Abstract
Summary
To evaluate the efficacy of unipedicular kyphoplasty in the treatment of patients with osteoporotic vertebral compression fractures, we compared the pre- and postoperative clinical and radiological results in the unipedicular and bipedicular kyphoplasty groups. The clinical and radiological results of unipedicular kyphoplasty were as good as those of bipedicular kyphoplasty.
Introduction
The purpose of this study was to evaluate the efficacy of unipedicular kyphoplasty in the treatment of patients with osteoporotic vertebral compression fractures. We compared the pre- and postoperative compression ratios (CRs), kyphotic angles (KAs), and visual analogue scale (VAS) scores of the patients in the unipedicular and bipedicular kyphoplasty groups. The results showed that the clinical and radiological results of unipedicular kyphoplasty were as good as those of bipedicular kyphoplasty. Percutaneous balloon kyphoplasty is a therapeutic option for patients with painful osteoporotic vertebral compression fractures (VCFs). Due to the relatively high-risk nature of the patient population, complications such as myocardial events, seizures, agitation, or dyspnea may occur and render completion of the procedure imprudent. We analyzed the clinical and radiological results of unipedicular and bipedicular balloon kyphoplasty for the treatment of vertebral compression fractures.
Methods
We retrospectively reviewed the records of 45 patients who underwent balloon kyphoplasty for the treatment of VCFs between January 2005 and April 2008. A unipedicular approach was used in 15 patients and a bipedicular approach was used in 30 patients. The CR, KA, and 100-point VAS score for pain were measured pre- and postoperatively in each patient.
Results
There was no significant difference in restoration of the CR (p = 0.376) and KA (p = 0.888) between the unipedicular and bipedicular kyphoplasty groups. The patients in the unipedicular group showed greater improvement in VAS score than those in the bipedicular group (p < 0.001). There were no postoperative complications, such as nerve injury or pedicle fracture, in either of the two groups.
Conclusion
The clinical and radiological results of unipedicular balloon kyphoplasty for the treatment of VCFs were as good as those of bipedicular balloon kyphoplasty. Thus, unipedicular balloon kyphoplasty can be used as an alternative treatment for patients with VCFs.
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References
Lieberman IH, Dudeney S, Reinhardt MK et al (2001) Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine 26:1631–1638
Jensen ME, Evans AJ, Mathis JM et al (1997) Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures. Technical aspects. Am J Neuroradiol 18:1897–1904
Coumans JV, Reinhardt MK, Lieberman IH (2003) Kyphoplasty for vertebral compression fracture. 1-year clinical outcomes from a prospective study. J Neurosurg 99:44–50
Garfin S, Lin G, Lieberman I et al (2001) Retrospective analysis of the outcomes of balloon kyphoplasty to treat vertebral compression fracture refractory to medical management. Eur Spine J 10(suppl 1):S7
Nussbaum DA, Gailloud P, Murphy K (2004) A review of complications associated with vertebroplasty and kyphoplasty as reported to the Food and Drug Administration medical device related web site. J Vasc Interv Radiol 15:1185–1192
Phillips FM, Ho E, Campbell-Hupp M et al (2003) Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Spine 28:2260–2267
Weisskopf M, Herlein S, Birnbaum K et al (2003) Kyphoplasty—a new minimally invasive treatment for repositioning and stabilizing vertebral bodies (in German). Z Orthop Ihre Grenzgeb 141:406–411
Yoon WK, Roh SW, Rhim SC et al (2005) Postoperative results of kyphoplasty for osteoporotic vertebral compression fractures. J Korean Neurosurg Soc 37:253–257
Kim DY, Lee SH, Lee HY et al (2005) Validation of the Korean version of the Oswestry disability index. Spine 30:E123–E127
Kado DM, Browner WS, Plermo L et al (1999) Vertebral fractures and mortality in older women. A prospective study. Arch Intern Med 14:1215–1220
Lapras C, Mottolese C, Deruty R et al (1989) Percutaneous injection of methyl-methacrylate in osteoporosis and severe vertebral osteolysis (Galibert’s technic) (in French). Ann Chir 43:371–376
Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: Kyphoplsty and vertebroplasty for the treatment of painful osteoporotic compression fracture. Spine 26:1511–1515
Grohs JG, Matzner M, Trieb K et al (2005) Minimal invasive stabilization of osteoporotic vertebral fractures. A prospective nonrandomized comparison of vertebroplasty and balloon kyphoplasty. J Spinal Disord Tech 18:238–242
Ledlie JT, Renfro M (2003) Balloon kyphoplasty. One-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg 98:36–42
Berlemann U, Franz T, Orler R et al (2004) Kyphoplasty for treatment of osteoporotic vertebral fracture: a prospective nonrandomized study. Eur Spine J 13:496–501
Gaitanis IN, Hadjipavlou AG, Katonis PG et al (2005) Balloon kyphoplasty for the treatment of pathological vertebral compressive fractures. Eur Spine J 14:250–260
Yoon ST, Qureshi AA, Heller JG et al (2005) Kyphoplasty for salvage of a failed vertebroplasty in osteoporotic vertebral compression fracture. Case report and surgical technique. J Spinal Disord Tech 18(Suppl):S129–S134
Tohmeh AG, Marthis JM, Fenton DC et al (1999) Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for the management of osteoporotic compression fractures. Spine 24:1772–1776
Steinmann J, Tingey CT, Cruz G et al (2005) Biomechanical comparison of unipedicular versus bipedicular kyphoplasty. Spine 30:201–205
Cotton A, Dewarre F, Cortet B et al (1996) Percutaneous vertebroplasty for osteolytic metastases and myeloma. Effects of the percentage of lesion filling and the leakage of methylmehtacrylate at clinical follow-up. Radiology 200:525–530
Boszczyk BM, Bierscneider M, Hauck S et al (2005) Transcostovertebral kyphoplasty of the mid and high thoracic spine. Eur Spine J 14:992–999
Hoh BL, Rabinov JD, Pryor JC et al (2004) Balloon kyphoplasty for vertebral compression fracture using a unilateral balloon tamp via a uni-pedicular approach: technical note. Pain Physician 7:111–114
Hu MM, Eskey CJ, Tong SC et al (2005) Kyphoplasty for vertebral compression fracture via a uni-pedicular approach. Pain Physician 8:363–367
Kim SH, Kang HS, Choi JA et al (2004) Risk factor of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty. Acta Radiol 45:440–445
Fribourg D, Tang C, Sra P et al (2004) Incidence of subsequent vertebral fracture after kyphoplasty. Spine 29:2270–2276
Syed MI, Patel NA, Jan S et al (2005) New symptomatic vertebral compression fractures within a year following vertebroplasty. AJNR 26:1601–1604
Traut AT, Kallmes DF, Kaufmann TJ (2006) New fractures after vertebroplasty: adjacent fractures occur significantly sooner. AJNR 27:217–223
Voormolen MH, Lohle PN, Juttmann JR et al (2006) The risk of new osteoporotic vertebral compression fractures in the year after percutaneous vertebroplasty. J Vasc Interv Radiol 17:16–71
Komemushi A, Tanigawa N, Kariya S et al (2006) Percutaneous vertebroplasyfor osteoporotic compression fracture: multivariate study of predictors of new vertebral body fracture. Cardiovasc Intervent Radiol 29(4):580–585
Lin WC, Cheng TT, Lee YC et al (2008) New vertebral osteoporotic compression fractures after percutaneous vertebroplasty: retrospective analysis of risk factors. J Vasc Interv Radiol 19:225–232
Harrop JS, Prpa B, Reinhardt MK et al (2004) Primary and secondary osteoporosis’ incidence of subsequent vertebral compression fractures after kyphoplasty. Spine 29:2120–2125
Villarraga ML, Bellezza AJ, Harrigan TP et al (2005) The biomechanical effects of kyphoplasty on treated and adjacent nontreated vertebral bodies. J Spinal Disord Tech 18:84–91
Lindsay R, Silverman SL, Cooper C et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:321–323
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Song, BK., Eun, JP. & Oh, YM. Clinical and radiological comparison of unipedicular versus bipedicular balloon kyphoplasty for the treatment of vertebral compression fractures. Osteoporos Int 20, 1717–1723 (2009). https://doi.org/10.1007/s00198-009-0872-7
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DOI: https://doi.org/10.1007/s00198-009-0872-7