Effect of percutaneous kyphoplasty for osteoporotic thoracolumbar single vertebral wedge and concave fractures

English Keywords:Vertebral compression fracture  Percutaneous kyphoplasty  Osteoporosis

English Abstract:

  【Abstract】 Objective：To evaluate the clinical efficacy of percutaneous kyphoplasty（PKP） for osteoporotic thoracolumbar single vertebral wedge and concave fractures.Method：From January 2008 to December 2009，33 cases with osteoporotic thoracolumbar single vertebral fractures including 18 wedge fracture（group A） and 15 concave fracture（group B） underwent PKP.Preoperative and postoperative visual analog scale（VAS） scores，anterior and middle vertebral height rate and kyphosis Cobb angle were recorded and analyzed.Result：All operations were performed successfully.Cement leakage into the inferior intervertebral disc occurred in 1 case in group A，while cement leakage into the superior intervertebral disc in 1 case and cement leakage into the needle channel occured in group B.Both were asymptomatic.Preoperative and postoperative VAS scores in group A were 8.1±1.0 and 2.3±0.6 respectively，and those for group B were 8.2±0.8 and 1.9±0.6，which showed statistically significant difference between preoperative and postoperative VAS scores in each group（P＜0.001）.The postoperative anterior and middle vertebral height ratio improved and kyphosis Cobb angle decreased significantly compared with the preoperative ones in group A（P＜0.05）.In group B，the postoperative middle vertebral height improved significant compared with the preoperative ones（P＜0.05），but there was no significant difference as for anterior vertebral height and kyphosis Cobb angle（P＞0.05）.There was significant difference as for anterior vertebral body height restoration rate between both groups（P＜0.05）[group A：（19.3±11.4）%，group B：（6.4±6.2）%]，but no significant difference as for middle vertebral body height restoration rate existed between both groups（P＞0.05）[group A：（15.9±9.3）%，group B：（15.1±6.7）%].There was also statistically significant difference as for Cobb angles（P<0.001）（group A corrected 6.7°±2.2°，group B corrected 1.4°±1.3°）.The follow-up ranged 8-31 months（average，18.3months）.No vertebrae refracture or adjacent vertebral fractures was noted.Conclusion：PKP for osteoporotic thoracolumbar single vertebral wedge and concave fractures can relieve pain quickly，restore the height of fractured vertebra and maintain the spinal alignment，which ensure good short-term outcome.