• Title, Summary, Keyword: vertebral compression fracture

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Spontaneous Height Restoration of Vertebral Compression Fracture - A Case Report-

  • Joo, Young;Lee, Pyung-Bok;Nahm, Francis Sahngun
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.235-238
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    • 2011
  • Vertebral compression fractures result in vertebral height loss and alter sagittal spinal alignment, which in turn can lead to increased morbidity and mortality. Acute osteoporotic vertebral compression fractures are known to increase mobility and instability of the spine. There are limited published data correlating the degree of dynamic mobility and the efficacy of kyphoplasty on vertebral compression fractures. Here we report a 73-year-old female with a severe acute osteoporotic L2 compression fracture who obtained total vertebral height restoration following kyphoplasty, with resolution of back pain.

The Proper Volume and Distribution of Cement Augmentation on Percutaneous Vertebroplasty

  • Kim, Dong-Joon;Kim, Tae-Wan;Park, Kwan-Ho;Chi, Moon-Pyo;Kim, Jae-O
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.125-128
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    • 2010
  • Objective : The purpose of this study was to determine the optimal volume of injected cement and its distribution when used to treat vertebral compression fractures, and to identify factors related to subsequent vertebral fractures. Methods : A retrospective analysis of newly developing vertebral fractures after percutaneous vertebroplasty was done. The inclusion criteria were that the fracture was a single first onset fracture with exclusion of pathologic fractures. Forty-three patients were included in the study with a minimum follow up period of six months. Patients were dichotomized for the analysis by volume of cement, initial vertebral height loss, bone marrow density, and endplate-to-endplate cement augmentation. Results : None of the four study variables was found to be significantly associated with the occurrence of a subsequent vertebral compression fracture. In particular, and injected cement volume of more or less that 3.5 cc was not associated with occurrence (p = 0.2523). No relation was observed between initial vertebral height loss and bone marrow density (p = 0.1652, 0.2064). Furthermore, endplate-to-endplate cement augmentation was also not found to be significantly associated with a subsequent fracture (p = 0.2860) by Fisher's exact test. Conclusion : Neither volume of cement, initial vertebral height loss, bone marrow density, or endplate-to-endplate cement augmentation was found to be significantly related to the occurrence of a subsequent vertebral compression fracture. Our findings suggest that as much cement as possible without causing leakage should be used.

Feasibility of Serum Pentosidine Level as a Potential Risk Factor for Osteoporotic Vertebral Compression Fracture

  • Choi, Dong-Hyuk;Lee, Sang-Min;Lim, Sung-An;Choi, Yong-Soo
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.992-997
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    • 2018
  • Study Design: Feasibility study. Purpose: To evaluate the feasibility of using serum pentosidine level as a potential marker for osteoporotic vertebral compression fracture (OVCF). Overview of Literature: A review of previous studies suggests a negative correlation between serum pentosidine concentration and bone strength. However, it is unclear whether serum pentosidine level might be a potential marker of OVCF in Koreans. Methods: Forty patients who underwent bone mineral density examination were included in this study, and their serum pentosidine levels were prospectively analyzed. Serum pentosidine level was evaluated using enzyme-linked immunosorbent assay. Among all the patients, 11 with OVCF were assigned to the vertebral fracture group and 29 who did not have vertebral fracture were included in the non-fracture group. In addition, we used the Fracture Risk Assessment (FRAX) tool Korean version for assessing the 10-year probability of fracture. Results: There was a statistically significant difference in the mean serum pentosidine level (p=0.04) of the vertebral fracture group (110.8 ng/mL) and the non-fracture group (64.3 ng/mL). Logistic regression analyses showed that serum pentosidine was significantly associated with OVCF. The vertebral fracture group had significantly higher 10-year probability of major osteoporotic fracture as per FRAX than the non-fracture group. There was a positive correlation between pentosidine level and FRAX results (r=0.35, p=0.02). Conclusions: These results suggest that increased serum pentosidine level could be a potential marker for OVCF.

Percutaneous Vertebroplasty in the Treatment of Vertebral Body Compression Fracture with Osteoporosis - Preliminary Report - (골다공증을 동반한 척추체 압박골절에 대한 경피적 척추 성형술 - 예비보고 -)

  • Lee, Sang-Gu;Yoo, Chan-Jong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.615-622
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    • 2000
  • Objective : Percutaneous vertebroplasty is an effective and minimally invasive procedure consisting of the injection of a PMMA(polymethyl methacrylate) into the vertebral body compression fracture with osteoporosis. Matherials and Methods : Twenty-eight procedures were performed for vertebral body compression fractures with osteoporosis in 25 patients(22 women, 3 men). The mean age was 65.9 years old. The inclusion criteria for percutaneous vertebroplasty were 1) acute vertebral body compression fracture with osteoporosis, 2) expected high operative morbidity in old age, 3) no neurologic deficits, 4) no or minimal canal enchroachment, 5) patient refusal of invasive surgery. All patients underwent MR images before the procedure. Under local anesthesia, after the percutaneous needle puncture of the involved vertebra via a transpedicular approach and venography using the water soluble contrast material, PMMA injection was introduced into the fractured vertebral body. Results : The procedure was technically successful in all patients. All patients experienced excellent pain relief (complete pain relief ; 10, marked pain relief ; 14). One patient experienced marked pain relief, however, the patient died during the follow-up period due to stomach cancer. There were twelve paravertebral tissue leaks, twelve paravertebral venous plexus leaks, four epidural leaks and one intradiskal leak, but no clinically significant complications occurred in all patients. Conclusion : Percutaneous vertebraoplasty is a valuable procedure in the treatment of vertebral body compression fracture with osteoporosis, providing immediate pain relief and early mobilization. MRI is the most reliable diagnostic tool for identifying painful fractured vertebral body.

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Early Bone Marrow Edema Pattern of the Osteoporotic Vertebral Compression Fracture : Can Be Predictor of Vertebral Deformity Types and Prognosis?

  • Ahn, Sung Eun;Ryu, Kyung Nam;Park, Ji Seon;Jin, Wook;Park, So Young;Kim, Sung Bum
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.137-142
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    • 2016
  • Objective : To evaluate whether an early bone marrow edema pattern predicts vertebral deformity types and prognosis in osteoporotic vertebral compression fracture (OVCF). Methods : This retrospective study enrolled 64 patients with 75 acute OVCFs who underwent early MRI and followed up MRI. On early MRI, the low SI pattern of OVCF on T1WI were assessed and classified into 3 types (diffuse, globular or patchy, band-like). On followed up MRI, the vertebral deformity types (anterior wedge, biconcave, crush), degree of vertebral body height loss, incidence of vertebral osteonecrosis and spinal stenosis were assessed for each vertebral fracture types. Results : According to the early bone marrow edema pattern on T1WI, 26 vertebrae were type 1, 14 vertebrae were type 2 and 35 vertebrae were type 3. On followed up MRI, the crush-type vertebral deformity was most frequent among the type 1 OVCFs, the biconcave-type vertebral deformity was most frequent among the type 2 OVCFs and the anterior wedge-type vertebral deformity was most frequent among the type 3 OVCFs (p<0.001). In addition, type 1 early bone marrow edema pattern of OVCF on T1WI were associated with higher incidence of severe degree vertebral body height loss, vertebral osteonecrosis and spinal stenosis on the follow up MRI. Conclusion : Early bone marrow edema pattern of OVCF on T1WI, significant correlated with vertebral deformity types on the follow up MRI. The severe degree of vertebral height loss, vertebral osteonecrosis, and spinal stenosis were more frequent in patients with diffuse low SI pattern.

Vertebral Compression Fractures: Distinction Between Benign and Malignant Causes with Tc-99m Labeled Antigranulocyte Antibody Immunoscintigraphy (Tc-99m 표지 항과립구항체 면역신티그라피(Tc-99m labeled antigranulocyte antibody immunoscintigraphy)를 이용한 척추압박골절의 원인질환 감별)

  • Cho, Ihn-Ho;Lee, Hyong-Woo;An, Sang-Ho;Won, Kyu-Chang;Bae, Jang-Ho;Cho, Soo-Ho
    • Yeungnam University Journal of Medicine
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    • v.15 no.2
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    • pp.254-262
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    • 1998
  • We evaluated the effectiveness of Tc-99m labeled antigranulocyte antibody immunoscintigraphy in differentiating the causes of vertebral compression fracture. This study involved 16 patients with vertebral compression fracture; 8 were due to trauma or osteoporosis, 3 were due to metastasis and 5 were due to tuberculous spondylitis. We retrospectively analyzed the location and the extent of decreased tracer uptake in tomographic images of Tc-99m labeled antigranulocyte antibody immunoscintigraphy. Eight patients had a 16 vertebral compression fractures due to trauma or osteoporosis, three patients had 3 vertebral compression fractures due to metastasis and 5 patients had 6 vertebral compression fractures due to tuberculous spondylitis. Sixteen vertebral compression fractures by trauma or osteoporosis showed a normal tracer uptake in pedicle, laminar and spinous process, but there was noted with 6 decreased uptake, 8 absence of tracer uptake and 2 normal tracer uptake in the vertebral body. Two vertebral compression fractures by metastasis showed the absence of uptake in vertebral body, pedicle, laminar and spinous process, and one showed an absence of vertebral body and spinous process. Six vertebral compression fractures by tuberculous spondylitis showed the absence of uptake in six compression fractures, the absence of pedicle in five compression fractures. We concluded Tc-99m labeled antigranulocyte antibody immunoscintigraphy may be helpful to differentiate the causes of vertebral compression fractures.

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Fire Needling Therapy in Patients with a Vertebral Compression Fracture: A Report of Three Cases (가열식 화침을 이용한 척추 압박골절 환자 증례보고)

  • Kim, Tae-Ryeong;Kim, Young-Jun;Woo, Chang-Hoon
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.147-154
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    • 2017
  • The purpose of this study is to report the effectiveness of Fire needling therapy in patients with a vertebral compression fracture. Three patients with a acute vertebral compression fracture were treated using Fire needling therapy. To evaluate the effectiveness of Fire needling therapy, we checked Numerical rating scale on a daily and Oswestry disability index on admission and discharge. Numerical rating scale decreased as the number of Fire needling therapy increased. Oswestry disability index on discharge improved compared to admission. The limitation of this study is the insufficient number of cases and outcome measurements. Further studies are needed to prove effect and safety.

Conservative treatment of Osteoporotic Compression Fractures in Thoracolumbar spine (골다공증성 흉요추부 압박 골절에서의 보존적 치료)

  • Kang, Kyu-Bok;Koh, Young-Do
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.107-111
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    • 2005
  • Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

Vertebral compression fractures after spine irradiation using conventional fractionation in patients with metastatic colorectal cancer

  • Rhee, Woo Joong;Kim, Kyung Hwan;Chang, Jee Suk;Kim, Hyun Ju;Choi, Seohee;Koom, Woong Sub
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.221-230
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    • 2014
  • Purpose: To evaluate the risk of vertebral compression fracture (VCF) after conventional radiotherapy (RT) for colorectal cancer (CRC) with spine metastasis and to identify risk factors for VCF in metastatic and non-metastatic irradiated spines. Materials and Methods: We retrospectively reviewed 68 spinal segments in 16 patients who received conventional RT between 2009 and 2012. Fracture was defined as a newly developed VCF or progression of an existing fracture. The target volume included all metastatic spinal segments and one additional non-metastatic vertebra adjacent to the tumor-involved spines. Results: The median follow-up was 7.8 months. Among all 68 spinal segments, there were six fracture events (8.8%) including three new VCFs and three fracture progressions. Observed VCF rates in vertebral segments with prior irradiation or pre-existing compression fracture were 30.0% and 75.0% respectively, compared with 5.2% and 4.7% for segments without prior irradiation or pre-existing compression fracture, respectively (both p < 0.05). The 1-year fracture-free probability was 87.8% (95% CI, 78.2-97.4). On multivariate analysis, prior irradiation (HR, 7.30; 95% CI, 1.31-40.86) and pre-existing compression fracture (HR, 18.45; 95% CI, 3.42-99.52) were independent risk factors for VCF. Conclusion: The incidence of VCF following conventional RT to the spine is not particularly high, regardless of metastatic tumor involvement. Spines that received irradiation and/or have pre-existing compression fracture before RT have an increased risk of VCF and require close observation.

The Clinical Study of 35 Admission Patients to Oriental Medical Hospital due to Thoraco-Lumbar Compression Fracture (흉요추부 압박골절 진단을 받고 한방병원에 입원한 환자 35명에 대한 임상적 고찰)

  • Jin, Eun-Seok;Koh, Dong-Hyun;Kim, Ha-Neul;Kim, Joo-Won;Hong, Soon-Sung;Kim, Han-Kyum;Lee, Jin-Hyuk
    • The Journal of Korea CHUNA Manual Medicine for Spine and Nerves
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    • v.3 no.2
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    • pp.19-27
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    • 2008
  • Objective : The purpose of this study is to investigate the results of korean traditional conservative therapy for thoraco-lumbar compression fracture and it's recovery rate and different result in accordance with sex, age, medical history. Method : We studied about 35 cases who were admitted to Jaseng Hospital of Oriental Medicine with diagnosis of 'Thoraco lumbar compression fracture' with X-ray examination. Result : Out of 35 patients 31 patients discharged with satisfying results. Most of the compression fracture occurred in age of $60{\sim}70$. And the single fractured patients recovered more easily than the multi-level fractured patients. It didn't affect the results whether the patient had another vertebral disease(such as Herniated intervertebral disc or osteoporosis) or not. And most of the patients who had vertebral compression fracture visited the western medicine hospital first. Conclusions : We analyzed the tendency of the patients who had vertebral compression fracture, and concluded that the conservative Korean traditional therapy is an effective means of treatment for the patients who have thoraco-lumbar compression fracture.

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