A classification and scoring system for primary osteoporotic vertebral fracture to guide PVP/PKP applications

How to Cite

Hu, Z. . (2017). A classification and scoring system for primary osteoporotic vertebral fracture to guide PVP/PKP applications. American Journal of Translational Medicine, 1(4), 221–236. Retrieved from https://ajtm.journals.publicknowledgeproject.org/index.php/ajtm/article/view/886


Many controversies regarding clinical application have been present since the advent of bone cement injection (BCI) for the treatment of primary osteoporotic vertebral fracture (POVF). There is no POVF classification system for guiding clinical percutaneous vertebroplasty/percutaneous kyphoplasty (PVP/PKP) treatment, which may have led to these controversies. This study was designed to establish a POVF classification and scoring system (POVF-CASS) to guide BCI clinical applications and scientific research. A total of 1355 vertebrae in 542 POVF cases from multiple medical centers from July 1, 2010 to January 1, 2017 were systematically analyzed and classified based on the case history and analysis of X-ray, CT, and MR images. Then, the repeatability and reliability of this classification system were tested. POVF-CASS consists of two components: fracture classification based on morphology and biomechanical characteristics and a scoring system based on clinical factors. The latter is used for decision-making regarding BCI. The former is used to guide the execution of BCI, such as unilateral or bilateral PVP or PKP. The reliability and repeatability of POVF-CASS were excellent. Clinical epidemiological data showed that the incidence of POVF was consistent with that of non-POVF in the general population. Therefore, the cases used in this study were representative. This study proposes a classification and scoring system, POVF-CASS, that can adequately guide clinical decision-making for POVF treatment and research toward a unified POVF classification. (Am. J. Transl. Med. 2017. 1:221-236)