J Korean Orthop Assoc.  2007 Dec;42(6):803-807. 10.4055/jkoa.2007.42.6.803.

Balloon Kyphoplasty using a Unilateral Approach for the Treatment of Osteoporotic Vertebral Compression Fractures

• Chung KJ
• Jung SO
• Yoon HS

• KMID: 1947788
• DOI: http://doi.org/10.4055/jkoa.2007.42.6.803

Abstract

PURPOSE: To evaluate the clinical results of a unilateral balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures (VCFs).
MATERIALS AND METHODS
Twenty patients, 23 cases of osteoporotic VCFs who failed to respond to nonoperative treatments and who were confirmed by a consultant radiologist, were enrolled in this study. Times between injury and operation varied from 2 weeks to 2 months. All patients except two (18 female, 2 male patients), were female, and mean patient age was 71.7 (58-82) years. Follow-ups were conducted at least 12 months (12-27, mean 18.3). All patients underwent unilateral balloon kyphoplasty. Roentgenographic assessments were perform to evaluate fractured vertebra restoration and reduction loss. A ten-point visual analogue scale was used to measure pre- and postoperative pain severity.
RESULTS
Preoperative anterior, middle and posterior heights of vertebra bodies were 57.8%, 66.1% and 85.3% of normal at presentation and these increased to 76.2%, 80.1%, 88.7% respectively at immediately after operation and at last follow-up, heights of each portion were 74.4%, 78.6%, 87.3%. Mean preoperative kyphotic angles of 17.6 degrees at presentation improved to 8.9 degrees at immediately after operations and to 9.1 degrees at last follow-ups. Loss of reduction was 1.8%, 1.5%, 1.4% and 0.2 degrees. Mean pain scores were 8.5 before surgery, 2.5 immediately after operations and 2.7 at last follow-ups. Statistical analysis showed a significant decrease in kyphotic angle (p=0.03) but VAS scores were no different (p=0.056). Anterior, middle and posterior body height was decreased with a statistical significance between two period (p<0.001). PMMA leakage occurred in 3 cases, but they did not cause neurologic deficits. CONSLUSION: Balloon kyphoplasty using a unilateral approach is a good treatment method for osteoporotic vertebral compression fractures and an alternative to the substitute bilateral approach.

Keyword

Spine; Osteoporosis; Compression fracture; Balloon kyphoplasty; Unilateral approach

MeSH Terms

Body Height
Consultants
Female
Follow-Up Studies
Fractures, Compression*
Humans
Kyphoplasty*
Male
Neurologic Manifestations
Osteoporosis
Pain, Postoperative
Polymethyl Methacrylate
Spine
Polymethyl Methacrylate

Figure

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  Fig. 1 The angle (a) formed by the two lines connecting the most ventral portion of the vertebra body and the spinous process, and the line is placing balloon in the middle of vertebra body, distance (b) between the two points where these two lines contacted the body surface.

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