interdigitation and bone-cement interface after augmenting fractured vertebrae: a cadaveric study. Internet J Spine Surg. 2012;6:115-123.

30

Jin ZX, Shu B, Wang Q, et al. Research progress of TCM syndrome differentiation in the treatment of osteoporotic fractures. Chin J Osteoporos. 2020;26(12):1843-1846[Chinese].

31

Niu J, Zhou H, Meng Q, et al. Factors affecting recompression of augmented vertebrae after successful percutaneous balloon kyphoplasty: a retrospective analysis. Acta Radiol. 2015;56(11):1380-1387.

32

Dong ST, Zhu J, Yang H, et al. Development and internal validation of supervised machine learning algorithm for predicting the risk of recollapse following minimally invasive kyphoplasty in osteoporotic vertebral compression fractures. Front Public Health. 2022;10:874672.

33

Qi Y, Zeng Y, Jiang C, et al. Comparison of percutaneous kyphoplasty versus modified percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures. World Neurosurg. 2019;122:e1020-e1027.

34

Lu J, Huang L, Chen W, et al. Bilateral percutaneous kyphoplasty achieves more satisfactory outcomes compared to unilateral percutaneous kyphoplasty in osteoporotic vertebral compression fractures: a comprehensive comparative study. J Back Musculoskelet Rehabil. 2023;36(1):97-105.

35

Wang C, Zhang X, Liu J, et al. Percutaneous kyphoplasty: risk factors for recollapse of cemented vertebrae. World Neurosurg. 2019;130:e307-e315.

36

Xie W, Jin D, Ma H, et al. Cement leakage in percutaneous vertebral augmentation for osteoporotic vertebral compression fractures: analysis of risk factors. Clin Spine Surg. 2016;29(4):E171-E176.

37

Luthman S, Widén J, Borgström F. Appropriateness criteria for treatment of osteoporotic vertebral compression fractures. Osteoporos Int. 2018;29(4):793-804.

38

Chen C, Fan P, Xie X, et al. Risk factors for cement leakage and adjacent vertebral fractures in kyphoplasty for osteoporotic vertebral fractures. Clin Spine Surg. 2020;33(6):E251-E255.

39

Anssen I, Ryang YM, Gempt J, et al. Risk of cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine. Spine J. 2017;17(6):837-844.

40

Guo HZ, Tang YC, Guo DQ, et al. The cement leakage in cement-augmented pedicle screw instrumentation in degenerative lumbosacral diseases: a retrospective analysis of 202 cases and 950 augmented pedicle screws. Eur Spine J. 2019;28(7):1661-1669.

41

Ren H, Shen Y, Zhang YZ, et al. Correlative factor analysis on the complications resulting from cement leakage after percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture. J Spinal Disord Tech. 2010;23(7):e9-e15.

42

Guan H, Yang H, Mei X, et al. Early or delayed operation, which is more optimal for kyphoplasty? a retrospective study on cement leakage during kyphoplasty. Injury. 2012;43(10):1698-1703.

Journal of Traditional Chinese Medical Sciences
Pages 86-92
Cite this article:
Li Z, Chen J, Li D, et al. 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”. Journal of Traditional Chinese Medical Sciences, 2024, 11(1): 86-92. https://doi.org/10.1016/j.jtcms.2023.12.006

247

Views

5

Downloads

0

Crossref

0

Scopus

Altmetrics

Received: 15 October 2023
Revised: 04 December 2023
Accepted: 04 December 2023
Published: 07 December 2023
© 2024 Beijing University of Chinese Medicine.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Return