Kyphoplasty for vertebral compression fractures: 1-year clinical outcomes from a prospective study.
OBJECTIVE
Over the past 15 years, vertebroplasty has emerged as a treatment for vertebral compression fractures. This technique, however, does not restore vertebral height and is associated with a high rate of cement leakage. Recently, kyphoplasty was developed in an effort to circumvent this problem. Although its immediate results have been reported, it is unclear whether the benefits endure.


METHODS
Seventy-eight consecutive patients underwent 188 kyphoplasty procedures. The patients responded to Short Form-36 (SF-36) questionnaires, a visual analog scale (VAS) for pain rating, and the Oswestry disability index (ODI) instrument; additionally they underwent detailed neurological and radiographic examinations pre- and postoperatively. The preoperative SF-36, VAS, and ODI scores, the neurological examination results, and the radiographic data were compared with the postoperative findings. Thirteen patients died of disease progression or unrelated illness. Of the surviving patients, complete data were available in 62% (minimum follow-up period 12 months, mean 18 months). Complications included one myocardial infarction and five cases of asymptomatic cement extravasation. No case of neurological deterioration occurred during the follow-up period. Significant improvements in seven measures of the SF-36 inventory as well as on the ODI and VAS were noted early postoperatively, and these persisted throughout the follow-up period, despite a statistically insignificant decline in the measure of general health at last follow-up examination.


CONCLUSIONS
Kyphoplasty is an effective treatment for vertebral compression fractures. The benefits presented in the early postoperative period and persisted at 1 year posttreatment.
Coumans
Jean-Valéry C E
JV
Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02118, USA. jcoumans@partners.org
Reinhardt
Mary-Kay
MK
Lieberman
Isador H
IH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019637:Orthopedic Procedures / Q000379:methods*; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D011446:Prospective Studies; D013117:Spinal Cord Compression; D016103:Spinal Fractures / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
D001843:Bone Cements; D019904:Polymethyl Methacrylate