Do the dynamic stress mobility radiographs predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty for osteoporotic thoracolumbar vertebral fractures with intravertebral cleft?

Do the dynamic stress mobility radiographs predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty for osteoporotic thoracolumbar vertebral fractures with intravertebral cleft?

Background: This prospective clinical–radiological study was conducted to determine whether the dynamic mobility stress radiographs can predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty. Methods: Patients included had the dia...

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Published in:Journal of orthopaedic surgery (Hong Kong) Vol. 26; no. 3; p. 2309499018806700
Main Authors: Chiu, Chee Kidd, Lisitha, Kulathunga Arachchige, Elias, Dahlia Munchar, Yong, Voon Wei, Chan, Chris Yin Wei, Kwan, Mun Keong
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01-09-2018
Sage Publications Ltd
SAGE Publishing
Subjects:
Anesthesia
Authorship
Back pain
Cement
Fractures
Medical imaging
NMR
Nuclear magnetic resonance
Older people
Osteoporosis
Patients
Polymethyl methacrylate
Postoperative period
Surgeons
Vertebrae
intravertebral cleft
dynamic stress radiographs
vertebroplasty
vertebra
thoracolumbar
osteoporosis
fracture
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Summary:Background: This prospective clinical–radiological study was conducted to determine whether the dynamic mobility stress radiographs can predict the postoperative vertebral height restoration, kyphosis correction, and cement volume injected after vertebroplasty. Methods: Patients included had the diagnosis of significant back pain caused by osteoporotic vertebral compression fracture secondary to trivial injury. All the patients underwent routine preoperative sitting lateral spine radiograph, supine stress lateral spine radiograph, and supine anteroposterior spine radiograph. The radiological parameters recorded were anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), MVH level below, wedge endplate angle (WEPA), and regional kyphotic angle (RKA). The supine stress versus sitting difference (SSD) for all the above parameters were calculated. Results: A total of 28 patients (4 males; 24 females) with the mean age of 75.6 ± 7.7 years were recruited into this study. The mean cement volume injected was 5.5 ± 1.8 ml. There was no difference between supine stress and postoperative radiographs for AVH (p = 0.507), PVH (p = 0.913) and WEPA (p = 0.379). The MVH (p = 0.026) and RKA (p = 0.005) were significantly less in the supine stress radiographs compared to postoperative radiographs. There was significant correlation (p < 0.05) between supine stress and postoperative AVH, MVH, PVH, WEPA, and RKA. The SSD for AVH, PVH, WEPA, and RKA did not have significant correlation with the cement volume (p > 0.05). Only the SSD-MVH had significant correlation with cement volume, but the correlation was weak (r = 0.39, p = 0.04). Conclusions: Dynamic mobility stress radiographs can predict the postoperative vertebral height restoration and kyphosis correction after vertebroplasty for thoracolumbar osteoporotic fracture with intravertebral clefts. However, it did not reliably predict the amount of cement volume injected as it was affected by other factors.
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ISSN:2309-4990
1022-5536
2309-4990
DOI:10.1177/2309499018806700