풍선 척추 성형술 시행 후 인접 부위에 발생하는 척추 압박 골절

Abstract

Background: Osteoporosis is very important social health problem and osteoporotic vertebral compression fracture (VCF) is life-threatening disease in the advanced age. Until now it has been treated conservatively. Now conservative treatment were replaced by percutaneous vertebral augmentation procedures, especially balloon kyphoplasty. But many physicians wonder the mechanical adverse effect of cement in vertebral body on the adjacent vertebra. The purpose of this study is to know the fracture pattern and the frequency of adjacent vertebra after balloon kyphoplasty.

Methods: We performed the retrospective study about 120 vertebrae in 96 patients. Mean time interval between the onset of symptom and the date of procedure was 29.6 days (range, 1~365 days). Mean follow up period after balloon kyphoplasty was 12 months (range, 6~25 months). Radiographic examination was performed every 2 month after procedure for evaluation of additional vertebral fracture.

Results: All of the patients experienced pain relief following the procedure (average improvement in VAS=7, p<0.01). Incidence of new vertebral compression fracture was 10% (10 new VCF in 96 patients). Among them there were only 5 adjacent fractures (5%). When we analyzed the cases, all adjacent fractures except one were located cephalad direction of previous fracture and fractured within 2 month after procedure. Adjacent fractures were occurred in the group which end plates were not completely reduced after kyphoplasty.

Conclusion: The additional fracture incidence of adjacent body after kyphoplasty is not higher than the incidence of natural osteoporotic fracture.