J Korean Soc Spine Surg.  2005 Dec;12(4):349-357.

Comparison of the Results of Percutaneous Vertebroplasty for Treating Osteoporotic Vertebral Compression Fracture and Posttraumatic Vertebral Collapse (Kummell's disease)

• Kim BJ
• Kim JH
• Seo JG
• Kim YC

Abstract

STUDY DESIGN: The comparison was based on the radiographc and clinically differences of 96 vertebroplasty cases. PURPOSE: This study evaluated the clinical and radiological results of performing percutaneous vertebroplasty for acute or subacute osteoporotic vertebral compression fracture (group A) and for posttraumatic vertebral collapse (Kummell's disease) (group B). SUMMARY OF LITERATURE REVIEW: Percutaneous vertebroplasty is a minimal invasive procedure for the treatment of a painful collapsed vertebral body
MATERIALS AND METHODS
We experienced 67 cases of group A and 29 cases of group B, and we followed these patients for 2 years or more. We evaluated the clinical results by using the serial visual analogue scale (VAS) and the radiological results were evaluated by measuring the restoration of the anterior vertebral height and the change of the kyphotic angle. We also compared both groups for their bone mineral density (BMD) and new fracture rate.
RESULTS
Statistically significant pain relief was obtained by both groups in the perioperative period. The average VAS change was 6.5 (from 8.7 preoperatively to 2.2 postoperatively) in group A, and 7.1 (from 9.1 preoperatively to 2.0 postoperatively) in group B on a 10 point pain scale. The anterior vertebral height increased an average of 4.9mm (16.5%), (from 16.8mm preoperatively to 21.7 mm postoperatively) in group A, and 6.5 mm (21%) (from 12.8 mm preoperatively to 19.3 mm postoperatively) in group B on the perioperative period. But the height was minimally decreased more that it was measured at the immediate postoperative period: 18.7 mm in group A, and 16.2 mm in group B on the last follow up. The kyphotic angle was restored an average of 5.2 degrees (from 32.4 degrees preoperatively to 27.2 degrees postoperatively) in group A, and 4.9 degrees (from 39.5 degrees preoperatively to 34.6 degrees postoperatively) in group B on the perioperative period. But the angle was increased more than that measured preoperatively: about 1.7 degree in group A and group B on the last follow up. There's no significant difference in the BMD between the groups. New fracture developed in 17.9% (12) of group A, and 20.7% (6) of group B. We did this procedure for 15 cases of new fracture, and then the VAS change was an average 5.0 immediately after the operation.
CONCLUSIONS
Percutaneous vertebroplasty was an effective treatment method for both groups and there were no statistically significant differences in the clinical and radiological results. Care must be taken due to the relatively high rate of new fracture and this can be resolved by repeat vertebroplasty

Keyword

Vertebroplasty; Osteoporosis; spine compression fracture; Posttraumatic vertebral collapse

MeSH Terms

Bone Density
Follow-Up Studies
Fractures, Compression*
Humans
Osteoporosis
Perioperative Period
Postoperative Period
Vertebroplasty*

Figure

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  Fig. 1. Diagram of measurement methods for anterior vertebral height(AVH) and kyphotic angle(α).

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  Fig. 2. This radiography shows (A: initial posttraumatic kyphosis, B: percutaneous vertebroplasty T11).

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  Fig. 3. This radiography shows refracture after percutaneous vertebroplasty T8 on bone scan.

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  Fig. 4. This radiography shows repeat percutaneous vertebroplasty on T8.

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  Fig. 5. This radiography shows repeat refracture after percutaneous vertebroplasty on T9, L2 follow up bone scan.

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  Fig. 6. This radiography shows repeat percutaneous vertebroplasty T9, L2 finally.

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