Efficacy and Safety of Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Body Compression Fractures: Compared with Vertebroplasty.

Yi, Won Jae; Lee, Jung Ho; Lee, Hyuk Gee; Ryu, Kee Young; Kang, Dong Gee; Kim, Sang Chul

Original Article

Journal of Korean Neurosurgical Society 2007;42(2): 112-117.

Won Jae Yi, Jung Ho Lee, Hyuk Gee Lee, Kee Young Ryu, Dong Gee Kang, Sang Chul Kim

Department of Neurosurgery, Fatima Hospital, Daegu, Korea. runboy96@hanmail.net

ABSTRACT

OBJECTIVE
Kyphoplasty and vertebroplasty are two minimally invasive procedures for osteoporotic vertebral compression fractures. The purpose of this retrospective study was to compare the radiological findings and clinical outcomes between two procedures.
METHODS
Osteoporotic vertebral fractures were treated in 76 vertebrae, using kyphoplasty (n=35 vertebrae) and using vertebroplasty (n=41 vertebrae). Fractured vertebral bodies were diagnosed by correlating the clinical symptoms with radiologic study. The responses of pain symptoms were measured by a self-reported Visual Analog Scale (VAS) score. Plain X-rays were checked preoperatively and postoperatively at admission and 6 months. The vertebral body height and kyphotic angle were measured to assess the reduction of the sagittal alignment.
RESULTS
The mean pain scores were decreased significantly for both procedures postoperatively, but there were no significant differences between two groups. Kyphoplasty led to a significant reduction of the vertebral body height and improvement of kyphotic angle. There were no neurological deficits after kyphoplasty, but one patient experienced paraparesis after vertebroplasty. During the 6 months follow-up both procedures provided stabilization of the sagittal alignment.
CONCLUSION
Kyphoplasty and vertebroplasty are considered effective minimally invasive techniques for the stabilization of osteoporotic vertebral body fractures, leading to a statistically significant reduction in pain. Kyphoplasty significantly restore sagittal alignment. Also, complications and the incidence of bone cement leakage are significantly lesser than vertebroplasty. Therefore, kyphoplasty seems to be reasonable procedure for osteoporotic vertebral body compression fractures when medical treatment fail.

Key Words: Osteoporosis; Vertebroplasty; Kyphoplasty; Kyphosis; Vertebral height; Spinal compression fracture