Percutaneous kyphoplasty by unilateral transverse process-pedicle approach for treatment of thoracolumbar osteoporotic vertebral compression fracture

English Keywords:Osteoporotic vertebral compression fracture  Percutaneous kyphoplasty  Thoracolumbar  Tranverse process  Pedicle

English Abstract:

  【Abstract】 Objectives: To explore the surgical technique and clinical efficacy of percutaneous kyphoplasty(PKP) by unilateral transverse process-pedicle approach for treatment of thoracolumbar osteoporotic vertebral compression fracture(OVCF). Methods: From January 2009 to March 2011, 26 patients with thoracolumbar OVCF were treated with PKP by unilateral transverse process-pedicle approach. There were 9 male patients and 17 female patients, aged 56-78 years(average 66 years) and 35 fractured vertebrae. In preoperation, the visual analogue scale(VAS) score was 7.96±0.95, the Cobb angle was 18.42°±5.98°, the anterior and medium height of fracture vertebra were 19.08±2.28mm and 17.02±1.72mm. At 2 days of postoperation and final follow-up, clinical efficacy was evaluated by VAS, and Cobb angle, anterior/medium height of vertebra were measured in X-ray films. Results: All the PKP operations were successful. The operation time was 15-75min(average 34min). The cement injected into every vertebra was 3-6ml(average 4.8ml). Cement was well-distributed in vertebrae without complications such as nerve injury, cement leakage into spinal canal. 23 patients were followed up for 12-36 months(average 29 months). At 2 days of postoperation and final follow-up, the VAS score was 2.42±0.39 and 2.01±0.37 seperately, the Cobb angle was 7.77°±0.77° and 8.71°±0.81°, the anterior height of vertebrae was 22.00±1.73mm and 21.28±1.24mm, the medium height was 20.80±0.75mm and 19.64±1.12mm. Compared with the preoperation, there were significant defferences in all the evaluations（P<0.05）. Between the 2 days of postoperation and the final follow-up, there was significant defference in the VAS score（P<0.05）, but no significant defference in the Cobb angle and the anterior/medium height of vertebrae（P>0.05）. Conclusions:　PKP by unilateral transverse process-pedicle approach is an efficient way to the treatment of thoracolumbar OVCF.