Percutaneous balloon kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures: a case-control study
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Published on: August 9, 2024
Jin Kyu Lee1, Hae-Won Jeong1, Il-Han Joo1
1Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Background Context:
Controversy exists regarding percutaneous balloon kyphoplasty (PBK) in patients with a very severe osteoporotic vertebral compression fracture (vsOVCF).
Purpose:
The study was conducted to investigate the clinical and radiological outcomes of PBK for the treatment of vsOVCF compared with those of non-vsOVCF.
Study Design/Setting:
This is a retrospective, case-control study.
Patient Sample:
A total of 167 consecutive patients (210 vertebral bodies) who underwent PBK for OVCF between March 2010 and January 2015 were assessed.
Outcome Measures:
Visual analog scale (VAS) scores for back pain, Korean Oswestry disability index (K-ODI) scores, vertebral body height variations, and kyphotic angles were evaluated preoperatively, postoperatively, and 1 year after treatment.
Materials And Methods:
Patients in the non-vsOVCF group (anterior vertebral compression of more than two-thirds on plain radiograph) who had undergone PBK where compared with those in the non-vsOVCF group (compression between 30% and two-thirds). Clinical and radiological outcomes were compared. In addition, complications were evaluated.
Results:
In total, 31 patients (33 vertebrae) in the vsOVCF group and 136 patients (177 vertebrae) in the non-vsOVCF group were treated with PBK. Both groups had significant postoperative improvements in the clinical and radiological outcomes (VAS score, K-ODI score, vertebral body height variation, and kyphotic angle). There was no difference regarding the VAS score and the K-ODI score between the two groups at the final follow-up (p>.05). The cement leakage occurred frequently in the vsOVCF group (26 vertebrae, 78.8%) than in the non-vsOVCF group (92 vertebrae, 52.0%), the difference was statistically significant (p<.05). But there was no case that showed neurologic complication or pulmonary embolism caused by cement leakage. The incidence of recollapse was significantly higher in the vsOVCF group (five vertebrae, 15.2%) than in the non-vsOVCF group (seven vertebrae, 4.0%) (p<.05). The incidence of an adjacent segment fracture (vsOVCF group, 6 vertebrae, 18.2%; non-vsOVCF group, 21 vertebrae, 11.9%) was not significantly different (p=.320).
Conclusions:
Percutaneous balloon kyphoplasty is a safe and effective procedure for the treatment of vsOVCF.
