RESUMEN
Objective To discuss the complications of percutaneous kyphoplasty (PKP) in treatment of osteoporotic compression fractures (OVCFs) of the thoracic and lumbar vertebrae,and to investigate their causes and prevention.Methods From Jan.2004 to Dec.2012,PKP or PKP combined with percutaneous vertebroplasty(PVP) was performed on 126 vertebrae in 112 thoracolumbar OVCFs patients.There were 21 males and 91 females.The average age was 69 years (ranging from 36 to 85).100 cases had single vertebra,10 cases had double vertebrae,and 2 cases had 3 vertebrae.The injured segments were identified by MRI before surgery,and the fractures of the vertebrae were observed clearly by X ray and CT scan.The causes of the complications were retrospective analyzed.Results Perioperative complication happened in 68 cases (54％).The leakage of the bone cement happened in 66 cases (52.4％):one of them had high fever after the leakage happened behind the post-wall of the vertebra body,and it disappeared after one week with the relevant treatment.There was no injury of the nerve.Most of the leakage happened in front of the vertebra body,few happened in the terminal plate,and few happened behind the vertebral plate.There was no pulmonary embolism.Toxic reaction of the bone cement wasn't found in this team.There was no artery or nerve injury.One temporary spinal cord injury happened,one case was punctured in a wrong vertebra,and balloon rupture happened in one case.One case didn't achieve pain release.No infection happened.Conclusion The bone cement leakage was the most common complication associated with PKP in treatment of OVCFs.The complication rate can be reduced if the operation indications are strict,the volume of the filling cementis is well controlled,and the operation is performed in experienced hands.
RESUMEN
Objective To discuss the methods and the effects of percutaneous kyphoplasty(PKP)in the treatment of thoracolumbar osteoporotic vertebral compression fractures ( OVCFs).Methods Retrospective analysis was made on 110 vertebrae in 96 thoracolumbar OVCFs patients undergoing transpedicular unilateral PKP or PKP combined with percutaneous vertebroplasty(PVP) from Jan.2004 to Nov.2011.We analyzed the change of the anterior heights of the vertebra,the clinical outcomes using VAS and Oswcstry bcforc and after the treatment,and the rate of cement leakage.Results 85 vertebrae were treated with the PKP sucessfully,and 25 vertebraewere treated with both PKP and PVP sucessfu]ly.All patients were satisfied with the diffusion of the cement.Theoperation time of each vertebra was about 20-40 minutes for one side.The injection volume of of each vertebrawas about 5.4 ml.According to VAS and Oswestry,the pain was alleviated obviously after the operation ( P ＜0.01) and the anterior heights of the vertebrae changed ( P ＜ 0.01).The leakage of the cement was the only complication in these patients and most of the leakage happened at the anterior of the vertebrae and the vein nearby.The overall rate of the leakage was 56.3％.For the 40 vertebrae of the 36 patients that were followed up,1patient had fracture in a neighbor vertebra and 1patient had subsidence in the upper anterior edge of the treated vertebra where there was no cement filled in,but the patient had no discomfort.Conclusion PKP or PKP combined with PVP are safe,convenient and effective methods in treating OVCFs.