J Korean Soc Spine Surg.  2009 Jun;16(2):89-94. 10.4184/jkss.2009.16.2.89.

Recompression of Vertebral Bodies after Balloon Kyphoplasty for Vertebral Compression Fractures : Preliminary Report

• Kim YY
• Park CG
• Rhyu KW

• KMID: 2209602
• DOI: http://doi.org/10.4184/jkss.2009.16.2.89

Abstract

STUDY DESIGN: This is a retrospective and preliminary study.
OBJECTIVES
We wanted to evaluate the characteristics of recompression of vertebral bodies without trauma after balloon kyphoplasty (KP) for treating osteoporotic vertebral compression fractures (VCF). SUMMARY OF THE LITERATURE REVIEW: KP has been used for fracture reduction, maintenance of vertebral height and relief of pain in VCF. Despite of numerous satisfactory results, several factors have been noted to affect the clinical results of KP.
MATERIALS AND METHODS
Six patients with recompression of vertebral bodies without trauma after KP were reviewed. All the patients were female and their mean age was 75.9+/-4.1 years old. The follow-up period was 17.2+/-8.5 months. The compression rates of the operated vertebral bodies (CR) and the kyphotic angles (KA) were checked by using plain roentgenograms at the initial, postoperative and last follow-up periods. The preoperative MRIs were also reviewed. The clinical results were checked using the VAS.
RESULTS
The CRs at the initial, postoperative and last follow-up periods were 33.7+/-14.8%, 13.4+/-7.6% and, 26.9+/- 9.9%, respectively. The KAs were 19.2+/-7.2degrees , 14.8+/-6.2degrees and 20.5+/-7.4degrees for each period, respectively. Statistically, the CR and KA at the initial-postoperative period and at the postoperative-last follow-up period showed significant differences (p < 0.05). Intervertebral clefts were found in all the cases on MRI. Normal bones superior or inferior to cement were also seen in all the cases after KP. The VAS scores were 8.5+/-0.5, 2.3+/-0.5 and 3.0+/-0.6, retrospectively, and there were significant differences between each periods (p<0.05).
CONCLUSIONS
Recompression of a vertebral body without trauma after KP for treating VCF was observed in the cases with a intervertebral cleft seen on MRI and normal bones superior or inferior to the cement were observed after KP. The causes of recompression may be subsequent compression or resorption of the remaining vertebral body.

Keyword

Osteoporotic vertebral compression fracture; Balloon kyphoplasty; Intervertebral cleft; Recompression

MeSH Terms

Female
Follow-Up Studies
Fractures, Compression
Humans
Kyphoplasty
Retrospective Studies

Figure

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  Fig. 1. 81 years-old female with D12 vertebral compression fracture (case 6). (A) Initial plain roentgenogram. The initial height loss was 34.5% and initial T-score was -4. Initial kyphotic angle was 31。 (black arrow). (B) The T2-weighted MRI image showed the intervertebral cleft (white arrow). (C) The balloon kyphoplasty was done and the fracture was reduced into 13.8% of body compression and 26。 of kyphotic angle. The normal portions of vertebral body were seen at superior and inferior aspect of the cement (black arrows) after surgery. (D) The plain roentgenogram showed resorption of the remained vertebral body at 14 months after the surgery (black arrows). The inferior portion of vertebral body was resolved mainly. Body compression rate was increased into 31% and the kyphotic angle was resulted to 33。. The initial, postoperative, and last VAS score were 9, 2 and 2, retrospectively.

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