Kyphoplasty for the treatment of painful osteoporotic thoracolumbar burst fractures

Orthopedics. 2010 Feb;33(2):88-92. doi: 10.3928/01477447-20100104-17.

Abstract

This study explored the feasibility and clinical outcome of kyphoplasty for the treatment of painful osteoporotic thoracolumbar burst fractures without neurological deficit. A total of 25 consecutive patients with painful type-A3 amyelic thoracolumbar fractures without neurological deficit were treated by kyphoplasty. Pain was measured using the self-reporting visual analog pain scale (VAS) preoperatively, postoperatively, and at 6-month follow-up. Disability was measured using the Oswestry Disability Index (ODI) preoperatively, postoperatively, and at 6-month follow-up. The height of the fractured vertebral body, kyphotic angle, and spinal canal compromise were measured preoperatively, postoperatively, and at 6-month follow-up. Relief of pain was achieved 24 hours postoperatively. Mean VAS score decreased from 8.2+/-1.3 preoperatively to 2.8+/-0.8 postoperatively (P<.05), and was maintained at 2.9+/-1.1 at 6-month follow-up. The ODI score varied from 68.2%+/-6.6% preoperatively to 35.3%+/-2.8% postoperatively (P<.05). Improvement was maintained at 6-month follow-up. Postoperatively, the height of anterior vertebrae (Ha) was restored from 61.5%+/-13.9% to 85.3%+/-10.6%, the height of midline vertebrae (Hm) restored from 73.0%+/-19.3% to 83.3%+/-7.4%, the kyphotic angle from 21.7 degrees +/-7.8 degrees to 8.6 degrees +/-6.6 degrees, and the spinal canal compromise from 20.1%+/-4.1% to 17.8%+/-1.3%. At 6-month follow-up, maintenance of the height restoration and kyphotic deformity correction was found. No significant difference was noted in pre- and postoperative spinal canal compromise. Kyphoplasty is a relatively safe and effective method for the treatment of painful osteoporotic thoracolumbar burst fractures.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Back Pain / etiology*
  • Back Pain / prevention & control*
  • Female
  • Fractures, Spontaneous / etiology
  • Fractures, Spontaneous / therapy
  • Humans
  • Male
  • Middle Aged
  • Osteoporosis / complications*
  • Osteoporosis / therapy*
  • Spinal Fractures / etiology*
  • Spinal Fractures / therapy*
  • Thoracic Vertebrae / surgery
  • Treatment Outcome
  • Vertebroplasty / methods*