Unilateral versus bilateral balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures

English Keywords:Vertebral compression fracture  Kyphoplasty  Osteoporosis  Unilateral  Bilateral

English Abstract:

  【Abstract】 Objective：To evaluate the efficacy of unilateral versus bilateral balloon kyphoplasty（BKP） for osteoporotic vertebral compression fractures（OVCFs）.Method：The clinical data of 67 patients with OVCFs without nerve deficit undergoing either unilateral or bilateral BKP were analyzed retrospectively.27 cases underwent unilateral BKP，including 11 males and 16 females with the age of 62.3±7.4 years.There were 2 T10，2 T11，5 L1，7 L2，7 L3，3 L4 and 1 L5.While 40 cases underwent bilateral BKP，including 17 males and 23 females，with the age of 68.5 years ± 5.7 years.There were 3 T9，7 T10，6 T11，3 T12，5 L1，6 L2，7 L3 and 3 L4.The operation time，X ray exposure times，complications，anterior and middle vertebral height restoration and VAS scores improvement at final follow-up after operation between unilateral and bilateral BKP were compared.Result：The mean operative time was 40±18min in unilateral BKP group and 65±25min in bilateral BKP group，there was statistically significant difference（P<0.05）.The average X-ray exposure times were （36±13） times in unilateral BKP group and （63±21） times in bilateral BKP group（P<0.05）.The cement leakage rate was 11.1% in unilateral BKP group and 12.5% in bilateral BKP group（P>0.05）.The fracture rate of non-surgical vertebra after BKP was 3.7% in unilateral BKP group and 5% in bilateral BKP group（P>0.05）.The mean follow-up was （14.7±4.5） months for unilateral BKP group and （14.3±5.2） months for bilateral BKP group.At final follow-up，the anterior vertebral height restoration rate was （29.0±14.7）% in unilateral BKP group and （34.2±17.8）% in bilateral BKP group（P>0.05），the middle vertebral height restoration rate was （24.5±17.9）% for unilateral BKP group and （30.8±21.1）% for bilateral BKP group（P>0.05）；VAS improvement rate was （75±9）% in unilateral BKP group，（73±7）% in bilateral BKP group（P>0.05）.Conclusion：Unilateral and bilateral BKP remain a reliable and effective treatment for OVCFs.Compared with bilateral BKP，unilateral BKP is of less operation time and less X ray exposure.