Abstract
Aim: Life quality is decreased due to pain and the consequences of kyphosis after osteoporotic vertebral fractures. Injections of bone cement (PMMA) are known to stabilise fractured vertebral bodies avoiding major surgeries. The balloon kyphoplasty was introduced for reduction of the local kyphosis. We wanted to observe the range of time in which a correction of the deformity might be possible. Methods: A needle is introduced via a transpedicular or extrapedicular approach into the vertebral body. Then a balloon is inserted and inßated to elevate the endplates and to decrease the local kyphosis. After removal of the balloon PMMA is þlled into the cavity for stabilisation. We performed this procedure in 64 vertebral bodies in 40 patients. Results: The method was mainly used in deformities of vertebral bodies after stable fracture of the endplates due to osteoporosis but also in non-unions within the vertebral bodies. In these cases no signs of ongoing bone remodelling were found within the horizontal fracture gaps in the magnetic resonance imaging despite of the long lasting history of pain. In functional x-rays the instability within the vertebral body was observed. Only the dorsal wall of the vertebral body and the spinal canal had been proven to be intact. A distinct decrease in pain and disability was found in the patients during the time of follow up. The vertebral bodies showed a partial restoration of height and reduction of the local kyphosis even after a period of 3months. The non-unions were stabilised. However the fracture rate of adjacent segments was twice compared to other segments. Conclusion: We conclude that the balloon kyphoplasty is a save procedure in the hand of spine surgeons and sufþcient to reduce pain and improve the mechanical properties of the spine.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
