KYPHOPLASTY: WHAT IS ITS EFFECT IN KYPHOTIC DEFORMITY

Abstract

Introduction: Minimally invasive augmentation techniques of vertebral bodies have been widely used in the treatment of painful osteoporotic vertebral compression fractures (VBCFs). Kyphoplasty seems to achieve pain relief and improvement in quality of life. However, the effect of kyphoplasty on the height and the kyphotic deformity of the vertebrae is now yet clear. The present study reports our experience in kyphoplasty procedures for osteoporotic VBCF’s.

Materials and Methods: A total of 105 VBCF (45 thoracic and 60 lumbar vertebrae) in 56 patients (16 male, 40 female; mean age: 69 years, range 32–87 years) were treated with kyphoplasty between 2002–2005. All patients were preoperatively evaluated with radiographs, MRI and bone scintigraphy, and postoperatively immediately following the procedure and 6 months later with radiographs. Eight patients were treated within a week from their injury (new fractures). All patients completed the Oswestry Disability Index Questionnaire pre- and immediately post-operatively and at 6 months. The height of the treated vertebrae and the kyphotic deformity were measured before, after the kyphoplasty and at 6 months. All procedures were performed under general anaesthesia and fluoroscopy guidance.

Results: 54 patients were included in the study; 2 patients expired from causes unrelated to the procedure. All patients experienced pain relief following the procedure and the average Oswestry Disability Index score decreased from 76% preoperatively to 12.4% postoperatively (P< 0.001) and to 18.5% (P< 0.001) at 6 months. The observed mean height restoration at 6 months was 3mm (range 0–15mm) (P=NS) and the kyphotic deformity correction was 3.70 (0–120) (P=NS). In the new fractures the height restoration was 7.1mm and the kyphotic correction 7.80 (P=0.01). There were no cases of pulmonary embolism nor were any significant cement leakages noted.

Conclusion: The treatment of painful osteoporotic VBCFs with kyphoplasty is safe and reduces pain and disability. However, it does not lead to restoration of the vertebral height nor to correction of the kyphotic deformity, except in new fractures.