The efficacy of percutaneous kyphoplasty in relieving painful osteoporotic vertebral compression fractures

Objective To evaluate the efficacy of percutaneous kyphoplasty in relieving pain caused by osteoporotic vertebral compression fractures.Methods 468 patients whose average age was 68.2 years old(range 54 to 94),with osteoporotic vertebral compression fracture were treated with percutaneous kyphoplasty.608 consecutive procedures(male 93 cases of 120 procedures,and female 375 cases of 488 procedures) were performed including single insertion of inflatable balloon through bilateral padicle of vertebal arch to make fracture reduction.The single vertebral body was 360 cases,the doubal of 76 cases,and the triple of 32 cases.The clinical effect was evaluated by observing the changes of visual analog scale(VAS),the use of pain-killer scale,locomotor activity scale,the Cobb's angle and the height of vertebral bodies.The complication was recorded simultaneously.Results 412 cases(540 procedures) were followed up for 3.6 years(range 6 months to 5 years).The back pain was marked relieved postoperatively.VAS pain score improved from 8.26±0.98 preoperatively to 1.63±0.83 postoperatively and 1.85±0.89 at the last follow up(P0.01).The use of pain-killer scale and locomotor activity scale were respectively improved from 1.62±0.94,3.15±0.83 preoperatively to 0.18±0.45,1.41±0.56 postoperatively and 0.21±0.54,1.47±0.62 at the last follow up(P0.01).The mean height of the anterior edge vertebral body was from 19.39±2.22 mm preoperatively to 24.47±2.04 mm postoperatively and 23.88±2.25 mm at final follow-up(P0.01).The media vertebral bodies was increased from 19.19±2.06 mm to 24.38±1.93 mm,and at final follow-up 23.57±2.12 mm(P0.01).The mean kyphosis was improved from 20.28°±4.64° to 12.2°±4.36°,and 13.12°±3.38° at final follow-up(P0.01).73 vertebral bodies(12%) had cement leakage,in which 2 cases with nervous lesion were obviously relieved by symptomatic treatment,and the others without adverse events.At the final follow-up,18 cases had old or novel back pain,and neighborhood vertebral compression fracture occurred in 16 cases which were treated with kyphoplasty.Conclusion Kyphoplasty for treatment of osteoporotic vertebral compression fracture can restore the height of fractured vertebra;relieve pain immediately,which is a safe and effective minimal invasion spinal intervention.