The influence of intravertebral cleft on the clinical effect of percutaneous kyphoplasty / 中华骨科杂志

ABSTRACT

Objective To evaluate the influence of intravertebral cleft on the clinical effect of percutaneous kyphoplasty (PKP).Methods One-hundred and eighty three patients with OVCFs who underwent PKP (from December 2009 to December 2011) were divided into IVC group and non-IVC group according to their radiographic features.In IVC group,there were 5 males and 39 females,with an average age of 71.6 years (range,56 to 89 years).And in non-IVC group,there were 22 males and 117 females,aged from 51 to 91 years (average,70.2 years).The distributions of fractured vertebra body,bone cement injection volume,bone cement leakage incidence and types,the postoperative height of fractured vertebral body,as well as the visual analogue scale (VAS) and Oswestry disability index (ODI) were compared between the two groups.Results The distributions of fractured vertebra body between two groups were different.Fractured vertebra body in IVC group mainly located from T11 to L2.Fractured vertebra body in non-IVC group located from T11 to L5,and from T7to T9.The bone cement injection volume and leakage incidence had no significant difference between IVC group and non-IVC group (3.4-5.6 ml vs.3.5-5.1 ml; 45.3％ vs.41.9％).However,the types of bone cement leakage were different.In the IVC group,bone cement mainly leaked into perivertebral soft tissues,while in the non-IVC group it mainly leaked along blood vessels.In both groups,the heights of the fractured vertebral bodies were significantly improved,and the restoration of vertebral height in IVC group was more evident than that in the non-IVC group.The postoperative VAS and ODI had no statistical difference between IVC group and non-IVC group (2.8±1.1 vs.2.4±0.7; 29.3％±6.8％ vs.27.6％±6.9％).Conclusion The osteoporotic compression vertebral fracture mainly located in the range from T12 to L2 vertebra.The application of PKP could obtain a very good result in the treatment of OVCF with intravertebral cleft,moreover,the anterior vertebral height can increase remarkablely.