PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Fractures, Compression”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed2006

Percutaneous vertebroplasty: functional improvement in patients with osteoporotic compression fractures.

STUDY DESIGN: Prospective, double-cohort study. OBJECTIVE: To evaluate conservative and percutaneous vertebroplasty (PV) management of osteoporotic vertebral fractures. SUMMARY OF BACKGROUND DATA: PV is an elective alternative to conservative management for the treatment of a painful osteoporotic vertebral fracture. METHODS: We performed a prospective study consisting of 101 consecutive patients who underwent PV and 27 patients who refused PV treatment and were managed conservatively. We used a data evaluation and outcomes system that was developed to evaluate the outcomes of surgical intervention. RESULTS: Patients that elected for PV as a treatment of their fractures had significantly more pain and functional impairment before the procedure than the patients of the conservative group (P < 0.001). The pain, functional, and general health scores of the PV group were improved from the preoperative mean values (P < 0.001) in all postoperative periods. Compared with the conservative treatment group, there was a significant difference at month 3. However, no statistical differences on function were observed between these groups at 6 months and 1 year posttreatment. CONCLUSIONS: PV demonstrated a rapid and significant relief of pain and improved the quality of life. PV election for treatment of painful osteoporotic vertebral fracture after 6 weeks of conservative treatment was based on pain and functional impairment.

Aged↗
PubMed1992

Compression fractures in patients undergoing spinal manipulative therapy.

Increasing numbers of elderly patients are currently seeking chiropractic care. One condition commonly seen in the elderly is osteoporosis of the spine, which carries with it the risk of compression fractures. We present four cases in which patients were noted to have compression fractures following chiropractic adjustments. In each of these cases, serious questions are raised concerning the relationship between the adjustment and the occurrence of fracture. What is clear is that failure to diagnose a compression fracture, together with the application of adjustment into the area of fracture, can increase symptoms and prolong disability. It is recommended that patients with osteoporosis who have suffered a fall or injury be X rayed before treatment is given. In addition, special care should be exercised in elderly patients with osteoporosis.

Accidental Falls↗
PubMed2006

Lordoplasty: report on early results with a new technique for the treatment of vertebral compression fractures to restore the lordosis.

Cement augmentation using PMMA cement is known as an efficient treatment for osteoporotic vertebral compression fractures with a rapid release of pain in most patients and prevention of an ongoing kyphotic deformity of the vertebrae treated. However, after a vertebroplasty there is no chance to restore vertebral height. Using the technique of kyphoplasty a certain restoration of vertebral body height can be achieved. But there is a limitation of recovery due to loss of correction when deflating the kyphoplastic ballon and before injecting the cement. In addition, the instruments used are quite expensive. Lordoplasty is another technique to restore kyphosis by indirect fracture reduction as it is used with an internal fixateur. The fractured and the adjacent vertebrae are instrumented with bone cannulas bipediculary and the adjacent vertebrae are augmentated with cement. After curing of the cement the fractured vertebra is reduced by applying a lordotic moment via the cannulas. While maintaining the pretension the fractured vertebra is reinforced. We performed a prospective trial of 26 patients with a lordoplastic procedure. There was a pain relief of about 87% and a significant decrease in VAS value from 7.3 to 1.9. Due to lordoplasty there was a significant and permanent correction in vertebral and segmental kyphotic angle about 15.2 degrees and 10.0 degrees , respectively and also a significant restoration in anterior and mid vertebral height. Lordoplasty is a minimal invasive technique to restore vertebral body height. An immediate relief of pain is achieved in most patients. The procedure is safe and cost effective.

Aged↗
PubMed1995

Thoracic compression fracture in a basketball player.

Thoracolumbar pain is a frequent complaint of many athletes, but the cause is often difficult to diagnose. Compression fractures of the spine are rarely seen in athletics and are not always recognized as a potential cause of the symptoms. Reported here is a case of a T12 compression fracture in a male basketball player. Pain films revealed the percentage of loss of vertebral body height, thereby determining the stability of the fracture. If treated with a thoracolumbar spinal orthosis brace and activity restrictions, stable compression fractures heal without surgical intervention and athletes can return to activity within a number of months. Athletic trainers and physicians should maintain a level of suspicion for this injury when violent trunk flexion or lateral flexion is the mechanism of injury.

Journal Article↗
PubMed2005

Correlation between preprocedural MRI findings and clinical outcomes in the treatment of chronic symptomatic vertebral compression fractures with percutaneous vertebroplasty.

OBJECTIVE: The purpose of our study was to correlate findings of prevertebroplasty MRI with outcomes in the treatment of chronic osteoporotic compression fractures. MATERIALS AND METHODS: Forty-five patients with osteoporotic spinal compression fractures of more than 1 year's duration were treated with vertebroplasty. Changes in pain and mobility were assessed by follow-up of 1-28 months. Preprocedural MR images were reviewed using the Modic criteria and were correlated with outcomes. RESULTS: Fifteen patients (33%) had marrow edema on MRI and 30 (67%) of the 45 patients did not. All 15 of the patients with edema had clinical benefit: six patients (40%) achieved complete relief and nine (60%) experienced symptom improvement. Ten patients (67%) had improvement in mobility, and the remaining five patients (33%) had no change. Of patients with no marrow edema (n = 30), five (17%) had complete resolution of pain, 19 (63%) were improved, and six (20%) were unchanged. None had worsening of their symptoms. Mobility was improved in 17 (57%) and unchanged in 10 (33%). Mobility was diminished in three patients (10%). In two cases, impaired mobility was due to causes other than spine disorders. CONCLUSION: Most (87%) of the 45 patients with compression fractures older than 1 year derived clinical benefit from vertebroplasty irrespective of MRI findings. Although 100% of patients with bone marrow edema had clinical benefit, no direct correlation was seen between symptom resolution and the presence of edema on preprocedural MRI. In our experience, absence of abnormal marrow signal does not definitively predict the outcome of vertebroplasty in chronic fractures.

Aged↗
PubMed1990

Thoracolumbar compression fractures presenting with an acute ileus.

Corticosteroids are commonly used in the treatment of connective tissue diseases such as systemic lupus erythematosus. Although they are usually efficacious, osteoporosis leading to spine compression fractures is not uncommon. In this case report, we describe an elderly patient with systemic lupus erythematosus on long-term corticosteroid therapy who presented with symptoms of acute abdomen with minimal low back symptoms. No intraabdominal process was found by abdominal studies and exploratory laparotomy. Increased lower back symptoms led to further skeletal spine studies, which initially demonstrated a compression fracture at the twelfth thoracic (T12) vertebra. Later, a T8 and a fourth lumbar (L4) compression fracture were also found. Her abdominal and lower back symptoms resolved on conservative therapy. Although the rate of these occurrences are unknown, compression spine fractures should be considered in elderly patients presenting with acute abdomen after being on long-term corticosteroid therapy.

Aged↗
PubMed2005

Percutaneous vertebroplasty for compression fracture: analysis of vertebral body volume by CT volumetry.

PURPOSE: To evaluate the relationships between volume of vertebral bodies with compression fracture (measured by CT volumetry) before percutaneous vertebroplasty, the amount of bone cement injected, and the effect of treatment. MATERIAL AND METHODS: We examined 49 consecutive patients, with 104 vertebral body compression fractures, who underwent percutaneous injection of bone cement. Vertebral body volume was measured by CT volumetry. The patient's pain level was assessed using a visual analog scale (VAS) before and after the procedure. Improvement in VAS was defined as the decrease in VAS after the procedure. Relationships between vertebral body volume, the amount of bone cement, and the effect of treatment were evaluated using Pearson's correlation coefficient test. RESULTS: Average vertebral body volume was 26.3 +/- 8.1 cm3; average amount of bone cement was 3.2 +/- 1.1 ml; and average improvement in VAS was 4.9 +/- 2.7. The vertebral body volume was greater if a larger amount of bone cement was injected. There was a significant positive correlation between vertebral body volume and amount of bone cement (r = 0.44; P < 0.0001). However, there was no correlation between vertebral body volume and improvement in VAS, or between amount of bone cement and improvement in VAS. CONCLUSION: In percutaneous vertebroplasty for vertebral body compression fracture, there is a positive correlation between vertebral body volume and amount of bone cement, but improvement in VAS does not correlate with vertebral body volume or amount of bone cement.

Aged↗
PubMed2003

Percutaneous vertebroplasty: treatment of painful vertebral compression fractures with intraosseous vacuum phenomena.

OBJECTIVE: This study was undertaken to determine the efficacy of percutaneous vertebroplasty in treating patients with painful compression fractures of the thoracic and lumbar vertebrae that contain intraosseous vacuum phenomena. MATERIALS AND METHODS: Nineteen cases of painful vertebral compression fractures with intraosseous phenomena occurring in 18 patients (six men, 12 women; age range, 59-88 years; mean age, 75.5 years) were identified from 393 percutaneous vertebroplasties performed in 199 patients during 32 and a half months. All patients had osteoporosis, with severe vertebral compression to less than one third of the vertebral body height in 13 of 19 cases. Affected levels were T6 (n = 1), T8 (n = 2), T9 (n = 1), T11 (n = 1), T12 (n = 4), L1 (n = 5), L2 (n = 2), L3 (n = 1), L4 (n = 1), and L5 (n = 1). All cases had the typical intravertebral body vacuum cleft appearance on radiographs. Imaging and clinical features were analyzed. RESULTS: The mean volume of polymethyl methacrylate injected was 7.43 mL (range, 4.0-15.0 mL). Typically, the polymethyl methacrylate filled the intravertebral vacuum cleft. Complications during radiography consisted of minimal polymethyl methacrylate leakage into the adjacent disk (15/19 cases) and the paravertebral soft tissues (8/19 cases). No complications required surgical intervention. At clinical follow-up, pain relief was complete in eight patients (44.4%), partial in six patients (33.3%), and unchanged in four patients (22.2%). CONCLUSION: Percutaneous vertebroplasty is effective in the treatment of patients with painful vertebral compression fractures with intraosseous vacuum phenomena.

Aged↗
PubMed2006

Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety.

STUDY DESIGN: Systematic review and meta-regression. OBJECTIVES: To compare the efficacy and safety of balloon kyphoplasty and vertebroplasty for the treatment of vertebral compression fractures, and to examine the prognostic factors that predict outcome. SUMMARY OF BACKGROUND DATA: A previous systematic review of vertebroplasty by Levine et al in 2000 identified seven case series studies and no controlled studies. METHODS: A number of electronic databases were searched through March 1, 2004. Citation searches of included studies were undertaken and contact was made with experts in the field. No language restrictions were applied. All controlled and uncontrolled studies were included with the exception of case reports. Prognostic factors responsible for pain relief and cement leakage were examined using meta-regression. RESULTS: The following studies were included: balloon kyphoplasty (three nonrandomized comparative studies against conventional medical therapy and 13 case series), vertebroplasty (one nonrandomized comparative study against conventional medical care and 57 cases series), balloon kyphoplasty versus vertebroplasty (one nonrandomized comparative study). The majority of studies were undertaken in older women with osteoporotic vertebral compression fractures with long-term pain that was refractory to medical treatment. At this time, there is no good quality direct comparative evidence of balloon kyphoplasty versus vertebroplasty. From indirect comparison of case series evidence, the procedures appear to provide similar gains in pain relief while for balloon kyphoplasty there is better documentation of gains in patient functionality and quality of life. The level of cement leakage and number of reported adverse events (pulmonary emboli and neurologic injury) in balloon kyphoplasty was significantly lower than for vertebroplasty. These findings were confirmed by meta-regression analysis. CONCLUSIONS: There is Level III evidence to support balloon kyphoplasty and vertebroplasty as effective therapies in the management of patients with symptomatic osteoporotic vertebral compression fractures refractory to conventional medical therapy. Although there was a good ratio of benefit to harm for both procedures, balloon kyphoplasty appears to offer the better adverse event profile. These conclusions need to be updated on the basis of the findings of ongoing randomized controlled trials.

Aged↗
PubMed2006

Latent mobility of osteoporotic vertebral compression fractures.

PURPOSE: To describe the property of latent mobility in osteoporotic vertebral compression fractures (VCFs) and discuss its clinical significance. MATERIALS AND METHODS: This was a retrospective case series of 14 patients with 14 painful osteoporotic VCFs who were comfortably confined to the supine position overnight for the purpose of vertebral height restoration. There was sufficient additional vertebral height restoration the following morning to allow percutaneous vertebroplasty (PV) in some patients when this had initially been deemed unsafe or technically impossible. Anterior vertebral height of the index VCF was measured from the preoperative standing lateral, immediate cross-table supine lateral, and postconfinement cross-table supine lateral radiographs as well as the first postoperative standing lateral radiograph. Dynamic mobility was defined as the difference in anterior vertebral height between preoperative standing lateral and immediate cross-table supine lateral radiographs. Latent mobility was defined as difference in anterior vertebral height between immediate cross-table supine lateral and postconfinement cross-table supine lateral radiographs. Postoperative vertebral height restoration was defined as the difference in anterior vertebral height between preoperative and first postoperative standing lateral radiographs. Mean patient age was 81.0 years, and mean fracture age was 83.6 days. RESULTS: Dynamic mobility averaged +4.7 mm (range, -2.1 to +12.6 mm; P = .001). Latent mobility averaged +2.7 mm (range, -1.9 to +15.5; P < .02). The average sum of preoperative dynamic and latent mobility (+7.4 mm; range -1.0 to +17.0; P < .001) was not different from final postoperative vertebral height restoration (P > .4). PV was successfully accomplished in all cases. CONCLUSIONS: Latent mobility occurs in some VCFs and contributes to vertebral height restoration. Recognition of latent mobility may permit vertebroplasty in some patients in whom the procedure had otherwise been deemed unsafe. Reports of vertebral height restoration following vertebral augmentation should account for that proportion resulting from dynamic and latent mobility.

Aged↗
PubMed1994

Acute compression fracture of the scaphoid.

A previously unreported radiological sign of a sclerotic margin to an acute displaced scaphoid fracture due to bone compression is reported. This should to be recognized because of the implied bone loss and hence risks of both mal-union and non-union, and because of the implication that volar compression fractures of the scaphoid may occur.

Acute Disease↗