Repeated Percutaneous Kyphoplasty for Refracture of the Same Cemented Vertebral Body

The refracture of the previously cemented vertebrae occurs rarely following percutaneous kyphoplasty (PKP). The present study was designed to assess the therapeutic efficacy of repeated PKP for refractures.

We conducted a retrospective analysis of 36 patients who underwent repeat PKP for refractures in same cemented vertebrae. The study evaluated the cement distribution pattern, restoration of middle vertebral height (MVH), and kyphosis angle (KA). Clinical efficacy was evaluated using visual analog scale (VAS) and the Oswestry Disability Index. A multivariate logistic regression model evaluated age, sex, cement volume, and bone mineral density, with the group's average pain reduction measured at 4.86 points on the VAS.

Preoperative VAS scores averaged 7.75 ± 1.23, significantly decreasing to 2.89 ± 0.92 after surgery (P < 0.05). The Oswestry Disability Index significantly improved from 73.83 ± 14.58 preoperatively to 35.97 ± 9.85 postoperatively (P < 0.05). The MVH significantly increased from 12.49 ± 2.95 preoperatively to 16.83 ± 3.49 postoperatively (P < 0.05). The KA significantly increased from 19.22 ± 4.28 preoperatively to 12.01 ± 4.59 postoperatively (P < 0.05). The mean of the correction of KA was 7.17 ± 5.10 and the mean of the restoration rate of MVH was 17.09 ± 9.68. Cement volumes of up to 4.5 ml had about a 40% probability of achieving a minimum 4.86-point VAS reduction, while volumes of at least 4.5 ml showed an 84.6% probability.

Repeated PKP effectively alleviates pain and restores spinal function in patients with refractures. A minimum cement volume of 4.5 ml appears optimal for achieving significant pain relief.