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An unconventional indication for open kyphoplasty.

¹Virginia Mason Medical Center, Section of Neurosurgery, Seattle, WA 98111, USA. nsrjnh@vmmc.org

The Spine Journal : Official Journal of the North American Spine Society

|November 12, 2003

Summary

Open kyphoplasty effectively treats painful vertebral compression fractures with spinal canal bone retropulsion. This procedure offers direct visualization, enabling safe and successful outcomes for selected patients.

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Area of Science:

Spinal surgery
Orthopedic procedures
Vertebral fracture management

Background:

Osteoporotic vertebral compression fractures can cause significant pain.
Percutaneous kyphoplasty is a treatment option, but not suitable for fractures with posterior cortical compromise or neurological deficits.
Open kyphoplasty is explored as an alternative for complex cases.

Observation:

A case study of a 79-year-old woman with an osteoporotic T12 vertebral compression fracture and significant retropulsion into the spinal canal.
The patient was ineligible for percutaneous kyphoplasty due to the extent of bone retropulsion.
Open kyphoplasty combined with laminectomy was performed three months post-injury.

Findings:

The open kyphoplasty successfully reduced the fractured vertebral body.

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No polymethylmethacrylate leakage into the spinal canal was observed.

The patient experienced pain relief and improved mobility one month after surgery.

Implications:

Open kyphoplasty provides direct visualization of the spinal canal during surgery.
This technique is safe and effective for selected vertebral compression fractures involving retropulsed bone and neurological compromise.
Offers a viable surgical option for complex vertebral fractures unsuitable for less invasive methods.