Kyphoplasty with bone cement injection for the treatment of osteoporotic vertebral compression fractures in different parts of the spine / 中国组织工程研究

ABSTRACT

BACKGROUND: Kyphoplasty with bone cement injection for the treatment of osteoporotic vertebral compression fractures has a good clinical effect, but it is unclear whether there is a difference in the efficacy on the fractures in different parts of the spine. OBJECTIVE: To compare the outcomes of kyphoplasty with bone cement injection in the treatment of osteoporotic vertebral compression fractures in different parts of the spine. METHODS: We retrospectively analyzed the clinical data of 247 cases of single-segmental osteoporotic vertebral compression fractures undergoing kyphoplasty with bone cement injection at the Department of Orthopaedic Surgery, the First Affiliated Hospital of Soochow University in China from January 2011 to August 2014. There were 24 cases of upper and middle thoracic (T1-T10) fractures, 187 cases of thoracolumbar (T11-L2) fractures and 36 cases of lower lumbar (L3-L5) fractures. The surgical time, X-ray exposure time, bone cement volume and leakage, the Visual Analog Scale score, the Oswestry Disability Index score, anterior vertebral height ratio and Cobb angle were assessed preoperatively, at 1 day posteroperatively and at the final visit. RESULTS AND CONCLUSION: (1) All patients underwent the surgery successfully, and were followed up for 12-44 months, with an average of (25.44±7.85) months. (2) There were 18 cases of bone cement leakage in the three groups, including 3 (12.5％) cases of upper and middle thoracic fractures, 13 (6.4％) cases of thoracolumbar fractures and 2 (5.6％) cases of lower lumbar fractures. (3) The surgical time and X-ray exposure time were significantly higher in the patients with upper and middle thoracic fractures than those with thoracolumbar fractures or lower lumbar fractures (P < 0.05) , while the volume of bone cement was significantly lower than that in the other two groups (P < 0.05) . Additionally, there were no significant differences in the surgical time, X-ray exposure time, and amount of bone cement between the patients with thoracolumbar fractures and with lower lumbar fractures (P> 0.05) . (4) There were no significant differences in the Visual Analog Scale score, Oswestry Disability Index score, anterior vertebral height ratio and Cobb angle among the three groups preoperatively, at 1 day postoperatively and at the final visit (all P> 0.05) . However, compared with baseline, these indicators were significantly improved in each group at 1 day postoperatively and at the final visit (P < 0.05) . (5) To conclude, kyphoplasty with bone cement injection has achieved satisfactory outcomes in the treatment of osteoporotic vertebral compression fractures in different parts of the spine.