- MeSH
- Back Pain etiology surgery MeSH
- Quality of Life MeSH
- Kyphoplasty methods statistics & numerical data utilization MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Metastasis therapy MeSH
- Spinal Neoplasms complications secretion therapy MeSH
- Orthopedic Procedures methods statistics & numerical data utilization MeSH
- Aged MeSH
- Vertebroplasty methods statistics & numerical data utilization MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
Vertebral compression fractures are very common. Symptomatic relief with conservative therapy is often difficult to achieve. Balloon kyphoplasty is a relatively new technique which stabilises the vertebral body and restores spinal alignment in recent fractures, it achieves significant pain relief and improved functional outcome is reported. The aim of this prospective study was to determine the level of pain relief and functional outcome in patients who were initially treated conservatively for 4-6 weeks and if symptoms did not have tendency to resolve, then had kyphoplasty surgery. MATERIAL AND METHODS: 105 patients underwent balloon kyphoplasty between April 2006 and August 2010 and had 1 year follow up. Total 170 levels were augmented, 65% (n=68) of patients were female and the average age was 74 years. Pain relief was assessed using visual analogue score (VAS) and functional outcome using Oswestry Disability Index (ODI). RESULTS: Results showed decrease of the average pre-operative VAS from 8.2 to 4.4 in the immediate postoperative period (p=0.000). This dramatic improvement remained and was 4.1 at 6 weeks, 3.3 at 6 months and 3.6 at 1 year. The average pre-operative ODI was 58. This improved to 47 in the immediate post-operative period (p=0.002). At 6 weeks this had improved further to 40 and further improvements were seen at 6 months (ODI 37) and 1 year (ODI 38). The average screening time was 2 minutes and 20 seconds. The average volume of cement used per level was 5.5 cm3. Radiographic measurements were performed by independent radiologist. The average pre-operative vertebral angle was 11.6° and 10.9° postoperatively. This was maintained throughout the follow up. This represented a negligible 6% improvement in vertebral body angle. We did not experience any clinically significant complications, we have encountered 11 minor complications which did not require any additional measures (cement leaks, penetration of the vertebral body margins by balloons or K wires and rib fractures). DISCUSSION: Pain relief and improvement of functional outcome was sustained after one year. Limited number of patients who had 2 year follow up showed trend of minimal deterioration of both parameters (VAS and ODI). This can be explained by incidence of few adjacent segment fractures and progressive overall osteoarthritic changes in this aging population. Radiological evaluation showed maintenance of achieved alignment which did not deteriorate over time. Complication rate was low and did not require any further surgical interventions and did not have any effect on final good clinical outcome. CONCLUSION: Balloon kyphoplasty proved to be safe surgical technique and should be considered in patients with ongoing pain following an acute vertebral compression fracture that does not improve with initial conservative treatment. It significantly improves pain and functional status in elderly patients.
- MeSH
- Back Pain surgery rehabilitation MeSH
- Spinal Fractures surgery complications MeSH
- Data Interpretation, Statistical MeSH
- Fractures, Compression surgery complications MeSH
- Quality of Life MeSH
- Kyphoplasty methods utilization MeSH
- Humans MeSH
- Recovery of Function MeSH
- Osteoporotic Fractures MeSH
- Osteoporosis complications MeSH
- Prospective Studies MeSH
- Aged MeSH
- Statistics as Topic MeSH
- Treatment Outcome MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
Patologické zlomeniny obratlů jsou velmi častým průvodním jevem pacientů trpících osteoporózou. Tyto zlomeniny vedou k výrazným bolestivým potížím, kyfotizaci páteře a snížení kvality života. Kyfoplastika a vertebroplastika představují moderní metody miniinvazivního řešení obratlových osteoporotických zlomenin. Umožňují bezpečnou výraznou redukci bolestivých potíží, prevenci další komprese a v případě kyfoplastiky i nastolení optimálního sagitálního profilu páteře.
Pathological vertebral fractures are one of the most common problems in osteoporotic patients. They lead to the painful problem, kyphotic deformation and quality of life deterioration. Kyphoplasty and vertebroplasty represent modern methods of miniinvasive vertebral osteoporotic fracture solution. They allow safe pain reduction, other vertebral compression prevention and optimalization of sagittal spinal profile in case of kyphoplasty.
