The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Balloon Kyphoplasty for the Treatment of Vertebral Compression Fractures

척추 압박골절 환자에서의 풍선 척추체 복원술의 치료 효과

  • Han, Kyung Ream (Pain Clinic, Department of Anesthesiology and Pain Medicine, University of Ajou) ;
  • Kim, Chan (Pain Clinic, Department of Anesthesiology and Pain Medicine, University of Ajou) ;
  • Yang, Jong Yoon (Pain Clinic, Department of Anesthesiology and Pain Medicine, University of Ajou) ;
  • Han, Seung Tak (Pain Clinic, Department of Anesthesiology and Pain Medicine, University of Ajou) ;
  • Kim, Yeui Seok (Pain Clinic, Department of Anesthesiology and Pain Medicine, University of Ajou)
  • 한경림 (아주대학교 의과대학 마취통증의학교실 신경통증클리닉) ;
  • 김찬 (아주대학교 의과대학 마취통증의학교실 신경통증클리닉) ;
  • 양종윤 (아주대학교 의과대학 마취통증의학교실 신경통증클리닉) ;
  • 한승탁 (아주대학교 의과대학 마취통증의학교실 신경통증클리닉) ;
  • 김의석 (아주대학교 의과대학 마취통증의학교실 신경통증클리닉)
  • Received : 2005.09.01
  • Accepted : 2006.03.29
  • Published : 2006.06.30
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Abstract

Background: Balloon kyphoplasty is the new technique that helps to decrease the pain and improve mobility as well as restore the vertebral body height and kyphotic curve in fractured vertebrae. We evaluated the outcome of balloon kyphoplasty in the reduction of vertebral body height, kyphotic curve and clinical improvement in the patients with painful vertebral compression fractures. Methods: From July 2002 to February 2005, 84 levels of vertebral compression fractures in 66 patients were treated with balloon kyphoplasty. The assessment criteria were the changes over time in visual analogue scale (VAS) and mobility score. We evaluated the vertebral body height and kyphotic curve at preoperative 1 day and postoperative 1 day. Results: Procedures were performed in 66 patients with a total of 84 affected vertebral bodies. The anterior wall height was restored in 74 / 84 (88%) levels with a mean increment of 2.9 mm, and the mid-vertebral body height was restored in 79 / 84 (94%) levels with a mean increment of 4.2 mm. Kyphosis correction was achieved in 60 / 84 (71.4%) from 10.1 degrees to 7.5 degrees. Pain intensity reduced by 60% in one day after operation and by 75-85% in later time. Mobility scores of all patients were improved immediately after the procedure. Cement leakage occurred in 3 levels but there was no clinical problem. Conclusions: Kyphoplasty is an efficient and safe treatment of painful vertebral compression fracture in pain relief, mobility improvement, and reduction of deformity.

Keywords

References

  1. Watts NB, Harris ST, Genant HK: Treatment of painful osteoporotic vettebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporosis Int 2001; 12: 429-37 https://doi.org/10.1007/s001980170086
  2. Convertino VA, Bloomfield SA, Gteenleaf JE: An overview of the issues: physiological effects of bed rest and restricted physical activity. Med Sa Exerc 1997; 29: 187-90
  3. Keller TS, Harrison DE, Colloca CJ, Harrison DD. Janik TJ. Prediction of osteoporotic spinal defotmity. Spine 2003; 28: 455-62 https://doi.org/10.1097/00007632-200303010-00009
  4. Hasserius R, Karlsson MK, Nilsson BE, Redlund-Johnell I, Johnell O: Prevalent vettebtal defotmities predict increased mortality and incteased fracture rate in both men and women: a 10-year population-based study of 598 individuals from the Swedish cohort in the European vertebtal osteoporosis study. Ostoporos Int 2003; 14: 61-8 https://doi.org/10.1007/s00198-002-1316-9
  5. Schlaich C, Minne HW, Bruchner T, Wagner G, Gebest HJ, Grunze M, et al: Reduced pulmonary function in patients with spinal osteoporotic ftactutes. Osteopotos Int 1998; 8: 261-7 https://doi.org/10.1007/s001980050063
  6. Leech JA, Dulberg C, Kellie S, Pattee L, Gay J: Relationship of lung function to sevetity of osteoporosis in women. Am Rev Respir Dis 1990; 141: 68-71 https://doi.org/10.1164/ajrccm/141.1.68
  7. Ross PD, Davis JW, Epstein RS, Wasnich RD: Pain and disability associated with new vertebral fractures and other spinal conditions. J Clin Epidemiol 1994; 47: 231-9 https://doi.org/10.1016/0895-4356(94)90004-3
  8. Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, et al: The association of tadiographically detected vertebtal fractures with back pain and function: a prospective study. Ann Intern Med 1998; 15: 793-800
  9. Silverman SL: The clinical consequences of verrebral compression fracture. Bone 1992; 13(suppl): 27-31
  10. Garfin SR, Yuan HA, Reiley MA: New technologies in spine: kyphoplasty and vertebroplasty for the trearment of painful osteoporotic comptession fractures. Spine 2001; 26: 1511-5 https://doi.org/10.1097/00007632-200107150-00002
  11. Cotten A, Dewatte F, Cortet B, Assaker R, Leblond D, Duquesnoy B, et al: Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up. Radiology 1996; 200: 525-30 https://doi.org/10.1148/radiology.200.2.8685351
  12. Crandall D, Slaughter D, Hankins PJ, Moore C, Jerman J: Acute versus chronic vertebtal compression fractures treated with kyphoplasty: early results. Spine J 2004; 4: 418-24 https://doi.org/10.1016/j.spinee.2004.01.003
  13. Han KR, Kim C, Eun JS, Chung YS: Exttapedicular approach of percutaneous vertebroplasty in the tteatment of upper and mid-thotacic vertebral compression fracture. Acta Radiol 2005; 46: 280-7 https://doi.org/10.1080/02841850510021058
  14. Belkoff SM, Mathis JM, Jaspet LE, Detamond H: The biomechanics of vertebroplasty: The effect of cement volume on mechanical behaviot. Spine 2001; 26: 1537-41 https://doi.org/10.1097/00007632-200107150-00007
  15. Beriemann U, Ferguson SJ, Nolte LP, Heini PF: Adjacent vertebral failure after vertebroplasty. A biomechanical investigation. J Bone Joint Sutg Br 2002; 84: 748-52 https://doi.org/10.1302/0301-620X.84B5.11841
  16. Polikeit A, Nolte LP, Ferguson SJ: The effect of cement augmentation on the load transfer in an osreoporotic functional spinal unit: finite-element analysis. Spine 2003; 28: 991-6 https://doi.org/10.1097/00007632-200305150-00006
  17. Steinmann J, Tingey CT, Cruz G, Dai Q: Biomechanical comparison of unipedicular versus bipedicular kyphoplasty. Spine 2005; 30: 201-5 https://doi.org/10.1097/01.brs.0000150831.46856.87
  18. Tohmeh AG, Mathis JM, Fenton DC, Levine AM, Belkoff SM: Biomechanical efficacy of unipedicular versus bipedicular vertebro-plasty for the management of osteoporotic compression fractures. Spine 1999; 24: 1772-6 https://doi.org/10.1097/00007632-199909010-00004
  19. Lieberman IH, Dudeney S, Reinhardt MK, Bell G: Initial outcome and efficacy of "kyphoplasty" in the treatment of painful osteoporotic vertebral compression fractures. Spine 2001; 26: 1631-8 https://doi.org/10.1097/00007632-200107150-00026
  20. Phillips FM, Ho E, Campbell-Hupp M, McNally T, Wetzel FT, Gupta P: Early radiographic and clinical results of balloon kypho plasty for the treatment of osteoporotic vertebral compression fractures. Spine 2003; 28: 2260-7 https://doi.org/10.1097/01.BRS.0000085092.84097.7B
  21. Ledlie JT, Renfro M: Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain and activity levels. J Neurosurg 2003; 98: 36-42
  22. Uppin AA, Hirsch JA, Centenera LV, Pfiefer BA, Pazianos AG, Choi IS: Occurrence of new vertebral body fracture after percutaneous vertebroploasty in patiens with osteoporosis. Radiology 2003; 226: 119-24 https://doi.org/10.1148/radiol.2261011911
  23. Lindsay R, Silverman SL, Cooper C, Hanley DA, Barton I, Broy SB, et al: Risk of new vertebral fracture in the year following a fracture. JAMA 2001; 285: 320-3 https://doi.org/10.1001/jama.285.3.320