Is Balloon Kyphoplasty Effective for Bone Remodeling of AO-Type A3-4 Fractures at the Thoracolumbar Junction?

To evaluate the parameters that affect bone retropulsion and restoration in patients with thoracolumbar junction (TLJ) vertebral compression fractures (VCF) without neurological deficits who underwent balloon kyphoplasty (BKP).

Thirty-one of Frankel E and Arbeitsgemeinschaft für Osteosynthesefragen (AO) A3?4 type VCFs fractures at the TLJ, with bone retropulsion into the spinal canal, from 2017 to 2020, were evaluated retrospectively. Data was gathered on patient demographics and medical histories. Measurements of anterior vertebral heights, posterior vertebral heights, local kyphotic angles, spinal cord area, and bone retropulsion into the spinal canal (BRC) were evaluated preoperatively, early postoperatively, and late postoperatively.

In those patients who underwent early surgery ( < 4 weeks postfracture), a significantly greater increase in anterior vertebral heights was seen between early postoperative and preoperative measurements than in patients who underwent late surgery ( > 4 weeks postfracture) (p=0.016). At the six-month follow-up, a significantly greater decrease in local kyphotic angle measurements was seen in patients over 65 years of age than those under 65 (p=0.023). Comparison of local kyphotic angles between sexes revealed a significant decrease in measurements at follow-up in female patients (p=0.029). Both early postoperative and late postoperative local kyphotic angle measurements of patients with a body mass index (BMI) ?25 were significantly lower than those of patients with a BMI < 25 (p=0.012).

The restoration of vertebral angles and heights with the maximum level of BKP can effectively reduce BRC.