Functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures.
BACKGROUND
Vertebral body compression fractures secondary to osteoporosis or malignant osteolysis are an increasingly common problem. The primary purpose of our study was to assess functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures. Our secondary purpose was to compare such functional outcomes in patients with osteoporosis versus multiple myeloma.


METHODS
The 314 consecutive patients prospectively included in our study had progressive and painful compression fractures as a result of osteoporosis or multiple myeloma that were refractory to nonoperative modalities. Of those 314 patients, the 211 (67.2%) patients (155 with osteoporosis and 56 with multiple myeloma) who had complete preoperative and postoperative data formed our final study group. All patients tolerated the kyphoplasty procedure well (that is, there were no adverse events in terms of perioperative patient condition). Follow-up ranged from 1 to 235 weeks (mean 55.0 weeks). Functional outcomes were assessed by the SF-36 and Oswestry Disability Index at baseline and at follow-up examinations. Data were analyzed by Student's t-test and the level of significance was set at P<or=0.05.


RESULTS
The average Owestry Disability Index score decreased by 12.6 points (P<0.001) in the overall group, by 11.8 points (P<0.001) at short-term follow-up, and by 8.6 points (P<0.001) at long-term follow-up. All SF-36 sub-scores except for general health and role-emotional showed statistically significant improvement from baseline values at the same time points. There was no statistically significant difference with regard to functional outcome in the osteoporosis and multiple myeloma sub-groups.


CONCLUSIONS
Kyphoplasty provided a safe and effective treatment for pain and disability in patients with verterbral compression fractures secondary to osteoporosis and multiple myeloma. In addition, we found no statistically significant difference with regard to functional outcome between patients with osteoporosis and multiple myeloma.
Khanna
A J
AJ
Cleveland Clinic Spine Institute and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, OH, USA. ehenze1@jhmi.edu
Reinhardt
M K
MK
Togawa
D
D
Lieberman
I H
IH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D050815:Fractures, Compression / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D011446:Prospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*
D001843:Bone Cements; D019904:Polymethyl Methacrylate