PURPOSE The prevalence of osteoporotic sacral fractures is increasing. Traditionally, conservative treatment is the 1st option, but it can increase the risk of comorbidity in the elderly. To reduce the complications and allow early mobility, iliosacral screw fixation with cement augmentation will be one of the treatment options for patients with osteoporotic sacral fractures. MATERIALS AND METHODS This study reviewed 25 patients (30 cases) who had undergone percutaneous iliosacral screw fixation with cement augmentation for osteoporotic sacral fractures from July 2012 to December 2018 with a minimum follow up of six months. The clinical outcomes were assessed using the measures of pain (visual analogue scale [VAS] score), hospital stay and the date when weight-bearing started. All patients were evaluated radiologically for pull-out of screw, bone-union, and cement-leakage. RESULTS Bone union was achieved in 30 cases (100%). The mean duration of the hospital stay was 24 days (4–66 days); weight-bearing was performed on an average nine days after surgery. The VAS scores immediately (3.16) and three months after surgery (2.63) were lower than that of the preoperative VAS score (8.3) (p<0.05). No cases of cement-leakage or neurologic symptoms were encountered. Two patients (6.7%) experienced a pulling-out of the screw, but bone-union was accomplished without any additional procedures. CONCLUSION Percutaneous iliosacral fixation with cement augmentation will be an appropriate and safe surgical option for osteoporotic sacral fractures in the elderly in terms of early weight-bearing, pain reduction, and bone-union.
PURPOSE This paper reviewed the safety and effectiveness of anchor augmentation with bone cement in osteoporotic femoral fractures. MATERIALS AND METHODS A systematic review was conducted by searching multiple databases including five Korean databases, Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. Safety was assessed through the incidence of complication. The effectiveness was assessed through the failure rate of anchor fixation, improvement of function and radiological assessment (sliding distance of lag screw and cutout). The safety and effectiveness of anchor augmentation with bone cement were assessed by reviewing all articles reporting on the treatment. Two researchers carried out independently each stage from the literature search to data extraction. The tools of Scottish Intercollegiate Guidelines Networks were used to assess the quality of studies. RESULTS Six studies were considered eligible. The safety results revealed a small amount of cement leakage (1 case), but no other severe complications were encountered. Regarding the effectiveness, the failure rate of anchor fixation was 16.7% and the Harris's hip score showed no significant improvement. The sliding distance of the anchor was similar in the cement augmentation group and non-cement group but there was no cutout. CONCLUSION The results of the assessment suggest that the safety is acceptable, but further research will be needed to verify the effectiveness of the treatment.
PURPOSE The purpose of this study was to examine incidence of recompression and risk factors in the patients with osteoporotic vertebral compression fracture (OVCF) after vertebroplasty or kyphoplasty. MATERIALS AND METHODS This study was conducted on 179 vertebral bodies of 126 patients who underwent vertebroplasty or kyphoplasty on OVCF from January 2004 to August 2013. RESULTS When anterior vertebral height of fractured vertebrae declined by more than 3 mm from the height immediately after vertebroplasty or kyphoplasty, it was judged that recompression had occurred. Recompression was observed in a total of 58 vertebrae (32.4%). Recompression occurrences were found to be decreasing significantly when fractured vertebrae were the thoracic spine. In addition, osteonecrosis occurred in the preoperative vertebrae and restoration degree of anterior vertebral height immediately after vertebroplasty or kyphoplasty affected recompression occurrences significantly. The other factors (age, sex, bone mineral density, steroid medication history, follow-up duration, cement volume, vertebroplasty or kyphoplasty, and approach method) were compared, but no statistical significance was found. CONCLUSION The risk of vertebral recompression is more common, especially when osteonecrosis occurred in preoperative vertebrae or when vertebroplasty or kyphoplasty achieved remarkable restoration of anterior vertebra height. When performing vertebroplasty or kyphoplasty, such conditions should be considered carefully.
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Effect of Weekly Teriparatide Administration Followed by Percutaneous Balloon Kyphoplasty on Post-Menopausal Osteoporotic Compression Fracture Treatment Sung-Ha Hong, Seung-Pyo Suh, Woo Jin Shin, Seung Gi Lee, Byung Jun Kang Journal of the Korean Orthopaedic Association.2022; 57(1): 35. CrossRef
Analysis of the Cement Distribution Pattern and Other Risk Factors that Affect the Incidence of Recompression Fractures of Vertebral Bodies after Vertebroplasty or Kyphoplasty Deuk Soo Jun, Jong Min Baik, Young Hyun Yoon Journal of the Korean Orthopaedic Association.2022; 57(3): 204. CrossRef
Clinical Characteristics of Elderly People with Osteoporotic Vertebral Compression Fracture Based on a 12-Year Single-Center Experience in Korea Seung-Kwan Lee, Deuk-Soo Jun, Dong-Keun Lee, Jong-Min Baik Geriatrics.2022; 7(6): 123. CrossRef
Risk Factors for Recollapse of the Augmented Vertebrae After Percutaneous Vertebral Augmentation: A Systematic Review and Meta-Analysis Weibo Yu, Weixing Xu, Xiaobing Jiang, De Liang, Wang Jian World Neurosurgery.2018; 111: 119. CrossRef
PURPOSE The purpose of this study was to evaluate the risks of undergoing intramedullary nailing with minimum surgical optimization (fast-track) for geriatric trochanter fracture due to fall from a standing height. MATERIALS AND METHODS From May 2006 to August 2013, 48 fractures were enrolled in fast-track, and were an average age of patients was 77.6 years (range, 62-97 years). They underwent primary testing for anesthesia, including basic body fluid test, arterial blood, electrocardiography, and chest radiographs. The time from visit to surgery was 28.9 hours (range, 1-96 hours). RESULTS During hospitalization, there was one case of stress-induced cardiac arrest; however, other complications, infection, and 30-day mortality did not occur. According to preoperative classic test, the average albumin was 3.45 g/dl, blood sugar, 169 mg/dl, blood urea nitrogen, 20.5 mg/dl, Cr, 1.5 mg/dl, Na, 135.3 mEq/L, and K, 4.21 mEq/L. The average PaCO2 of arterial blood was 37.6 mmHg. CONCLUSION We found that the fast-track for trochanteric fracture due to slip-down was relatively safe, and could be considered as a therapeutic approach.