J Korean Soc Spine Surg.  2009 Jun;16(2):79-88. 10.4184/jkss.2009.16.2.79.

The Efficacy of Kyphoplasty on Osteoporotic Vertebral Compression Fracture : A 1-Year Follow-up Study

• Ahn DK
• Lee S
• Choi DJ
• Park HS
• Kim KS
• Kim TW

• KMID: 2209601
• DOI: http://doi.org/10.4184/jkss.2009.16.2.79

Abstract

STUDY DESIGN: This is a retrospective study.
OBJECTIVE
We wanted to evaluate the efficacy of kyphoplasty for treating osteoporotic VCF and we wanted to determine the risk factors for additional VCF. SUMMARY OF THE LITERATURE REVIEW: Successful pain relief with performing kyphoplasty for VCF has been well documented. However, unsatisfactory reduction and additional VCF are remained problems for kyphoplasty.
MATERIALS AND METHODS
Sixty-three patients who underwent kyphoplasty were followed up for more than 1 year. The degree of reduction of the collapsed vertebral height, the vertebral kyphotic angle, the regional Cobb's angle and the overall sagittal alignment, the visual analogue scale (VAS), the fracture configuration, the bone mineral density (BMD), the presence of intradiscal cement leakage and additional VCF were investigated. The risk factors for additional VCF were analyzed.
RESULTS
In terms of deformity correction, the collapsed vertebral height were restored (67.3+/-15.6% to 82.5+/-11.8%), the vertebral kyphotic angle was improved (12.1+/-6.9degrees to 8.1+/-5.3degrees ), the degree of the regional Cobb's angle was reduced (3.1+/-4.5degrees ) and the overall sagittal balance was improved (1.7+/-5.3 cm to 0.5+/-3.9 cm) with clinical satisfaction (VAS: 6.9+/-1.3 points to 2.3+/-0.9 points). But less than 40% of the patients reached the expected reduction criteria (the vertebral height > 90%, the vertebral kyphotic angle and regional Cobb's angle reduction > 5degrees ). Additional VCF occurred in 10 patients (15.9%). The average BMD in the additional VCF group was T-score of -3.8 and that for the no-additional VCF group was T-score of -3.0 (p=0.025). The degree of reduction under general anesthesia was twice more than that under local anesthesia. Eleven cases (17.5%) of intradiscal cement leakages were noticed, but this showed no relevance to the fracture configurations and additional VCF. The overall sagittal alignment and cement volume showed no relevance to additional VCF.
CONCLUSION
Kyphoplasty was excellent for pain reduction, but it was unsatisfactory for correcting deformity. Vertebral height correction was more effectively performed under general anesthesia. Additional VCF was caused by severe osteoporosis.

Keyword

Osteoporosis; Vertebral compression fracture; Kyphoplasty; Additional VCF

MeSH Terms

Anesthesia, General
Anesthesia, Local
Bone Density
Congenital Abnormalities
Follow-Up Studies
Fractures, Compression
Humans
Kyphoplasty
Osteoporosis
Retrospective Studies
Risk Factors

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