暂无摘要。

暂无摘要。

BACKGROUND: Early assessment of the risk of nonunion in osteoporotic vertebral compression fracture (OVCF) is beneficial to early clinical decision making. However, a comprehensive understanding of the risk factors for OVCF nonunion is lacking.
METHODS: We conducted a case-control study to investigate risk factors for OVCF nonunion. Patients who underwent surgery for nonunited OVCFs between January 2011 and December 2021 were eligible for inclusion as cases. Patients with successful OVCF healing confirmed by MRI over the same period were identified as controls. Patient demographics, comorbidities, and fasting blood test data were extracted for analysis.
RESULTS: A total of 201 patients with nonunited OVCFs and 1044 controls were included to evaluate the risk factors for nonunited OVCFs. There were statistically significant differences in sex, age, number of patients with hypertension, number of patients on bed rest after OVCF and T-score of BMD between the two groups. Logistic regression showed that female patients had a higher risk of OVCF nonunion than male patients and that smoking, drinking, diabetes, and hypertension were risk factors for nonunion of OVCFs, while bed rest and spinal support were protective factors against nonunion of OVCFs. We also found that age, BMD, FBG, and β-CTX were positively correlated with nonunited OVCFs, and that HGB and 1,25-(OH)2VitD3 level were negatively correlated with nonunited OVCFs.
CONCLUSIONS: Smoking, drinking, diabetes and hypertension were risk factors for nonunion of OVCFs, while bed rest and spinal support were protective factors against nonunion of OVCFs. Age, BMD, FBG and β-CTX were positively correlated with nonunited OVCFs, while HGB and 1,25-(OH)2VitD3 level were negatively correlated with nonunited OVCFs. Based on the results of our study, we suggest that bed rest or spinal support for at least 3 consecutive weeks is necessary to reduce the risk of OVCFs nonunion.

UNASSIGNED: Percutaneous vertebroplasty (PVP) is a common treatment for osteoporotic vertebral compression fracture (OVCF). Perioperative bleeding is usually rare, so there are few reports of shock. However, we developed shock after treating a case of OVCF of the 5th thoracic vertebra with PVP.
UNASSIGNED: An 80 years old female patient received PVP due to OVCF of the 5th thoracic vertebra. The operation was successfully completed and the patient returned to the ward safely after the operation. At 90 min after operation, she developed shock, which was induced by subcutaneous hemorrhage up to 1500 ml at the puncture site. Before using vascular embolization, transfusion and blood transfusion were used to maintain blood pressure, and local ice bag compression was used to reduce swelling and stop bleeding, which achieved successful hemostasis. She recovered and discharged after 15 days, with the hematoma having absorbed. There was no recurrence during the 17-month follow-up.
UNASSIGNED: Although PVP is considered to be a safe and effective method to treat OVCF, the possible hemorrhagic shock still needs to arouse the vigilance of surgeons.

OBJECTIVE: To provide quality care to older adults, healthcare professionals should be aware that osteoporotic vertebral compression fractures (OVCFs) might occur sequentially in the same patient, involving different vertebral bodies, each separated by short intervals. This situation is called chronologically clustered OVCFs (CCOVCF).
METHODS: A total of 40 patients with CCOVCFs (index cohort) were retrospectively analyzed, and compared with 40 patients having only one OVCF (comparison cohort). All fractures were treated with percutaneous balloon kyphoplasty.
RESULTS: In the index cohort, the number of patients having the second, third, fourth and fifth OVCF events within 3 months were 40, 15, five and two, respectively. Recurring pain or seemingly non-stop pain were the major reasons why new OCVFs were found. The average interval between pain relief provided by percutaneous balloon kyphoplasty and radiographic diagnosis of new OVCFs was significantly longer than that between pain relief and a new episode of disabling pain (26.7 ± 16.8 vs 16.4 ± 15.8 days, P < 0.0001), reflecting how shortly new OCVFs occurred after successful surgery, and how often they were neglected. The mean T-score of the index cohort was significantly lower than that of the comparison cohort (-3.66 ± 0.79 vs -3.17 ± 0.80, P = 0.01).
CONCLUSIONS: CCOVCFs make a patient seem constantly in pain, despite repeated admissions and operations. Recurrent symptoms after an effective procedure should be taken as a warning that a new OCVF might have occurred, even if only a few days apart. Advanced osteoporosis is a significant risk factor for CCOVCFs. Geriatr Gerontol Int 2023; 23: 44-49.

BACKGROUND: Intradural anesthesia caused by anesthetic drug leakage during percutaneous vertebroplasty (PVP) has rarely been reported. We here report a 71-year-old woman who suffered this rare and life-threatening complication during PVP.
METHODS: A 71-year-old woman, who suffered from 2 wk of severe back pain with a visual analog score of 8, came to our outpatient clinic. She was later diagnosed with a newly compressed L1 fracture and was then admitted in our department. PVP was initially attempted again under local anesthesia. However, serendipitous intradural anesthesia leading to total spinal anesthesia happened. Fortunately, after successful resuscitation of the patient, PVP was safely and smoothly performed. Great pain relief was achieved postoperatively, and she was safely discharged on postoperative day 4. The patient recovered normally at 3-mo follow-up.
CONCLUSIONS: Total spinal anesthesia secondary to PVP by anesthetic drug leakage rarely occurs. In cases of inadvertent wrong puncture leading to drug leakage when performing it under local anesthesia, surgeons should be highly vigilant during the whole procedure. Electrocardiogram monitoring, oxygen inhalation, intravenous cannula set prior to surgery, regular checking of motor activity and a meticulous imaging monitoring with slower pushing of anesthetic drugs, etc. should be highly recommended.

BACKGROUND: Percutaneous kyphoplasty is a popular technique in the treatment of osteoporotic vertebral fractures, but intracardiac cement embolism can be a life-threatening complication.Case presentation: The authors present a case involving a patient who developed dyspnea and chest tightness after percutaneous kyphoplasty. Echocardiography and chest computed tomography confirmed several foreign bodies in the right atrium and pulmonary arteries causing cardiac perforation and pericardial tamponade. Conservative treatment was administered, and the patient died of respiratory and heart failure.
CONCLUSIONS: The present case highlights that surgical removal may be the first-choice treatment for symptomatic intracardiac cement embolism.

BACKGROUND: Few reports have described lumbar foraminal stenosis-induced radiculopathy after treatment by full-endoscopic spine surgery (FESS) combined with percutaneous vertebroplasty (PVP) in patients with vertebral compression fractures. We herein report such a case, including the patient\'s treatment process and doctor\'s surgical experience.
METHODS: A 79-year-old man presented with symptoms of radiculopathy after sustaining L4 vertebral compression fractures. Imaging and physical examination revealed L4 vertebral compression fractures combined with L3/4 Lumbar foraminal stenosis (LFS). The patient\'s symptoms were low back pain with pain in the lateral left leg. Although many reports have described radiculopathy induced by osteoporotic vertebral compression fractures, the use of FESS combined with PVP has rarely been reported. This case report indicates that the combination of FESS and PVP is a safe and effective approach for the treatment of LFS-induced radiculopathy after vertebral compression fractures. This minimally invasive technique has great potential to replace traditional lumbar fixation and decompression surgery. Thus, we suggest the continued accumulation of similar cases to discuss the wider application of FESS.
CONCLUSIONS: For patients with osteoporotic vertebral compression fracture (OVCF) and LFS, PVP and FESS can be used to restore the vertebral height and reduce the pressure around the intervertebral foramen. Additionally, the combination of FESS and PVP can treat the pain or numbness of the low back and lower limbs and allow for recovery in a short time with excellent postoperative effects. In general, FESS is a good treatment for radiculopathy caused by foraminal stenosis after OVCF.

Percutaneous vertebroplasty (PVP) was first reported in 1987 for treating vertebral hemangiomas. PVP is also an effective treatment for osteoporotic vertebral compression fracture that mainly involves a percutaneous injection of polymethylmethacrylate. Severe complications of PVP have been reported in recent years. However, to the best of our knowledge, cement-associated thrombotic embolism in the inferior vena cava and bilateral iliac veins after PVP has rarely been reported. We experienced a patient with cement-associated thrombotic embolism in the inferior vena cava and bilateral iliac veins after PVP. Fortunately, after conservative therapy, we achieved a satisfactory result. Unfortunately, we could not explain the cause of the cement leakage and formation of the thrombotic embolism. We believe that surgeons should have a better understanding of the fracture pattern and anatomy of the vertebral venous net system. They should also perform meticulous imaging monitoring with slower pushing of the cement to minimize the risks during the PVP. This case report highlights a rare, but potentially life-threatening, complication of PVP. Surgeons need to be aware of the possibility of cement leakage and the formation of cement-associated thrombotic embolism so that they are much more vigilant when performing PVP.

BACKGROUND: The impact of intravertebral cleft (IVC) on cement leakage in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs) has been discussed. However, the results were conflicting, as the study population and cement leakage classification were heterogeneous. The aim of the study was to evaluate the impact of IVC on the incidence of leakage through vein, leakage through cortex as well as general leakage in PVP for OVCFs.
METHODS: All patients with OVCFs who underwent PVP between January 2016 and June 2019 at our institution were retrospectively reviewed. Patients were eligible for this case-control study if they were diagnosed as single level fracture in spine. After inclusive and exclusive criteria were met, a total of 139 patients with IVC were enrolled as the study group. Non-IVC controls were matched in a 1:1 ratio in age (within 3 years), sex and fracture severity with patients in study group. Cement leakage were classified into four types [type B (through basivertebral vein), type S (through segmental vein), type-C (through a cortical defect), and type D (intradiscal leakage)], furtherly into two types [venous type (type-B or/and type S) and cortical type (type-C or/and type-D)]. A general leakage rate and a specific leakage rate per each type were compared between both groups.
RESULTS: Each group included 139 patients. Groups were homogenous for age, sex, fracture severity, fracture location, fracture type, cement volume, puncture approach and property of cement. Compared with control group, IVC group had a significantly lower rate of type-B (20.9% vs. 31.7%, P = 0.041), type-S (24.5% vs. 52.5%, P = 0.000), and venous type leakage (37.4% vs. 67.6%, P = 0.000), a significantly higher rate of type-C (25.9% vs. 12.2%, P = 0.004), type-D (16.5% vs. 6.5%, P = 0.009), and cortical type leakage (40.3% vs. 16.5%, P = 0.000), no significant difference on the rate of general leakage (67.6% vs. 76.3%, P = 0.109).
CONCLUSIONS: IVC decreased the risk of cement leakage through vein and increased the risk of cement leakage through cortex. However, it had no significant effect on the occurrence of general leakage.