[Kyphoplasty - a new minimally invasive treatment for repositioning and stabilising vertebral bodies].
OBJECTIVE
Osteoporotic vertebral fractures are an ailment of the aging population of increasing incidence and high socioeconomic impact. Intractable pain causing significant morbidity leads to long-term hospitalisation. Kyphoplasty offers a new minimal invasive operative stabilisation procedure for these vertebral compression fractures. This study is conducted to investigate whether this procedure significantly reduces both pain and the duration of hospital stay in comparison to conservative treatment modalities.


METHODS
From January until July 2002 a total of 22 patients had undergone kyphoplasty in 37 vertebral bodies. Osteoporotic vertebral fractures were treated in 18 cases, while in another 4 cases prophylactic stabilisation for osteolytic lesions was performed. Both the duration of hospital stay and the reduction of pain symptoms were determined and compared to a conservatively treated control group of 20 patients suffering from 35 fractured vertebral bodies. Pre- and postoperative endplate angles were measured to assess the restoration of the sagittal alignment. The effects on pain symptoms were measured on a self-reported Visual Analogue Score Scale.


RESULTS
The mean pain relief for the patients undergoing kyphoplasty was 82 %, which was significantly higher (p < 0.0001) compared to the group of the conservatively treated patients (42 %). Reduction of the kyphotic deformity was achieved in 4 cases (average 8.5 degrees ). The average in-patient treatment duration for the surgical treated patients was 10 days as opposed to a significantly longer mean hospitalisation of 20 days (p = 0.003). Cement extravasation was observed in 5 out of 37 treated vertebral bodies without clinical sequelae.


CONCLUSIONS
Kyphoplasty is a safe minimal invasive procedure for the stabilisation of osteoporotic vertebral fractures leading to a statistically significant reduction both of pain status and duration of hospitalisation.
Weisskopf
M
M
Orthopädische Universitätsklinik, Klinikum der Rheinisch Westfälischen Technischen Hochschule Aachen, Germany. mweisskopf@orthopaedie-aachen.de
Herlein
S
S
Birnbaum
K
K
Siebert
C
C
Stanzel
S
S
Wirtz
D C
DC
D000368:Aged; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D018786:Bone Substitutes; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010024:Osteoporosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D020127:Recovery of Function; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome
D018786:Bone Substitutes