Clinical and Radiographic Results of Unilateral Transpedicular Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures

Chang, Dong Kyu; Cho, Kyoung Suok; Lee, Sang Bok; Huh, Pil Woo; Yoo, Do Sung; Kang, Seok Go; Kim, Dal Soo; Park, Chun Kun

Abstract

OBJECTIVE
Pain and kyphosis caused by osteoporotic vertebral compression fractures adversely affect quality of life and survival. Kyphoplasty involves the inflation of a balloon bone tamp, percutaneously placed in a fractured vertebral body, followed by deposition of bone cement into the resulting cavity. Most previous reports indicate that traditional bilateral kyphoplasty improves patient function and restores height of collapsed vertebral bodies, but limited data about the effects of unilateral kyphoplasty on clinical and radiological outcome are available.
METHODS
One hundred five patients with osteoporotic vertebral compression fractures who did not respond to medical therapy were treated by unilateral kyphoplasty between January 2004 and December 2006. These patients underwent 105 operations to treat 132 vertebral compression fractures between T8 and L5. Sagittal alignment was analyzed from standing radiographs (pre-and post kyphoplasty). Clinical outcomes were determined by comparison of preoperative and postoperative data from patient-reported indexes (pain assessment, pain medication usage and visual analogue pain scale (VAS) score for Back Pain). Radiographs were assessed as to percent vertebral collapse, vertebral height restoration and local kyphosis correction.
RESULTS
Mean length of follow-up was 15.3 months (range 3-36 months); improved height 2.3 and 4.0 mm in the anterior and medial columns, respectively (p>0.05); cobb angle increased 8.8°(0-29°) (p<0.05), visual analogue pain scale score improved 7 points (p<0.05); no adverse medical or procedural complications; 6.8% (9/132) cement leakage rate.
CONCLUSION
Unilateral transpedicular kyphoplasty improves physical function, reduces pain, and may correct kyphotic deformity associated with vertebral compression fractures. This result comparable to traditional bilateral kyphoplasty procedure.