Office-Based Kyphoplasty: A Viable Option Using Local Anesthesia with Oral Sedation

Area of Science:

• Orthopedic Surgery
• Pain Management

Background:

• Vertebral compression fractures (VCFs) present significant pain and mobility challenges.
• Treatment options range from conservative management to surgical interventions like kyphoplasty and vertebroplasty.

Purpose of the Study:

• To evaluate the safety and efficacy of office-based percutaneous balloon kyphoplasty (PBK) under local anesthesia with oral sedation.
• To assess clinical outcomes including complications, re-fracture rates, and pain reduction.

Main Methods:

• A retrospective review of 99 patients undergoing their first PBK between January 2015 and May 2017.
• Procedures were performed in either an office-based setting (9 patients) or ambulatory surgical centers (ASCs) (90 patients).
• Outcomes analyzed included surgical complications, 6-month re-fracture rates, adjacent fracture rates, and pain scores.

Main Results:

• No intraoperative complications or re-fractures within 6 months were reported.
• 6% of patients experienced adjacent vertebral compression fractures, with no significant difference between facility types.
• Significant reduction in pain scores was observed post-procedure compared to pre-procedure levels in both office-based and ASC settings.

Conclusions:

• Office-based PBK under local anesthesia with oral sedation appears to be a safe and effective procedure for VCFs.
• The study suggests PBK effectively alleviates pain associated with VCFs.
• The observed adjacent fracture rate was comparable to or lower than previously reported rates for similar procedures.