Abstract
Kyphoplasty has become a standard procedure in the treatment of painful osteoporotic compression fractures. According to current guidelines, involvement of the posterior wall of the vertebral body is a relative contraindication. From February 2002 until January 2008, 97 patients with at least one AO classification A 3.1 fracture were treated by kyphoplasty. There was a structured follow-up for the medium-term evaluation of the patients’ outcome. Ninety-seven patients (68 of whom were females and 29 of whom were males) with involvement of the vertebra’s posterior margin averaging 76.1 ± 12.36 (59–98) years were treated by kyphoplasty. The fractures of 75 patients were caused by falls from little height, 5 patients had suffered traffic accidents and in the case of 17 patients, no type of trauma was remembered. According to the AO classification, there were 109 A 3.1.1 and one A3.1.3 injuries. Prior to surgery, all patients were neurologically without pathological findings. Seventy-nine fractures were accompanied by a narrowing of the spinal canal [average of 15% (10–40)]. Overall, 134 vertebras were treated by Balloon kyphoplasty (81 × 1 segment, 22 × 2 segments, 3 × 3 segments). In 47.4% of the patients, cement leakage was observed after surgery. All patients with cement extravasation, however, were clinically unremarkable. Using the visual analog scale, patients stated that prior to surgery their pain averaged 8.1, whereas after surgery it significantly decreased and averaged 1.6 (p < 0.001). In geriatric patients with osteoporotic vertebral fractures with partial inclusion of the posterior wall of the vertebral body, kyphoplasty is an effective procedure with few complications.
Similar content being viewed by others
References
Becker S, Garoscio M, Meissner J, Tuschel A, Ogon M (2007) Is There an Indication for Prophylactic Balloon Kyphoplasty? A Pilot Study. Clin Orthop Relat Res 458:83–89
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
Faciszewski T, McKiernan F (2002) Calling all vertebral fractures classification of vertebral compression fractures: a consensus for comparison of treatment and outcome. J Bone Miner Res 17:185–191
Genant HK, Jergas M, Palermo L et al (1996) Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 11:984–996
Greene DL, Isaac R, Neuwirth M, Bitan FD (2007) The eggshell technique for prevention of cement leakage during kyphoplasty. J Spinal Disord Tech 20:229–232
Hulme PA, Krebs J, Ferguson SJ, Berlemann U (2006) Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies. Spine 31:1983–2001
Knop C, Bastian L, Lange U, Oeser M, Zdichavsky M, Blauth M (2002) Complications in surgical treatment of thoracolumbar injuries. Eur Spine J 11:214–226
Lane JM, Hong R, Koob J et al. (2004) Kyphoplasty enhances function and structural alignment in multiple myeloma. Clin Orthop Relat Res 426:49–53
Lavelle W, Carl A, Lavelle ED, Khaleel MA (2007) Vertebroplasty and kyphoplasty. Anesthesiol Clin 25:913–928
Lieberman IH, Togawa D, Kayanja MM (2005) Vertebroplasty and kyphoplasty: filler materials. Spine J 5:305S–316S
Lindsay R, Silverman SL, Cooper C et al (2001) Risk of new vertebral fracture in the year following a fracture. JAMA 285:320–323
Louis R (1985) Die stabilisierende Funktion der Wirbelsäule. In: Die Chirurgie der Wirbelsäule. Springer, Berlin
Maestretti G, Cremer C, Otten P, Jakob RP (2007) Prospective study of standalone balloon kyphoplasty with calcium phosphate cement augmentation in traumatic fractures. Eur Spine J 16:601–610
Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201
Siebenga J, Leferink VJ, Segers MJ et al (2006) Treatment of traumatic thoracolumbar spine fractures: a multicenter prospective randomized study of operative versus nonsurgical treatment. Spine 31:2881–2890
Stadhouder A, Buskens E, de Klerk LW et al (2008) Traumatic thoracic and lumbar spinal fractures: operative or nonoperative treatment: comparison of two treatment strategies by means of surgeon equipoise. Spine 33:1006–1017
Taylor RS, Fritzell P, Taylor RJ (2007) Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J 16:1085–1100
Taylor RS, Taylor RJ, Fritzell P (2006) Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine 31:2747–2755
Thomas KC, Bailey CS, Dvorak MF, Kwon B, Fisher C (2006) Comparison of operative and nonoperative treatment for thoracolumbar burst fractures in patients without neurological deficit: a systematic review. J Neurosurg Spine 4:351–358
van der RN, de Lange ES, Bakker FC, de Vet HC, van Tulder MW (2005) Management of traumatic thoracolumbar fractures: a systematic review of the literature. Eur.Spine J. 14:527–534
Voggenreiter G (2005) Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine 30:2806–2812
Wardlaw D, Cummings SR, Van Meirhaeghe J et al (2009) Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet 373:1016–1024
Wilke HJ, Mehnert U, Claes LE, Bierschneider MM, Jaksche H, Boszczyk BM (2006) Biomechanical evaluation of vertebroplasty and kyphoplasty with polymethyl methacrylate or calcium phosphate cement under cyclic loading. Spine 31:2934–2941
Wood K, Buttermann G, Mehbod A et al (2003) Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit. A prospective, randomized study. J Bone Joint Surg Am 85-A:773–781
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Krüger, A., Zettl, R., Ziring, E. et al. Kyphoplasty for the treatment of incomplete osteoporotic burst fractures. Eur Spine J 19, 893–900 (2010). https://doi.org/10.1007/s00586-010-1281-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-010-1281-5