Kyphoplasty for the treatment of painful osteoporotic thoracolumbar burst fractures.

Abstract

This study explored the feasibility and clinical outcome of kyphoplasty for the treatment of painful osteoporotic thoracolumbar burst fractures without neurological deficit. A total of 25 consecutive patients with painful type-A3 amyelic thoracolumbar fractures without neurological deficit were treated by kyphoplasty. Pain was measured using the self-reporting visual analog pain scale (VAS) preoperatively, postoperatively, and at 6-month follow-up. Disability was measured using the Oswestry Disability Index (ODI) preoperatively, postoperatively, and at 6-month follow-up. The height of the fractured vertebral body, kyphotic angle, and spinal canal compromise were measured preoperatively, postoperatively, and at 6-month follow-up. Relief of pain was achieved 24 hours postoperatively. Mean VAS score decreased from 8.2+/-1.3 preoperatively to 2.8+/-0.8 postoperatively (P<.05), and was maintained at 2.9+/-1.1 at 6-month follow-up. The ODI score varied from 68.2%+/-6.6% preoperatively to 35.3%+/-2.8% postoperatively (P<.05). Improvement was maintained at 6-month follow-up. Postoperatively, the height of anterior vertebrae (Ha) was restored from 61.5%+/-13.9% to 85.3%+/-10.6%, the height of midline vertebrae (Hm) restored from 73.0%+/-19.3% to 83.3%+/-7.4%, the kyphotic angle from 21.7 degrees +/-7.8 degrees to 8.6 degrees +/-6.6 degrees, and the spinal canal compromise from 20.1%+/-4.1% to 17.8%+/-1.3%. At 6-month follow-up, maintenance of the height restoration and kyphotic deformity correction was found. No significant difference was noted in pre- and postoperative spinal canal compromise. Kyphoplasty is a relatively safe and effective method for the treatment of painful osteoporotic thoracolumbar burst fractures.