Percutaneous balloon kyphoplasty for treatment of very severe osteoporotic vertebral compression fractures: a case-controlled study

Publication date: Available online 18 October 2017
Source:The Spine Journal
Author(s): Jin Kyu Lee, Hae-won Jeong, Il-Han Joo, Young-Il Ko, Chang-Nam Kang
Background ContextThere exists controversy regarding percutaneous balloon kyphoplasty (PBK) in patients with very severe osteoporotic vertebral compression fracture (vsOVCF).PurposeThe study was conducted to investigate the clinical and radiological outcomes of PBK for the treatment of vsOVCF compared with those of non-vsOVCF.Study Design/SettingRetrospective, case controlled.Patient Sample167 consecutive patients (210 vertebral bodies) who underwent PBK for OVCF between March 2010 and January 2015 were assessed.Outcome MeasuresVisual analogue scale (VAS) for back pain, Korean Oswestry disability index (K-ODI), vertebral body height variation and kyphotic angle were evaluated preoperatively, postoperatively and 1 year after treatment.MethodsPatients with vsOVCF (anterior vertebral compression of more than two-thirds on the plain radiograph) who had undergone PBK where compared with non-vsOVCF (compression between 30% and two-thirds) patients group. Clinical and radiological outcomes were compared. In addition, complications were evaluated. There were no sources of funding and no conflicts of interest associated with this study.ResultsIn total, 31 patients (33 vertebrae) in vsOVCF group and 136 patients (177 vertebrae) in non-vsOVCF group were treated with PBK. Both groups had significant postoperative improvements in the clinical and radiological outcomes (VAS, K-ODI, vertebral body height variation and kyphotic angle). There was no difference regarding VAS and K-ODI between two groups at final follow up (p>0.05). The cement leakage occurred frequently in vsOVCF group (26 vertebrae, 78.8%) compared with that in non-vsOVCF group (92 vertebrae, 52.0%), the difference was statistically significant (p<0.05). But there was no case that showed neurological complication or pulmonary embolism due to cement leakage. The incidence of recollapse was significant higher in vsOVCF group (5 vertebrae, 15.2%) than in non-vsOVCF group (7 vertebrae, 4.0%) (p<0.05). The incidence of adjacent segment fracture (vsOVCF group, 6 vertebrae, 18.2%, non-vsOVCF group, 21 vertebrae, 11.9%) was not significantly different (p=0.320).ConclusionPBK is a safe and effective procedure for the treatment of vsOVCF.



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