The Outcome of Radiofrequency Kyphoplasty in the Treatment of Vertebral Compression Fractures in Osteoporotic Patients

Hegazy, Ramy; El-Mowafi, Hesham; Hadhood, Mahmood; Hannout, Yasser; Allam, Yasser; Silbermann, Jeorg

Abstract

STUDY DESIGN: Retrospective study. PURPOSE: The study aims to assess the effectiveness and safety of radiofrequency (RF) kyphoplasty in the treatment of vertebral compression fractures (VCFs) in osteoporotic patients. OVERVIEW OF LITERATURE: Vertebroplasty and balloon kyphoplasty are established procedures for the treatment of osteoporotic VCFs. However, RF kyphoplasty is a new method which controls cement viscosity.
METHODS
We reviewed the results of 41 consecutive patients with 23 thoracic and 38 lumbar VCFs who underwent RF kyphoplasty. The study population included 14 males (34%) and 27 females (66%). The mean patients age was 78 years (range, 51-89 years), and the follow-up period was 1 year. Clinical and radiographic analyses were performed during follow-up at 6 weeks, 6 months, and 1 year. All patients were assessed clinically pre- and postoperative using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiological assessment with X-ray in two views preoperatively, postoperatively, and during follow-up visits.
RESULTS
The mean preoperative VAS was 8.7 (range, 5-10; standard deviation [SD], 1.2). Postoperatively, VAS decreased by 3.3 (range, 2-5; SD, 0.9). At the end of the follow-up, VAS decreased by 1.22 (range, 0-7; SD, 1.6). The mean preoperative ODI score was 85.9, decreasing to 9.6 postoperatively and improving to 18.4 during the 1-year follow-up. The mean local kyphotic angle was 9.04° before the procedure and decreased by a mean of 6.16° after the operation and at the end of the follow-up. The mean increase in vertebral body height was 3.3 mm postoperatively and after 1-year follow-up. The rate of cement leakage was 8% (five out of 61 levels of fracture).
CONCLUSIONS
RF kyphoplasty is a safe and effective augmentation technique with an advantage of controlling the cement viscosity to minimize the risk of cement leakage. It also shortens operation time.