S3065 BALLOON KYPHOPLASTY IN VERTEBRAL NON-UNIONS AFTER OSTEOPOROTIC COMPRESSION FRACTURES

Abstract

Aim: Stabilisation of vertebral bodies by injection of bone cement after osteoporotic fracture is well known for reduction of pain. During the last years the balloon kyphoplasty was introduced for reduction of kyphosis and increase of vertebral height. We investigated the used of this method in vertebral bodies even months after osteoporotic fractures with delayed ossification or unstable non-unions within the vertebral bodies. Methods: These fractures had a median age of 17 weeks. In the magnetic resonance imaging no signs of ongoing bone remodelling were found within the horizontal fracture gaps. In functional x-rays the instability within the vertebral body was proven. During surgery the needle was introduced via a transpedicular or extrapedicular approach and passed straight through the gap of the non-union. In very flat bones this procedure can be more tricky. The balloon was inserted and inflated to decrease the local kyphosis. After removal of the balloon bone cement (PMMA) was filled into the hole to fixate the fragments and stabilize the vertebral body. Results: The Patients had a distinct decrease in pain by preventing the movements within the vertebral body. Life quality measured with the Oswestry disability questionnaire showed a distinct and long lasting increase. Conclusion: In selected cases the balloon kyphoplasty is sufficient to reduce and stabilize vertebral bodies despite of a long period after the fracture.