Clinical effects between Kyphon XpanderⅠ and Kyphon XpanderⅡ percutaneous kyphoplasty on the treatment of osteoporotic vertebral compression fractures

English Keywords:Kyphon XpanderⅡ  Osteoporosis  Vertebral compression fracture  Percutaneous kyphonplasty  Minimally invasive surgery

English Abstract:

  【Abstract】 Objectives: To compare the clinical efficacy of Kyphon XpanderⅡ and Kyphon XpanderⅠ on the treatment of osteoporotic vertebral compression fractures(OVCFs). Methods: A total of 61 patients and 70 surgical vertebrae accompanied with fracture anterior wall or sidewall fracture were divided into KyphonⅠ group and KyphonⅡ group based on different balloon types. The imaging parameters including vertebral height and Cobb angle, the vertebral distraction effect was assessed by calculating the ratio of anterior body and the recovery of vertebral height and the degree of posterior collapse. Visual analogue scale(VAS) and oswestry disability index(ODI) were applied to evaluate the degree of pain and function. Results: KyphonⅠ group included 33 patients and 38 vertebrae, there were 9 males and 24 females with an average age of (66.31±7.85) years old. KyphonⅡ group included 28 patients and 32 vertebrae, there were 10 males and 18 females with an average age of (68.01±8.63) years old. There was no significant difference in the clinical data between the two groups(P>0.05), and the same results were also shown in hospital stay, surgical time, cement volume and blood loss(P>0.05). But the average balloon pressure of KyphonⅡ group(374.14±165.15psi) was significantly higher than that of KyphonⅠ group(171.45±97.81psi), (P<0.05). The comparison of Cobb angle, height of anterior body and its ratio between 1d and 12m after operation was statistical different(P<0.05), but VAS and ODI score did not show obviously different(P>0.05). In addition, KyphonⅡ group also showed significant advantage at the recovery value of Cobb angel and vertebral height 1 day after operatio(P<0.05), and KyphonⅠ group was more remarkable at the degree of Cobb angle loss at 12 months after operation(P<0.05). When considering complication, 8 vertebrae(21.05%) in KyphonⅠ group and 1 vertebra(3.13%) in KyphonⅡ group were noted cement leakage respectively, and 3 adjacent vertebral fractures(9.09%) happened in KyphonⅠ group, while the number was 0 in KyphonⅡ group. All complications did not cause obvious clinical symptoms. Conclusions: For the treatment of OVCFs patients accompanied with anterior wall and sidewall fracture, the new type of Kyphon XpanderⅡ can effectively restore the vertebral height and maintain the effect, the incidence rate of cement leakage and adjacent vertebral fracture is obviously lower, which comes to the satisfying clinical efficacy.