• Proceedings of the KSME Conference
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• 2007.05a
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• pp.746-750
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• 2007

Vertebroplasty has drawn much attention as a medical treatment for the compression fracture of spine, which strengthens the vertebral body and corrects deformity, and relieves pain in patients by injecting bone cement. However vertebroplasty can cause fracture on adjacent vertebra due to relative stiffness change. This study involves the biomechanical evaluation of the vertebroplasty especially on adjacent vertebral body. The finite element method has been employed to analyze the patient who was treated vertebroplasty under static and dynamic loading. For this study, a three-dimentioal model of the three-level ligamentous lumbar segment ($L1{\sim}L3$)is created from medical image data (CT)and compared with the experimental results in vitro.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.10a
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• pp.240-243
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• 2005

Osteoporosis, one of the age-related disease causes vertebra body fracture due to weakening trabecular bone and makes a substantial effect on load sharing among vertebras. Recently, vertebroplasty is one of the most popular treatment, as augmenting PMMA into vertebra. Biomechanical studies about vertebroplasty have been evaluated by several experiments or analysis under static loading but there has been no study on response under dynamic loading. This study included the FE analysis of patients who treated vertebroplasty under dynamic loading. For this study, 3-D FE model of lumbar spine(L1-L2) was modeled from CT scanning data and compared with experimental results in vitro in order to validate this model. Biomechanical behavior about each of normal person, osteoporotic patient and patient treated vertebroplasty for quantitative evaluations of vertebroplasty was compared and investigated.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.92-95
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• 2006

Objective : Severe vertebral body collapse [vertebra plana] is considered a contraindication to vertebroplasty by most authors. The purpose of this study is to determine the efficacy of vertebroplasty in treating severe compression fracture patients with osteoporosis. Methods : 16 patients underwent 18 vertebroplasties following postural reduction for vertebra plana. The fractures were defined vertebrae that have collapsed to more than 75% of their original height. Imaging and clinical features were analyzed, including involved vertebrae level, vertebral height after postural reduction for 2 days, injected cement volume, clinical outcome and complications. Results : Involved veretebra were located from level T7 to L4. Vertebral body collapse averaged 79% [range $12{\sim}25%$] of the original height. After pillow reduction for 2 days, vertebral body height increased 35% of the original height [range $15{\sim}45%$]. The kyphotic wedge was $12^{\circ}$ before procedure and was decreased $7.0^{\circ}$ after vertebroplasty. The mean injected cement volume was 3.8ml [range $2.0{\sim}4.9ml$]. After the procedure, surgical outcome was excellent in 8 [50%] of 16 patients, good in 7 [42%] and unchanged in one [8%]. The mean pain score [VAS score] prior to vertebroplasty was 8.3 and it changed 3.2 after the procure. Cement leakage to the adjacent disc [5 cases] and paravertebral soft tissues [4 cases] developed but there were no major complications. Conclusion : We propose that vertebra plana due to osteoporosis is not a contraindication to vertebroplasty. Vertebroplasty following postural reduction for severe compression fracture is safe and effective treatment.

• Journal of Korean Neurosurgical Society
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• v.47 no.5
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• pp.399-402
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• 2010

Osteoporosis is a worldwide problem and it mainly affects postmenopausal women. Osteoporosis associated with pregnancy or lactation is a rare condition. The incidence and mechanism of this phenomenon has not been clarified, but it can cause one or more vertebral compression fractures with severe, prolonged back pain in the affected women. We experienced this uncommon case, treated it with percutaneous vertebroplasty. A 35-old-woman visited our hospital with complaints of severe back pain and flank pain 2 months after normal vaginal delivery. She was diagnosed with osteoporotic vertebral compression fractures on the T5, 8, 9 and 11 vertebral bodies and we performed percutaneous vertebroplasty on the T8, 9 and 11 vertebrae with a good result. We present here an unusual case of pregnancy-associated compression fractures treated by percutaneous vertebroplasty.

• Journal of Korean Neurosurgical Society
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• v.40 no.2
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• pp.95-98
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• 2006

Objective : The aim of this study is to evaluate the feasibility, safety and effectiveness of radiofrequency neurotomy[RFN] for remnant pain after vertebroplasty for the treatment of severe compression fracture. Methods : 25 patients with remnant pain after vertebroplasty for one level severe compression fracture were treated by RFN. The severe compression fractures were defined to the vertebrae which less than 50% of their original heights have collapsed. Pain relief was evaluated at 2 weeks, 6 weeks and 3 months after the procedure using a visual analog scale[VAS]. Results : Successful outcome was determined if pain reduction exceeded 50% on the VAS at 6 weeks. Six of the 25 patients did not respond favorably to RFN [pain reduction less than 50%], and nineteen patients showed successful responses. Mean VAS score was decreased from 5.48 to 2.96 at 6 weeks. Conclusion : The radiofrequency neurotomy may be both feasible and useful treatment for the remnant pain after vertebroplasty. However long-term follow up is needed to confirm the effectiveness.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.06a
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• pp.1324-1327
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• 2003

The compressed fracture of spine caused by osteoporosis is one of the most frequent diseases in bone fracture. Recently the vertebroplasty has drawn much attention as a medical treatment for the compressed fracture of spine, which strengthens the vertebral body and corrects deformity, and relieves pain in patients by injecting bone cement. The finite element analysis is used to investigate the vertebroplasty quantitatively. Previous works with finite element analysis have drawbacks in their simplified models geometry of vertebral body and with material properties of bone. In this paper the exact geometry of vertebral body has been constructed from medical image data and the biomechanical property changes of vertebral body in vertebroplasty have been investigate by using three dimensional finite element analysis.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.202-205
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• 2015

Purpose: Pulmonary cement embolization after vertebroplasty is a well-known complication. The reported incidence of pulmonary cement emboli after vertebroplasty ranges frome 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Onset and severity of symptoms are variable. Case description: We present the case of a 83-year-old women who underwent fourth lumbar vertebroplasty and subsequently had dyspnea several days later. Posteroanterior chest radiography showed multiple linear densities. Computed tomography of thorax revealed also multiple bilateral, linear hyperdensities within the lobar pulmonary artery branches are detected in axial and coronal views. Literature Reviews: Operative management of vertebral compression fractures has included percutaneous vetebroplasty for the past 25 years. Symptoms of pulmonary cement embolism can occur during procedure, but more commonly begin days to weeks, even months, after vertebroplsty. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces. Conclusion: Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately.

• Journal of Korean Neurosurgical Society
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• v.38 no.5
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• pp.350-354
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• 2005

Objective : The aim of this study is to assess the immediate and long-term efficacy of percutaneous vertebroplasty for treating painful vertebral osteoporotic fractures. Methods : A retrospective review of 149patients who had undergone 167 vertebroplasty procedures for osteoporotic fractures was performed. Clinical, radiologic, and procedural datas were analyzed as parameters of prognostic significance, including age, sex, bone marrow density score, symptom duration, bone cement filling grade, number of fractured vertebrae, compression grade of vertebrae, leakage of bone cement, volume of bone cement injected and complications. Results : In 158 of the 167 procedures assessed, immediate pain relief was obtained [94.6%]. The extent of collapse of the vertebral body was assessed as a parameter for prognostic significance [p=0.015]. Three months postoperatively, no improvement of the pain was observed in four of the 167 procedures that had undergone the vertebroplasty [2%]. At long-term follow-up, the improvement of pain was not correlated with the compression grade of vertebrae [p=0.420]. Conclusion : The immediate outcome of vertebroplasty are less effective in vertebrae more collapsed.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.142-145
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• 2005

Background: Vertebroplasty that is performed in the upper and middle thoracic spine presents technical challenges that are different from those in the lower thoracic or lumbar region due to the small pedicle size and angular severity for thoracic kyphosis. We report the results of percutaneous vertebroplasty and review its effectiveness in treating intractable osteoporotic compression fractures in the upper and middle thoracic spine. Methods: Patients who underwent vertebroplasty due to painful osteoporotic compression fractures at T3 T8 were retrospectively analyzed. The compression rate, volume of injected cement, clinical outcome (VAS score) and complications were analyzed. Results: Forty-three vertebral bodies from 41 patients (32 females and 9 males, age from 64 to 78 years old) underwent vertebroplasty. The mean compression rate improved from 35% to 17%. Bipedicular injections of bone cement were performed at 3 levels of 2 patients, and unipedicular injections were performed in 40 levels of 39 patients. The mean VAS score prior to surgery was 7.7, which improved to 2.4 within 48 hours after surgery, and the mean VAS score after 6 months was 1.5, which was significantly lower. All patients recovered uneventfully, and the neurological examination revealed no deficits. Cement leakage to the adjacent disc (9 levels) and paravertebral soft tissues (10 levels) developed. However, there were no significant complications related to the procedure such as a pneumothorax or pulmonary embolism. Conclusions: Transpedicular vertebroplasty is a safe and effective treatment for the upper and middle thoracic regions, and has a low complication rate.

• Journal of Korean Neurosurgical Society
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• v.42 no.2
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• pp.112-117
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• 2007

Objective : Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures. Methods : Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment. Results : The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment. Conclusion : Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.