Background: Kyphoplasty has been established as
treatment for painful osteoporotic vertebral compression fractures for
over ten years. Its effectiveness has been substantiated in multiple
clinical studies. Not only is prompt pain reduction achieved, but
according to a new, large, long-term study, long-term survival is also
increased.
Patients: Balloon kyphoplasty was performed for
1069 patients between 01.01.2008 and 31.12.2013. In all cases, pain was
rated more than 6/10 points, and a recent fracture was evident on
cross-sectional imaging (CT or MRT
STIR T2) performed to supplement spine X-rays.
Average patient age was 77 ± 5.2 years. 73 % of patients were female.
Treated fracture levels ranged from T 3 to L 5.
Methods: A single level was treated in 627 cases,
two levels were treated simultaneously in 246 cases, three levels in 73
cases, and four levels in 29 cases. Average operative time for all
patients was 35 minutes. Pain was reduced from 8.0 ± 1.0 preoperative to
2.2 ± 1.3 points postoperative in visual analogue scale (p < 0.1).
Average intrahospital time was 9 days. Asymptomatic cement
leckages were seen in 20 % of the cases. 855
were released home from the hospital and 210 patients went on to
rehabilitation. Seven major complications (0.9 %) occurred during the
hospital time (four mortalities during hospital admission, three
neurological deficits, one lateral implant protrusion and a subdural
bleeding).
Conclusion: Kyphoplasty is a good procedure for
treating painful osteoporotic fractures from the lumbar to the thoracic
spine. Major complications occur rarely after kyphoplasty; however, they
must be considered and clarified.
Comment: Unfortunately, the article does not focus on long-term follow-ups. It can be expected that the pain level is the same regardles of conservative or minimal invasive treatment.
Kyphoplasty in the Treatment of Osteoporotic Spine Fractures – Experience with 1069 Cases; Z Orthop Unfall 2014; 152(4): 315-318
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