Kyphoplasty Augmentation in Thoracolumbar Spine - Clinical Outcomes after 2 Years

PURPOSE OF THE STUDY With the ageing of population the vertebral insufficiency fractures are increasing in number and occur ever more frequently. Symptomatic relief is often difficult to achieve by non-operative treatment. The aim of this study was to determine the level of pain relief and functional outcomes in patients who failed initial non-operative treatment and, because of persisting or growing symptoms, underwent kyphoplasty. MATERIAL AND METHODS Total number of 303 patients who underwent balloon kyphoplasty between January 2011 and December 2016 were included in our study. These 303 patients had 357 surgeries. This is a retrospective review of a prospectively updated database maintained by our spinal surgery department. In total, 575 levels were augmented. The patients were mostly females (246). The age of the patients ranged from 30 years to 98 years, with the mean age being 72.6 years. The average follow-up for our series was 17.2 months (2-63 months). Pain relief was assessed using the Visual Analogue Scale (VAS) and functional outcome using the Oswestry Disability Index (ODI). RESULTS The average pre-operative VAS was 6.34 (p = 0.00003). At 6 weeks postoperatively the average VAS decreased to 3.80 (p = 0.00000). In our series, the VAS scores showed a progressive decline progressing from the mean value of 3.18 (p = 0.15890) at 1 year to the mean value of 2.85 (p = 0.00205) at 2 years. The average pre-operative ODI was 25.65 (p = 0.03604). At 6 weeks, the value improved to 17.69 (p = 0,00120) and further improvements were seen at 1 year (ODI 14.13) and at 2 years (ODI 12.08). In our series no clinically significant complications were reported. The social drift was observed in 17 patients in our study. DISCUSSION The pain relief and the improvement of functional outcomes were maintained even at a two-year follow-up. No clinically significant complications were reported that would require further surgical intervention and that would affect the good clinical results of our study. CONCLUSIONS Balloon kyphoplasty proved to be a safe surgical technique and should be considered in patients with an ongoing pain following vertebral insufficiency fractures that do not improve with the initial non-operative treatment. Cement augmentation significantly improves pain levels and as well functional status in elderly patients. Key words:cement augmentation, osteoporotic fracture, kyphoplasty, vertebroplasty, osteoporotic spine fracture.