[Selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fractures].
OBJECTIVE
To investigate the selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fracture.


METHODS
Twenty-two consecutive procedures were performed in 17 aged patients with osteoporotic spinal compression fractures from April 2002 to June 2004. The signal changes in different sequences were confirmed by magnetic resonance imaging before the procedures. This operation involved the percutaneous insertion of two inflatable bone tamps into a fractured vertebral body transpedicularly under fluoroscopic guidance. Every patient was treated individually, according to the results of radiography and CT scan before operation. Preoperative and postoperative complications, visual analogue scale, and radiographic findings such as vertebral height and Cobb angle were recorded and analyzed.


RESULTS
All patients tolerated the procedure well with immediate relief of their back pain in 24 hours. There was no leakage of cement into the epidura. The mean loss percent of the anterior and middle vertebral heights were (35.32 +/- 13.15)% and (27.53 +/- 12.61)% before operation, and (14.21 +/- 12.43)% and (16.2 +/- 7.5)% after operation. The height restoration of vertebra was confirmed by X-ray after the procedure (P < 0.01). The mean kyphosis was improved from (25.3 +/- 4.2) degrees to (8.6 +/- 5.1) degrees. No complications occurred. No patient had nerve injury. The patients were allowed to walk next day after the procedure.


CONCLUSIONS
The selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fractures has satisfactory short-term clinical efficacy. It is also an effective way to prevent complications.
Yang
Hui-lin
HL
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Gu
Xiao-hui
XH
Chen
Liang
L
Lu
Jian
J
Mao
Hai-qing
HQ
Meng
Bin
B
Niu
Guo-qi
GQ
Zhao
Liu-jun
LJ
Tang
Tian-si
TS
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010024:Osteoporosis / Q000150:complications*; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D016103:Spinal Fractures / Q000601:surgery*