Is additional balloon Kyphoplasty safe and effective for acute thoracolumbar burst fracture?

BMC Musculoskeletal Disorders

Research Article

Chia-Wei Yu¹  Wen-Jer Chen¹  Ping-Jui Tsai¹  Lih-Huei Chen¹  Kuo-Feng Fan¹  Chi-Chien Niu¹  Tsung-Ting Tsai¹  Po-Liang Lai¹  Ming-Kai Hsieh² 

[1] Department of Orthopedic Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan;Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;Department of Orthopedic Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan;Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;5, Fu-Hsin Street, Kweishan Shiang, Taoyuan ,333, Linkou, Taiwan;

关键词: Burst fracture;    Vertebroplasty;    Kyphoplasty;    Calcium sulfate/phosphate cement;    Acute thoracolumbar burst fracture;   

DOI  :  10.1186/s12891-017-1753-4

 received in 2017-01-12, accepted in 2017-09-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundBurst fracture is a common thoracolumbar injury that is treated using posterior pedicle instrumentation and fusion combined with transpedicular intracorporeal grafting after reduction. In this study, we compared the outcome of these two techniques by using radiologic imaging and functional outcome.MethodsSixty-one patients with acute thoracolumbar burst fracture were operated with kyphoplasty (n = 31) or vertebroplasty (n = 30) and retrospectively reviewed in our institution between 2011 and 2014. All 61 patients underwent surgery within 5 days after admission to the hospital and then followed-up for 12 to 24 months after surgery.ResultsSignificant improvement was found in the anterior vertebral height (92 ± 8.9% in the kyphoplasty group, 85.6 ± 7.2% in the vertebroplasty group, p < 0.01) at 1 month post-operatively and (89 ± 7.9% in the kyphoplasty group, 78 ± 6.9% in the vertebroplasty group, p < 0.01) at the 24-month follow-up. Significant improvement was also observed in the kyphotic angle (1.2 ± 0.5° in the kyphoplasty group, 10.5 ± 1.2° in the vertebroplasty group, p < 0.01) at 1 month post-operatively and (5.4 ± 1.2° in the kyphoplasty group, 11.5 ± 8.5° in the vertebroplasty group, p < 0.01) at the 24-month follow-up. Both operations led to significant improvement of the patients’ pain and the Oswestry disability index (p < 0.01). Cement leakage was noted in 29% of patients after kyphoplasty and 77% of patients after vertebroplasty (p < 0.01). Only one implant failure (3.3%), which required further surgical intervention, was reported in the vertebroplasty group.ConclusionsReduction with additional balloon at the fractured site is better than indirect reduction only by posterior instrumentation. The better reduction of kyphotic angle and the lower cement leakage rate in the kyphoplasty group indicate that additional balloon kyphoplasty is safe and effective for acute thoracolumbar burst fracture.

【 授权许可】

CC BY   
© The Author(s). 2017