![]() The benefit of these minimally invasive procedures compared to conservative treatment or open surgery is better pain relief and functional spine improvement. Two kinds of bone cement injection methods are used in PKP and PVP: unilateral or bilateral injection. The difference between these procedures is that PVP is used to stabilize the fracture primarily through a very small skin incision in which bone cement is injected, and PKP can achieve more restoration of VH through insertion of a balloon through the same skin incision and expansion of the fractured vertebral body before the cement injection. To stabilize fractures quickly, relieve pain fast, and achieve restoration of VH for the treatment of OVCFs, two minimally invasive VA procedures, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP), have been performed by percutaneously injecting bone cement into the fractured vertebral body. īefore vertebral augmentation (VA) techniques were developed, conservative treatment options of OVCFs included bed rest, analgesic drugs, calcium supplementation, antiresorptive drugs, and a spine brace for a few weeks. OVCFs occur more frequently than other osteoporotic fractures, such as hip fractures and distal radius fractures, and they have become a more increasingly serious disease and a significant health problem worldwide that will obviously increase economic burden to society and family in the future. Osteoporotic vertebral compression fracture (OVCF) is a common disease in the elderly population accompanied by decreased bone mineral density, which can cause acute or chronic back pain, functional limitations of the spine, a thoracolumbar vertebral deformity, vertebral height (VH) loss, and deterioration of quality of life. Vertebral augmentation can sufficiently reduce von Mises stresses at different heights of OVCFs of the vertebral body, although this technique does not completely restore vertebral height to the anatomical criteria. The von Mises stress significantly decreased between pre-augmentation and post-augmentation in T12 OVCF models of grade 0–3 vertebral heights. There was no significant difference between the von Mises stresses of grade 0, 1, and 3 vertebral heights postoperatively. The von Mises stresses of the T12 vertebral body significantly decreased in four different loads and at different vertebral body heights (grades 0–3) after augmentation. The von Mises stresses were significantly different between different vertebral heights preoperatively. The maximum stress of grade 3 vertebral height pre-augmentation was produced at approximately 200%, and at more than 200% for grade 0. Resultsĭata showed that the von Mises stresses significantly increased under four loads of OVCFs of the T12 vertebral body before the operation from grade 0 to grade 3 vertebral heights. These models were assumed to represent vertical compression and flexion, left flexion, and right flexion loads, and the von Mises stresses of the T12 vertebral body were assessed under different vertebral heights before and after bone cement augmentation. Four different kinds of vertebral height models included Genant semi-quantitative grades 0, 1, 2, and 3, which simulated unilateral augmentation. ![]() The CT images were reconstructed as simulated three-dimensional finite-element models of the T11-L1 levels (before and after the T12 vertebra was augmented with cement). Methodsįour patients with OVCFs of T12 underwent computed tomography (CT) of the T11-L1 levels. Therefore, the present study aimed to investigate the biomechanical effects between different vertebral heights of OVCFs before and after augmentation using three-dimensional finite element analysis. However, no significant results regarding biomechanical effects post-augmentation have been found with different types of vertebral deformity or vertebral heights by biomechanical analysis. Clinical results have shown that different vertebral heights have been restored post-augmentation of osteoporotic vertebral compression fractures (OVCFs) and the treatment results are consistent. ![]()
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