Neurospine

Comparative Clinical Results of Vertebroplasty Using Jamshidi® Needle and Bone Void Filler for Acute Vertebral Compression Fractures: Se-Il Jeon, Il-Seung Choe, Young Sub Kwon, Dae-Hee Seo, Kyu Chang Lee, Sung-Choon Park; Korean J Spine 2012;9(3):239-243. Published online September 30, 2012; DOI: https://doi.org/10.14245/kjs.2012.9.3.239

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Comparative Clinical Results of Vertebroplasty Using Jamshidi® Needle and Bone Void Filler for Acute Vertebral Compression Fractures

Korean J Spine. 2012;9(3):239-243. Published online September 30, 2012

DOI: https://doi.org/10.14245/kjs.2012.9.3.239

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Comparative Clinical Results of Vertebroplasty Using Jamshidi® Needle and Bone Void Filler for Acute Vertebral Compression Fractures

Korean J Spine. 2012;9(3):239-243. Published online September 30, 2012

DOI: https://doi.org/10.14245/kjs.2012.9.3.239

Objective

Percutaneous vertebroplasty (PVP) is an effective treatment modality for management of osteoporotic compression fracture. However physicians sometimes have problems of high pressure in cement delivery and cement leakage when using Jamshidi® needle (JN). Bone void filler (BVF) has larger lumen which may possibly diminish these problems. This study aims to compare the radiologic and clinical outcome of JN and BVF for PVP.

Methods

One hundred twenty-eight patients were treated with PVP for osteoporotic vertebral compression fracture (VCF) where 46 patients underwent PVP with JN needle and 82 patients with BVF. Radiologic outcome such as kyphotic angle and vertebral body height (VBH) and clinical outcome such as visual analog scale (VAS) scores were measured after treatment in both groups.

Results

In JN PVP group, mean of 3.26 cc of polymethylmethacrylate (PMMA) were injected and 4.07 cc in BVF PVP group (p<0.001). For radiologic outcome, no significant difference in kyphotic angle reduction was observed between two groups. Cement leakage developed in 6 patients using JN PVP group and 2 patients using BVF group (p=0.025). No significant difference in improvement of VAS score was observed between JN and BVF PVP groups (p=0.43).

Conclusion

For the treatment of osteoporotic VCF, usage of BVF for PVP may increase injected volume of cement, easily control the depth and direction of PMMA which may reduce cement leakage. However, improvement of VAS score did not show difference between two groups. Usage of BVF for PVP may be an alternative to JN PVP in selected cases.

Citations

Citations to this article as recorded by

Percutaneous Vertebral Body Augmentations
Majid Khan, Sergiy V. Kushchayev
Neuroimaging Clinics of North America.2019; 29(4): 495. CrossRef

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Therapeutic Effects and Prognostic Factors of Kyphoplasty for Thoracolumbar Osteoporotic Burst Fracture Patients.: Kwang Chun Cho, Sung Choon Park, Dae Hee Seo, Kyu Chang Lee, Il Seung Choe; Korean J Spine 2011;8(3):172-177.; DOI: https://doi.org/10.14245/kjs.2011.8.3.172

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Therapeutic Effects and Prognostic Factors of Kyphoplasty for Thoracolumbar Osteoporotic Burst Fracture Patients.

Korean J Spine. 2011;8(3):172-177.

DOI: https://doi.org/10.14245/kjs.2011.8.3.172

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Therapeutic Effects and Prognostic Factors of Kyphoplasty for Thoracolumbar Osteoporotic Burst Fracture Patients.

Korean J Spine. 2011;8(3):172-177.

DOI: https://doi.org/10.14245/kjs.2011.8.3.172

OBJECTIVE
There are few studies of osteoporotic burst fractures with spinal canal compromise that were treated with kyphoplasty. The purpose of this study was to assess the efficacy and the safety of kyphoplasty for the treatment of thoracolumbar spine osteoporotic burst fractures without neurological deficits and to investigate predictors that can improve the effectiveness of this treatment.
METHODS
From October 2004 until December 2010, 79 osteoporotic burst fracture patients with asymptomatic spinal canal compromise were treated by kyphoplasty. Kyphoplasty involved injecting polymethylmethacrylate (PMMA) from the anterior one-third of the vertebral body into the posterior one-third of the vertebral body. PMMA powder and liquid were mixed in a ratio of 1:3 at 21-23degrees C. Preoperative and postoperative visual analog scores (VAS), kyphotic angles, the heights of the vertebral body, and the degrees of spinal canal compromise were analyzed. The relationships between the factors and the VAS difference between the preoperative and postoperative states were analyzed.
RESULTS
The mean postoperative VAS, the postoperative kyphotic angle, the vertebral body height measurement from the anterior and the middle of the body were significantly improved after kyphoplasty (p<0.05). Postoperatively, the mean VAS was restored from 7.35 to 2.11, the postoperative kyphotic angle was restored from 18.21degrees to 12.08degrees, the vertebral body height measurement from the anterior of the body was from 18.56mm to 23.54mm and the middle of the body was from 24.81mm to 27.90mm. Among the variables, only the duration of symptoms before surgical treatment was implicated as a factor in the outcome (p<0.01).
CONCLUSION
Kyphoplasty is a very effective and safe therapeutic modality for the treatment of osteoporotic burst fractures without neurological deficits. The standardization of this procedure helps to avoid complications. In the acute stages, early treatment is more effective for the reduction of pain. Further investigation is warranted in order to assess the effectiveness of early surgery in improving outcome.