Comparision of Vertebroplasty between Vertebral Osteoporotic Compression Fracture and Kummell's Disease

Ha, Kee Yong; Lee, Jun Seok; Kim, Yang Soo; Chon, Jin Sung; Seo, Jun Young

Abstract

PURPOSE
To evaluate the clinical outcomes of the vertebroplasty in the treatment of osteoporotic vertebral compression fracture and Kummell's disease. MATERIALS AND METHODS: The clinical and the radiological results of 54 vertebrae in 47 patients, who were followed for more than one year after vertebroplasty for 46 painful osteoporotic compression fractures (group 1) and 8 Kummell's disease (group 2) were analyzed. Clinically, the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) were analyzed prospectively. Radiologically, kyphotic deformity, vertebral height, cement leakage and bone resorption around cement were analyzed retrospectively at preoperative, postoperative and last follow-up. RESULTS: The ODI and VAS at each group were lowered after vertebroplasty and the pain relief of vertebroplasty was significant (p<0.001). However the mean ODI and VAS of group 2 were higher than those of group 1 at preoperative and postoperative (p=0.02 (ODI), p=0.02 (VAS)). The kyphotic deformity was more severe at group 2 than at group 1 but it was not statistically significant. The loss of vertebral height was also not statistically significant at each group. The cement leakage was found in 21 vertebrae among 54 vertebrae (38.8%). Group 2 had 75% (6/8) of cement leakage and most of them were type C leakage. Group 1 had 32.6% (15/46) of cement leakage and most of them were type B leakage. Bone resorption around cement was found at 2 vertebrae of group 2 and 1 vertebra of group 1. There were adjacent vertebral fractures in one case of group 2, four cases of group 1 and reoperation was needed in one case of group 2. CONCLUSION: The vertebropasty is an excellent method as a treatment of osteoporotic compression fracture and Kummell's disease, providing pain relief and early mobility in appropriate patients. However it must be kept in mind that higher rates of complications are related to cement in Kummell's disease.