Therapeutic effects of new-type hydraulic delivery vertebroplasty, balloon kyphoplasty and conventional pusher-type vertebroplasty on single segmental osteoporotic vertebral compression fracture

Zhang,Ping; Zhong,Zhi-Hong; Yu,Hao-Tao; Zhou,Wei; Li,Jian

doi:10.3892/etm.2018.6624

Therapeutic effects of new-type hydraulic delivery vertebroplasty, balloon kyphoplasty and conventional pusher-type vertebroplasty on single segmental osteoporotic vertebral compression fracture

Authors:
- Ping Zhang
- Zhi-Hong Zhong
- Hao-Tao Yu
- Wei Zhou
- Jian Li
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Affiliations: Department of Orthopaedic, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, P.R. China
Published online on: August 20, 2018 https://doi.org/10.3892/etm.2018.6624
Pages: 3553-3561
Copyright: © Zhang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This study aims to evaluate safety and practicality in clinical application for better guidance of single segmental osteoporotic vertebral compression fractures treatment. From May 2012 to September 2013, a total of 188 cases of patients with fractures, who received different treatment, were incorporated in the study and then divided into: group A (n=59), conventional pusher-type vertebroplasty; group B (n=54), balloon kyphoplasty; group C (n=60), new-type hydraulic delivery vertebroplasty treatment. The overall follow-up rate was 92.02%. Postoperative visual analogue scale (VAS) and Oswestry disability index (ODI) scores were significantly improved more than those of the preoperative scores in the three groups. Bone cement injection volumes in group A were significantly lower than those in group B and group C. Vertebral height recovery rates among groups were obviously different, showing statistical significance. After a year of follow-up, the vertebral height recovery outcome in group A was obviously poorer than that in group B and group C. A poorer outcome in group B was also found when compared with group C. In addition, the vertebral height restoration had a certain degree of loss, with the loss rate of 20.5, 14.0 and 7.5% in the three groups, respectively. Three operation methods have equivalent effects in the improvement of symptoms and functional recovery. Therefore, the new-type hydraulic delivery vertebroplasty provides a relatively more concise operation and shorter operation time, displaying more outstanding performance of clinical efficacy in spinal reconstruction and reduction of complications risks by evaluating the diffusion of the bone cement, vertebral height restoration rate and postoperative complications.

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1	DESA, . World Population Prospects: The 2012 Revision. Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. New York: 2013
2	Harper S: Economic and social implications of aging societies. Science. 346:587–591. 2014. View Article : Google Scholar : PubMed/NCBI
3	Bliuc D, Alarkawi D, Nguyen TV, Eisman JA and Center JR: Risk of subsequent fractures and mortality in elderly women and men with fragility fractures with and without osteoporotic bone density: The Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res. 30:637–646. 2015. View Article : Google Scholar : PubMed/NCBI
4	Fernández-Ruiz M, Guerra-Vales JM, Trincado R, Medrano MJ, Benito-León J and Bermejo-Pareja F: Hip fracture in three elderly populations of central Spain: Data from the NEDICES study. Intern Emerg Med. 9:33–41. 2014. View Article : Google Scholar : PubMed/NCBI
5	Svensson HK, Olofsson EH, Karlsson J, Hansson T and Olsson LE: A painful, never ending story: Older women's experiences of living with an osteoporotic vertebral compression fracture. Osteoporos Int. 27:1729–1736. 2016. View Article : Google Scholar : PubMed/NCBI
6	Stauff MP and Carragee EJ: Vertebral compression fracture rules. Spine J. 14:971–972. 2014. View Article : Google Scholar : PubMed/NCBI
7	Sinaki M: Yoga spinal flexion positions and vertebral compression fracture in osteopenia or osteoporosis of spine: Case series. Pain Pract. 13:68–75. 2013. View Article : Google Scholar : PubMed/NCBI
8	Ha KY, Park KS, Kim SI and Kim YH: Does bisphosphonate-based anti-osteoporosis medication affect osteoporotic spinal fracture healing? Osteoporos Int. 27:483–488. 2016. View Article : Google Scholar : PubMed/NCBI
9	Su FM, Chen YC, Cheng TT, Lin WC and Lui CC: Is raloxifene associated with lower risk of mortality in postmenopausal women with vertebral fractures after vertebroplasty?: A hospital-based analysis. BMC Musculoskelet Disord. 16:2092015. View Article : Google Scholar : PubMed/NCBI
10	Lazzari AA, Dussault PM, Thakore-James M, Gagnon D, Baker E, Davis SA and Houranieh AM: Prevention of bone loss and vertebral fractures in patients with chronic epilepsy - antiepileptic drug and osteoporosis prevention trial. Epilepsia. 54:1997–2004. 2013. View Article : Google Scholar : PubMed/NCBI
11	Chen AT, Cohen DB and Skolasky RL: Impact of non-operative treatment, vertebroplasty, and kyphoplasty on survival and morbidity after vertebral compression fracture in the medicare population. J Bone Joint Surg Am. 95:1729–1736. 2013. View Article : Google Scholar : PubMed/NCBI
12	Chen HG, Zhang Z, Liang HP, Kong QZ, Chen JH and Zhou Y: Clinical observation of effects and complications of the mid-stage in treating osteoporotic vertebral compression fracture with percutaneous kyphoplasty. Zhongguo Gu Shang. 23:743–745. 2010.(In Chinese). PubMed/NCBI
13	Ma XL, Xing D, Ma JX, Xu WG, Wang J and Chen Y: Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: Grading the evidence through a systematic review and meta-analysis. Eur Spine J. 21:1844–1859. 2012. View Article : Google Scholar : PubMed/NCBI
14	Tseng YY, Su CH, Lui TN, Yeh YS and Yeh SH: Prospective comparison of the therapeutic effect of teriparatide with that of combined vertebroplasty with antiresorptive agents for the treatment of new-onset adjacent vertebral compression fracture after percutaneous vertebroplasty. Osteoporos Int. 23:1613–1622. 2012. View Article : Google Scholar : PubMed/NCBI
15	Gu YF, Li YD, Wu CG, Sun ZK and He CJ: Safety and efficacy of percutaneous vertebroplasty and interventional tumor removal for metastatic spinal tumors and malignant vertebral compression fractures. AJR Am J Roentgenol. 202:W298–W305. 2014. View Article : Google Scholar : PubMed/NCBI
16	Tomé-Bermejo F, Piñera AR, Duran-Álvarez C, López-San Román B, Mahillo I and Alvarez L: Identification of risk factors for the occurrence of cement leakage during percutaneous vertebroplasty for painful osteoporotic or malignant vertebral fracture. Spine. 39:E693–E700. 2014. View Article : Google Scholar : PubMed/NCBI
17	Lai PL, Tai CL, Chu IM, Fu TS, Chen LH and Chen WJ: Hypothermic manipulation of bone cement can extend the handling time during vertebroplasty. BMC Musculoskelet Disord. 13:1982012. View Article : Google Scholar : PubMed/NCBI
18	Boger A, Benneker LM, Krebs J, Boner V, Heini PF and Gisep A: The effect of pulsed jet lavage in vertebroplasty on injection forces of PMMA bone cement: An animal study. Eur Spine J. 18:1957–1962. 2009. View Article : Google Scholar : PubMed/NCBI
19	Zhu SY, Zhong ZM, Wu Q and Chen JT: Risk factors for bone cement leakage in percutaneous vertebroplasty: A retrospective study of four hundred and eighty five patients. Int Orthop. 40:1205–1210. 2016. View Article : Google Scholar : PubMed/NCBI
20	Wang CH, Ma JZ, Zhang CC and Nie L: Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Pain Physician. 18:E187–E194. 2015.PubMed/NCBI
21	Zhang L, Wang J, Feng X, Tao Y, Yang J, Wang Y, Zhang S, Cai J and Huang J: A comparison of high viscosity bone cement and low viscosity bone cement vertebroplasty for severe osteoporotic vertebral compression fractures. Clin Neurol Neurosurg. 129:10–16. 2015. View Article : Google Scholar : PubMed/NCBI
22	Langley GB and Sheppeard H: The visual analogue scale: Its use in pain measurement. Rheumatol Int. 5:145–148. 1985. View Article : Google Scholar : PubMed/NCBI
23	Park SW, Shin YS, Kim HJ, Lee JH, Shin JS and Ha IH: The dischargeable cut-off score of Oswestry Disability Index (ODI) in the inpatient care for low back pain with disability. Eur Spine J. 23:2090–2096. 2014. View Article : Google Scholar : PubMed/NCBI
24	Disch AC and Schmoelz W: Cement augmentation in a thoracolumbar fracture model: Reduction and stability after balloon kyphoplasty versus vertebral body stenting. Spine. 39:E1147–E1153. 2014. View Article : Google Scholar : PubMed/NCBI
25	Chen C, Li D, Wang Z, Li T, Liu X and Zhong J: Safety and efficacy studies of vertebroplasty, kyphoplasty, and mesh-container-plasty for the treatment of vertebral compression fractures: Preliminary Report. PLoS One. 11:e01514922016. View Article : Google Scholar : PubMed/NCBI
26	Hu X, Zhai X and Hirt T: A new concept for more biocompliant bone cements for vertebroplasty and kyphoplasty. Macromol Biosci. 9:195–202. 2009. View Article : Google Scholar : PubMed/NCBI
27	Hernández L, Parra J, Vázquez B, Bravo AL, Collía F, Goñi I, Gurruchaga M and San Román J: Injectable acrylic bone cements for vertebroplasty based on a radiopaque hydroxyapatite. Bioactivity and biocompatibility. J Biomed Mater Res B Appl Biomater. 88:103–114. 2009. View Article : Google Scholar : PubMed/NCBI
28	Shen Y, Ren H, Zhang Y, Zhi X, Ding W, Xu J and Yang D: Correlative factor analysis of complications resulting from cement leakage after percutaneous kyphoplasty in treatment of osteoporotic vertebral body compression. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 24:27–31. 2010.(In Chinese). PubMed/NCBI
29	Bolander JE, Choi S and Duddukuri SR: Fracture of fiber-reinforced cement composites: Effects of fiber dispersion. Int J Fract. 154:73–86. 2008. View Article : Google Scholar
30	Hulme PA, Boyd SK and Ferguson SJ: Regional variation in vertebral bone morphology and its contribution to vertebral fracture strength. Bone. 41:946–957. 2007. View Article : Google Scholar : PubMed/NCBI