Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Pain Relief and Associated Factors after a Kyphoplasty for Treating an Osteoporotic Vertebral Compression Fracture

골다공증성 척추 압박 골절에서 풍선 척추 성형술 후 통증의 호전 및 관련 요인에 대한 분석

  • Koh, Young Do (Department of Orthopedic Surgery, School of Medicine, Ewha Womans University) ;
  • Kim, Dong Jin (Department of Orthopedic Surgery, School of Medicine, Ewha Womans University)
  • 고영도 (이화여자대학교 의과대학 이대목동병원 정형외과) ;
  • 김동진 (이화여자대학교 의과대학 이대목동병원 정형외과)
  • Received : 2014.10.17
  • Accepted : 2014.11.08
  • Published : 2014.12.31
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Abstract

Purpose: The objectives of this study were to assess pain relief according to the time after kyphoplasty and to evaluate the factors affecting pain relief after kyphoplasty in the treatment of a single-level osteoporotic vertebral compression fracture. Methods: A retrospective review of 34 kyphoplasties for single-level osteoporotic vertebral compression fractures was performed. Pain relief was assessed by using the visual analogue scale (VAS) at preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Associated factors, including age, sex, pain duration, bone mineral density, and cement leakage, were evaluated using the patients' medical records. Statistical analyses were conducted using the paired t-test to assess pain relief and using the independent t-test and Pearson's correlation coefficient to evaluate the relationship between those factors and pain relief. Results: Preoperatively, the mean VAS score was 7.06. Postoperatively, it declined to 3.66 (p=0.001), 2.81 (p=0.001) and 2.24 (p=0.001) at 6 weeks, 3 months and 6 months, respectively. Also, statistically significant pain relief was observed during the periods from 6 weeks to 3 months (p=0.001) and from 3 months to 6 months (p=0.001). However, reduction of the VAS score showed no significant correlation with age, sex, pain duration, bone mineral density, or cement leakage (p>0.05). Conclusion: Our study suggests that a kyphoplasty may be effective in osteoporotic vertebral compression fracture patients with acute pain and that after the kyphoplasty, pain is reduced remarkably for 6 weeks and then continuously for 6 months.

Keywords

References

  1. Bonnick SL. Osteoporosis in men and women. Clin Cornerstone 2006; 8: 28-39. https://doi.org/10.1016/S1098-3597(06)80063-3
  2. Ryu K, Park C. The prognostic factors influencing on the therapeutic effect of percutaneous vertebroplasty in treating osteoporotic vertebral compression fractures. J Korean Neurosurg Soc 2009; 45: 16-23. https://doi.org/10.3340/jkns.2009.45.1.16
  3. Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 2001; 26: 1511-15. https://doi.org/10.1097/00007632-200107150-00002
  4. Silverman SL. The clinical consequences of vertebral compression fracture. Bone 1992; 13: S27-31. https://doi.org/10.1016/8756-3282(92)90193-Z
  5. Chen AT, Cohen DB, Skolasky RL. Impact of nonoperative treatment, vertebroplasty and kyphoplasty on survival and morbidity after vertebral compression fracture in the medicare population. J Bone Joint Surg Am 2013; 95: 1729-36. https://doi.org/10.2106/JBJS.K.01649
  6. Van Meirhaeghe J, Bastian L, Boonen S, Ranstam J, Tillman JB, Wardlaw D. A randomized trial of balloon kyphoplasty and nonsurgical management for treating acute vertebral compression fractures. Spine 2013; 38: 971-83. https://doi.org/10.1097/BRS.0b013e31828e8e22
  7. Bozkurt M, Kahilogullari G, Ozdemir M, Ozgural O, Attar A, Caglar S et al. Compartive analysis of vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures. Asian Spine J 2014; 8: 27-34. https://doi.org/10.4184/asj.2014.8.1.27
  8. Wenger M, Markwalder TM. Re:Percutaneousvetebroplasty for pain relief and spinal stabilization. Spine 2000; 25: 2968-9.
  9. Alvarez L, Perez-Higueras A, Granizo JJ, de Miguel I, Quinones D, Rossi RE. Predictors of outcomes of percutaneous vertebroplasty for osteoporotic vertebral fratures. Spine 2005; 30: 87-92. https://doi.org/10.1097/00007632-200501010-00016
  10. Majd ME, Farley S, Holt RT. Preliminary outcomes and efficacy of the first 360 consecutive kyphoplasties for the treatment of painful osteoporotic vertebral compression fractures. Spine J 2005; 5: 244-255. https://doi.org/10.1016/j.spinee.2004.09.013
  11. Berlemann U, Franz T, Orler R, Heini PF. Kyphoplasty for treatment of osteoporotic vertebral fractures: a prospective non-randomized study. Eur Spine J 2004; 13: 496-501. https://doi.org/10.1007/s00586-004-0691-7
  12. Truumees E. Osteoporosis. Spine 2001; 26: 930-2. https://doi.org/10.1097/00007632-200104150-00016
  13. Park H, Kim M, Yoo M, Lee S, Park J, Hwang W et al. Complications after vertebroplasty of treatment for compression fracture with osteoporosis. J Korean Fracture Soc 2003; 16: 534-40. https://doi.org/10.12671/jksf.2003.16.4.534
  14. Phillips FM, Todd Wetzel F, Lieberman I, Campbell-Hupp M. An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty. Spine 2002; 27: 2173-9. https://doi.org/10.1097/00007632-200210010-00018
  15. Voormolen MH, Mali WP, Lohle PN, Fransen H, Lampmann LE, van der Graaf Y et al. Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral comopression fractures. The VERTOS study. AJNR Am J Neuroradiol 2007; 28: 555-60.
  16. Deramond H, Depriester C, Galibert P, Le Gars D. Percutaneous vertebroplasty with poly-methylmethacrylate. Technique, indications and results. RadiolClin North Am 1998; 36: 533-46. https://doi.org/10.1016/S0033-8389(05)70042-7
  17. Cortet B, Cotton A, Boutry N, Flipo RM, Duquesnoy B, Chastanet P et al. Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: an open prospective study. J Rheumatol 1999; 26: 2222-8.
  18. Eck JC, Nachtigall D, Humphreys SC, Hodges SD. Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J 2008; 8: 488-97. https://doi.org/10.1016/j.spinee.2007.04.004
  19. Lindsay R, Burge RT, Strauss DM. One year outcomes and costs following a vertebral fracture. Osteoporos Int. 2005; 16: 78-85. https://doi.org/10.1007/s00198-004-1646-x
  20. Rho Y, Choe, W, Chun Y. Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur Spine J 2012; 21: 905-911. https://doi.org/10.1007/s00586-011-2099-5