Evidence map›Paper›PMID 32367420›Full record

ArticleEuropean radiology2020

Safety of vertebral augmentation with cranio-caudal expansion implants in vertebral compression fractures with posterior wall protrusion.

Louis Meyblum, Kévin Premat, Mahmoud Elhorany, Eimad Shotar, Évelyne Cormier, Vincent Degos, Hugues Pascal-Mousselard, Sylvie Rosenberg, Frédéric Clarençon, Jacques Chiras

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Article in European radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Review
  2. Article
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  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Louis MeyblumDepartment of Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Kévin PrematDepartment of Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Mahmoud ElhoranyDepartment of Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Eimad ShotarDepartment of Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Évelyne CormierDepartment of Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Vincent DegosDepartment of Anaesthesiology and Critical Care, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Hugues Pascal-MousselardDepartment of Orthopedic Surgery, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Sylvie RosenbergDepartment of Rheumatology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Frédéric ClarençonDepartment of Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France. fredclare5@gmail.com.
Jacques ChirasDepartment of Neuroradiology, Sorbonne University, AP-HP, Pitié Salpêtrière - Charles Foix Hospitals, F75013, Paris, France.
Pitié-Salpêtrière Hospital · FRAssistance Publique – Hôpitaux de Paris · FRHôpital Charles-Foix · FRSorbonne Université · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesVertebral augmentation (VA) has become routinely used in vertebral compression fractures (VCFs). VCFs are often associated with posterior wall protrusions (PWPs), which theoretically contraindicates vertebroplasty due to a higher risk of neurological complications. The latest generation of VA devices uses intravertebral cranio-caudal expandable implants to improve the correction of structural deformities but could also be used to prevent further PWP during cement injection. The aim of this study was to evaluate the safety of VA with expandable implant for VCFs with PWP.

methodsAll consecutive patients treated with expandable implants were considered eligible for inclusion if they met the following criteria: (1) non-neurological VCF, (2) considered unstable (A3-A4 in AOSpine classification), (3) significant PWP (> 2 mm), (4) back pain with a visual analogue scale (VAS) ≥ 4. PWPs were independently measured by two investigators; Pearson's statistics were used for interobserver reproducibility.

resultsFifty-one consecutive patients, with a mean age of 75 ± 8.3 years (range, 50-92), were included. There was a slight decrease between mean preoperative (6.7 mm ± 2.2 mm) and postoperative (6.5 mm ± 2.2 mm) PWP (p = 0.02), with an excellent interobserver reproducibility (Pearson correlation coefficient = 0.92). A mean kyphosis reduction of 34.9% (± 28.4) was observed (p < 0.001). Forty-two patients (82.4%) had significant pain improvements (mean preoperative VAS = 6.9 [± 1.7] versus 3.1 [± 2.0] postoperatively [p < 0.001]). Secondary adjacent level fractures were noted in 16 patients (31.4%), with a reduction of that risk down to 18.8% if a preventive adjacent vertebroplasty was performed, without reaching the significance threshold (p = 0.14).

conclusionsVA with expandable implants appeared safe for non-neurological VCFs with PWP, while allowing satisfactory pain relief. KEY POINTS: • Vertebral augmentation with cranio-caudal expandable implants is safe for non-neurological vertebral compression fractures with posterior wall protrusions. • Vertebral augmentation with cranio-caudal expandable implants might increase the occurrence of secondary adjacent level fractures. • Adjacent level vertebroplasty might be helpful to prevent secondary adjacent level fractures.

Indexed as

AgedAged, 80 and overBack PainBone CementsFemaleFractures, CompressionHumansKyphosisMaleMiddle AgedOsteoporotic FracturesPain ManagementPain MeasurementPatient SafetyProstheses and ImplantsReproducibility of ResultsBone CementsBack painOsteoporotic fracturesSpinal fracturesVertebroplasty

Identifiers

PMID32367420
OpenAlexW3023102849

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.