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Does balloon kyphoplasty improve the global spinal alignment in osteoporotic vertebral fracture?

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Abstract

Purpose

Balloon kyphoplasty (BKP) has been a well-accepted procedure in the treatment of osteoporotic vertebral compression fracture (OVCF), whereas it remains unclear whether or not this procedure has an impact on the global spinal alignment. The purpose of this study is to evaluate the effect of BKP on the global spinal alignment in OVCF.

Methods

Fifty-six consecutive patients who had undergone BKP for symptomatic OVCF were retrospectively reviewed with a mean follow-up of 32 months. They were seven males and 49 females with a mean age of 75 years. Radiographic assessment was performed using upright whole spine radiographs. The parameters included vertebral kyphosis, mid-vertebral body height and global sagittal spinal alignment (C7 plumb line deviation). Clinical outcomes were evaluated using visual analog scale of back pain.

Results

Fifty-one of 56 patients (91.1 %) achieved immediate pain relief. Vertebral kyphosis significantly decreased from 18 to 14 degrees, but 43 patients (76.8 %) still had more than 10 degrees of local kyphosis. Subsequent vertebral compression fractures were observed in seven patients (12.5 %). Anterior deviation of a C7 plumb line (C7PL) was 3.1 cm pre-operatively, 3.1 cm postoperatively, and significantly increased to 5.9 cm at the final follow-up. Consistent results were obtained in those with pre-operative sagittal imbalance (>5 cm anterior deviation of C7PL) and with pre-existing OVCFs.

Conclusions

BKP contributed to immediate pain relief, but did not improve the global sagittal spinal alignment after OVCF. This procedure should be solely indicated for painful OVCF or non-union, and could not be expected to restore the global sagittal alignment.

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References

  1. Berlemann U, Franz T, Orler R, Heini PF (2004) Kyphoplasty for treatment of osteoporotic vertebral fractures: a prospective non-randomized study. Eur Spine J 13:496–501

    Article  PubMed Central  PubMed  Google Scholar 

  2. Biino G, Casula L, de Terlizzi F, Adamo M, Vaccargiu S, Francavilla M et al (2011) Epidemiology of osteoporosis in an isolated Sardinian population by using quantitative ultrasound. Am J Epidemiol 174:432–439

    Article  PubMed  Google Scholar 

  3. Bornemann R, Jansen TR, Kabir K, Pennekamp PH, Stuwe B, Wirtz DC, et al (2013) Comparison of radiofrequency-targeted vertebral augmentation with balloon kyphoplasty for the treatment of vertebral compression fractures: 2-year results. J Spinal Disord Tech. Nov 15 [Epub ahead of print]

  4. Cagli S, Isik HS, Zileli M (2010) Vertebroplasty and kyphoplasty under local anesthesia: review of 91 patients. Turk Neurosurg 20:464–469

    PubMed  Google Scholar 

  5. Chen L, Yang H, Tang T (2011) Unilateral versus bilateral balloon kyphoplasty for multilevel osteoporotic vertebral compression fractures: a prospective study. Spine (Phila Pa 1976) 36:534–540

    Article  Google Scholar 

  6. Chung HJ, Chung KJ, Yoon HS, Kwon IH (2008) Comparative study of balloon kyphoplasty with unilateral versus bilateral approach in osteoporotic vertebral compression fractures. Int Orthop 32:817–820

    Article  PubMed Central  PubMed  Google Scholar 

  7. Crandall D, Slaughter D, Hankins PJ, Moore C, Jerman J (2004) Acute versus chronic vertebral compression fractures treated with kyphoplasty: early results. Spine J 4:418–424

    Article  PubMed  Google Scholar 

  8. Dong R, Chen L, Gu Y, Han G, Yang H, Tang T et al (2009) Improvement in respiratory function after vertebroplasty and kyphoplasty. Int Orthop 33:1689–1694

    Article  PubMed Central  PubMed  Google Scholar 

  9. Erkan S, Ozalp TR, Yercan HS, Okcu G (2009) Does timing matter in performing kyphoplasty? Acute versus chronic compression fractures. Acta Orthop Belg 75:396–404

    PubMed  Google Scholar 

  10. Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine (Phila Pa 1976) 26:1511–1515

    Article  CAS  Google Scholar 

  11. Han S, Wan S, Ning L, Tong Y, Zhang J, Fan S (2011) Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: a meta-analysis of randomised and non-randomised controlled trials. Int Orthop 35:1349–1358

    Article  PubMed Central  PubMed  Google Scholar 

  12. Jalava T, Sarna S, Pylkkanen L, Mawer B, Kanis JA, Selby P et al (2003) Association between vertebral fracture and increased mortality in osteoporotic patients. J Bone Miner Res 18:1254–1260

    Article  PubMed  Google Scholar 

  13. Jensen ME, Evans AJ, Mathis JM, Kallmes DF, Cloft HJ, Dion JE (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects. AJNR Am J Neuroradiol 18:1897–1904

    CAS  PubMed  Google Scholar 

  14. Kanayama M (2013) Sagittal plane correction in pedicle subtraction osteotomy using the Xia 3 SUK direct vertebral rotation system: technical note. J Neurosurg Spine 19:507–514

  15. Kanayama M, Ishida T, Hashimoto T, Shigenobu K, Togawa D, Oha F et al (2010) Role of major spine surgery using Kaneda anterior instrumentation for osteoporotic vertebral collapse. J Spinal Disord Tech 23:53–56

    Article  PubMed  Google Scholar 

  16. Kaneda K, Asano S, Hashimoto T, Satoh S, Fujiya M (1992) The treatment of osteoporotic-posttraumatic vertebral collapse using the Kaneda device and a bioactive ceramic vertebral prosthesis. Spine (Phila Pa 1976) 17:S295–S303

    Article  CAS  Google Scholar 

  17. Klezl Z, Clamp JA, Becker J, Jones M, Calthorpe D, Bommireddy R (2012) Impact of kyphoplasty treatment for vertebral compression fractures on pain and function in 105 patients. Acta Chir Orthop Traumatol Cech 78:551–555

    Google Scholar 

  18. Korovessis P, Zacharatos S, Repantis T, Michael A, Karachalios D (2008) Evolution of bone mineral density after percutaneous kyphoplasty in fresh osteoporotic vertebral body fractures and adjacent vertebrae along with sagittal spine alignment. J Spinal Disord Tech 21:293–298

    Article  PubMed  Google Scholar 

  19. Li X, Yang H, Tang T, Qian Z, Chen L, Zhang Z (2012) Comparison of kyphoplasty and vertebroplasty for treatment of painful osteoporotic vertebral compression fractures: twelve-month follow-up in a prospective nonrandomized comparative study. J Spinal Disord Tech 25:142–149

    Article  CAS  PubMed  Google Scholar 

  20. Lieberman IH, Dudeney S, Reinhardt MK, Bell G (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 26:1631–1638

    Article  CAS  Google Scholar 

  21. Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323

    Article  CAS  PubMed  Google Scholar 

  22. Mengmeng Z, Yagang L, Ying L, Xuena P, Binbin L, Liu Z (2012) A study of bone mineral density and prevalence of osteoporosis in Chinese people of Han nationality from Changchun. Arch Osteoporos 7:31–36

    Article  PubMed  Google Scholar 

  23. Munting E (2010) Surgical treatment of post-traumatic kyphosis in the thoracolumbar spine: indications and technical aspects. Eur Spine J 19(Suppl 1):S69–73

  24. Patil S, Rawall S, Singh D, Mohan K, Nagad P, Shial B et al (2012) Surgical patterns in osteoporotic vertebral compression fractures. Eur Spine J 22:883–891

    Article  PubMed Central  PubMed  Google Scholar 

  25. Phillips FM, Ho E, Campbell-Hupp M, McNally T, Todd Wetzel F, Gupta P (2003) Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 28:2260–2265, discussion 2265–2267

    Article  Google Scholar 

  26. Pradhan BB, Bae HW, Kropf MA, Patel VV, Delamarter RB (2006) Kyphoplasty reduction of osteoporotic vertebral compression fractures: correction of local kyphosis versus overall sagittal alignment. Spine (Phila Pa 1976) 31:435–441

    Article  Google Scholar 

  27. Ross PD, Davis JW, Epstein RS, Wasnich RD (1991) Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med 114:919–923

    Article  CAS  PubMed  Google Scholar 

  28. Saracen A, Kotwica Z (2014) Treatment of multiple osteoporotic vertebral compression fractures by percutaneous cement augmentation. Int Orthop 38:2309–2312

    Article  PubMed  Google Scholar 

  29. Shen GW, Wu NQ, Zhang N, Jin ZS, Xu J, Yin GY (2010) A prospective comparative study of kyphoplasty using the Jack vertebral dilator and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. J Bone Joint Surg Br 92:1282–1288

    Article  CAS  PubMed  Google Scholar 

  30. Suk SI, Kim JH, Lee SM, Chung ER, Lee JH (2003) Anterior-posterior surgery versus posterior closing wedge osteotomy in posttraumatic kyphosis with neurologic compromised osteoporotic fracture. Spine (Phila Pa 1976) 28:2170–2175

    Article  Google Scholar 

  31. Voggenreiter G (2005) Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine (Phila Pa 1976) 30:2806–2812

    Article  Google Scholar 

  32. Wang G, Yang H, Chen K (2010) Osteoporotic vertebral compression fractures with an intravertebral cleft treated by percutaneous balloon kyphoplasty. J Bone Joint Surg (Br) 92:1553–1557

    Article  CAS  Google Scholar 

  33. Yokoyama K, Kawanishi M, Yamada M, Tanaka H, Ito Y, Hirano M, et al (2013) In not only vertebroplasty but also kyphoplasty, the resolution of vertebral deformities depends on vertebral mobility. AJNR Am J Neuroradiol 34(7):1474–1478

  34. Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M et al (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27:620–628

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Spine Center, Hakodate Central General Hospital, Hon-cho 33-2, Hakodate, Hokkaido, 040-8585, Japan

    Masahiro Kanayama, Fumihiro Oha, Akira Iwata & Tomoyuki Hashimoto

  2. Clinical Collaborative Department, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Masahiro Kanayama & Tomoyuki Hashimoto

Authors
  1. Masahiro Kanayama
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  2. Fumihiro Oha
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  3. Akira Iwata
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  4. Tomoyuki Hashimoto
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Corresponding author

Correspondence to Masahiro Kanayama.

Additional information

Masahiro Kanayama holds a degree in MD, Spine Center, Hakodate Central General Hospital and Clinical Collaborative Department, Hokkaido University Graduate School of Medicine

Fumihiro Oha holds a degree in MD, Spine Center, Hakodate Central General Hospital

Akira Iwata holds a degree in MD, Spine Center, Hakodate Central General Hospital

Tomoyuki Hashimoto holds a degree in MD, Spine Center, Hakodate Central General Hospital and Clinical Collaborative Department, Hokkaido University Graduate School of Medicine

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Kanayama, M., Oha, F., Iwata, A. et al. Does balloon kyphoplasty improve the global spinal alignment in osteoporotic vertebral fracture?. International Orthopaedics (SICOT) 39, 1137–1143 (2015). https://doi.org/10.1007/s00264-015-2737-3

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  • DOI: https://doi.org/10.1007/s00264-015-2737-3

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