[Timing of kyphoplasty influences the outcome: a prospective study]

The aim of this prospective study was to evaluate the efficiency of early versus delayed treatment of vertebral fractures by balloon kyphoplasty with regard to fracture age. A total of 106 patients (37 male and 69 female) with 128 vertebral body fractures, an average age of 67.5 years (21 to 92) and a body mass index of 26.4 (16 to 40.4) were recorded. All fractures were evaluated radiologically and clinically. Pain intensity (visual analogue scale 0-10), analgesics consumption (WHO steps 1 to 3) and the relevant surgery data (operating time, cement consumption, complications) were recorded. 37 A 1.1, 43 A 1.2, 43 A 1.3, 4 A 3.1 and 1 A 2.3 classifications were collected. Fracture age in days was less than 23 days in 75 patients; the mean time of surgery was 43 minutes. Analgesics consumption was reduced from 1.8 ± 0.8 preoperatively to 1.0 ± 0.6 postoperatively. A significant improvement was found in pain intensity, which fell significantly from 8.2 ± 0.9 preoperatively to 3.9 ± 0.8 postoperatively. In relation to fracture age and pain intensity, a significantly higher pain reduction was achieved with timing of kyphoplasty between 0 and 23 days. Here, pain intensity decreased to 2.5 ± 0.5 postoperatively, compared with 4.5 ± 0.4 for fractures treated later. Fracture age had no influence on vertebral body alignment or improvement of the kyphotic angle. In summary, it can be stated that balloon kyphoplasty is a sufficient method to treat vertebral body fractures, to improve the kyphotic angle and reduce pain significantly.