Preliminary study on a single balloon cross-midline expansion via unipedicular approach in kyphoplasty / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recently, bilateral transpedicular kyphoplasty with a single balloon was performed for osteoporotic vertebral body compression fractures (OVCFs) to reduce the fees of the operation, but the time of operation and radiation exposure are longer. The aim of this study was to determine the safety and effectiveness of a single balloon cross-midline expansion via unipedicular approach in kyphoplasty for OVCFs.</p><p><b>METHODS</b>Thirty-six patients with painful OVCFs (61 vertebrae) were enrolled in this research. Unilateral transpedicular puncture was performed under the fluoroscopy monitoring of an oblique angle down the pedicle. A single balloon was introduced through unipedicular approach. The final balloon position was in the midline of the vertebral body with the balloon cross-midline expansion and bone cement filled. Clinical outcomes were determined by comparison of the preoperative and postoperative visual analogue scale (VAS) and Oswestry disability index (ODI). Radiographic assessment included restoration of vertebral height and correction of kyphosis. Follow-up was conducted for 6 - 12 months (mean 9.2 months).</p><p><b>RESULTS</b>Thirty-six consecutive patients with 61 vertebrae were successfully operated on with a mean operation time of 37.4 minutes per vertebra. All patients had dramatic pain relief and functional recovery within 96 hours after the procedure with no surgery or device-related complications. VAS score improved from 7.27 +/- 1.02 preoperatively to 2.71 +/- 0.75 postoperatively (P < 0.01). ODI score was decreased from (71.14 +/- 10.94)% preoperatively to (26.56 +/- 6.35)% postoperatively. The average loss of anterior body height was (14.33 +/- 2.76) mm before procedure and (10.03 +/- 1.83) mm after procedure (P < 0.01), while the average loss of middle body height was (10.15 +/- 2.70) mm before procedure and (5.89 +/- 1.83) mm after procedure (P < 0.01). The kyphotic deformity was corrected from (23.43 +/- 5.00) degree to (16.16 +/- 2.77) degree (P < 0.01). The pain relief and functional recovery were substantial and maintained to the last follow-up without any re-collapse or adjacent level fracture.</p><p><b>CONCLUSIONS</b>A single-balloon cross-midline expansion via unipedicular approach in kyphoplasty for OVCFs is an effective and safe procedure with less cost, less operation time and less radiation exposure when compared with the conventional kyphoplasty technique.</p>

Balloon kyphoplasty:a view from points of technique and technique-related issues / 中华放射学杂志

Objective To discuss the technique and technique-related issues of percutaneous kyphoplasty(PKP).Methods The study involved 69 vertebrae in 51 cases of painful osteoporotic vertebral compressive fractures.Under X-ray fluoroscopy monitoring,the fractured vertebral bodies were treated by kyphonplasty with inflatable balloon.The preoperative and postoperative vertebral height and Cobb angle in radiography were measured and analyzed.Results All patients tolerated the procedure well with dramatic pain relief within 72 hours after the procedure.No clinical complication was found.The loss heights of the anterior and mid portion of the vertebral body reduced from 15?4mm and 11?4mm preoperatively to 10? 4mm and 6?3mm postoperatively,respectively.Cobb angle corrected averagely from 22??6? preoperatively to 12??4?.There was significant difference between preoperative and postoperative measures (P