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Percutaneous vertebroplasty for the treatment of osteoporotic burst fractures

 Jun Jae Shin  ;  Dong Kyu Chin  ;  Young Sul Yoon 
 ACTA NEUROCHIRURGICA, Vol.151(2) : 141-148, 2009 
Journal Title
Issue Date
Age Factors ; Aged ; Back Pain/etiology ; Back Pain/physiopathology ; Back Pain/surgery ; Female ; Humans ; Kyphosis/etiology ; Kyphosis/pathology ; Kyphosis/surgery ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/pathology ; Lumbar Vertebrae/surgery* ; Magnetic Resonance Imaging ; Male ; Minimally Invasive Surgical Procedures/methods ; Minimally Invasive Surgical Procedures/statistics & numerical data ; Osteoporosis/complications* ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/pathology ; Spinal Fractures/surgery* ; Spinal Stenosis/etiology ; Spinal Stenosis/pathology ; Spinal Stenosis/surgery ; Thoracic Vertebrae/diagnostic imaging ; Thoracic Vertebrae/pathology ; Thoracic Vertebrae/surgery* ; Tomography, X-Ray Computed ; Treatment Outcome ; Vertebroplasty/methods* ; Vertebroplasty/statistics & numerical data
Percutaneous vertebroplasty ; Postural reduction ; Burst fracture ; Thoraco-lumbar spine
BACKGROUND: Vertebroplasty is a minimally invasive surgical procedure which involves injecting polymethylmethacrylate into the compressed vertebral body. At present the indications include the treatment of osteoporotic compression fractures, vertebral myeloma, and metastases. the value of vertebroplasty in osteoporotic compression fracture has been discussed comprehensively. the surgical operation for burst fractures without neurological deficit remains controversial. Some authors have asserted that vertebroplasty is contraindicated in patients with burst fracture. However, we performed the procedure, after considering the patents general condition, to reduce surgical risks and the duration of immobilisation. the purpose of this study is to investigate clinical outcomes, kyphosis correction, wedge angle, and height restoration of thoraco-lumbar osteoporotic burst fractures treated by percutaneous vertebroplasty.

MATERIALS and METHODS: Twenty-five patients with osteoporotic burst fracture were treated with postural reduction followed by vertebroplasty. We measured the kyphosis, wedge angle, spinal canal compromise and the height of the fractured vertebral body initially, after postural reduction, and after vertebroplasty.

FINDINGS: the average height of the collapsed vertebral bodies was 24.8% of the original height. Average kyphosis angle was 19.4 degrees and average wedge angle was 19.8 degrees at first. Mean canal encroachment was initially 25.1%. Kyphosis angle, wedge angle, and anterior, middle, and posterior height improved significantly after the procedure. the mean amelioration of the spinal canal encroachment after vertebroplasty was 23.3%. the average increase in anterior vertebral body height was 7.5 mm, central was 5.8 mm, and posterior was 0.9 mm. the mean reduction in kyphosis angle was 6.8 degrees and the mean reduction in wedge angle was 9.7 degrees .

CONCLUSION: Although vertebroplasty has been considered as contraindicated in thoraco-lumbar burst fractures, we successfully used the procedure as a safe treatment in patients with osteoporotic burst fracture without neurologic deficit. This method could eliminate the need for and risks of major spinal surgery. We would like to offer it as a relatively safe and effective methods of management in thoraco-lumbar burst fractures.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Yoon, Young Sul(윤영설)
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
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