Balloon kyphoplasty combined with posterior instrumentation for the treatment of burst fractures of the spine--1-year results.
OBJECTIVE
Clinical and radiologic follow-up of patients with osteoporosis with painful, traumatic A3-type vertebral compression fractures in the thoracic and lumbar spine.


METHODS
Prospective study over the period of 1 year.


METHODS
Level I Trauma Center.


METHODS
Twenty-five patients with osteoporosis (14 women and 11 men) and painful, traumatic A3-type fractures were treated with Balloon Kyphoplasty in combination with a short-segment posterior fixation (using the Universal Spine System). Twenty-one patients returned for their 1-year follow-up visit. X-rays were taken preoperatively, postoperatively, and at 3, 6, and 12 months' follow-up to evaluate vertebral height and local Cobb angle. Pain was measured using the self-reporting Visual Analogue pain Scale (VAS). Disability was measured using the Oswestry Disability questionnaire (ODI).


RESULTS
The mean pain score (VAS) improved significantly from pretreatment to posttreatment from 7.8 +/- 2.2 (5.6-10) to 4.9 +/- 2.1 (2.8-8.0) (P < 0.001). It improved further to 2.9 +/- 1.4 (2.1-4.3) at 3 months and increased slightly after 1 year (3.8 +/- 1.9) (1.9-4.7). Limitation of daily activities (ODI) improved significantly from 88% (78-100) to 35% (15-48) at 3 months (P < 0.05). Improvement was maintained at 1 year at 36.5% (10-42). At 1-year follow-up, maintenance of the height restoration and kyphotic deformity correction was found.


CONCLUSIONS
Balloon Kyphoplasty in combination with short-segment posterior instrumentation in traumatic A3 vertebral fractures led to a significant reduction in pain and disability. The combination of both surgical techniques was able to restore and maintain vertebral body height and correction of angular deformity. This technique might offer important safety advantages over an invasive anterior-posterior approach.
Pflugmacher
Robert
R
Charité-Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie, Campus Virchow-Klinikum, Augustenburgerplatz 1, Berlin, Germany. robert.pflugmacher@charite.de
Agarwal
Anand
A
Kandziora
Frank
F
K-Klostermann
Cyrus
C
D000368:Aged; D001843:Bone Cements / Q000627:therapeutic use; D001863:Bone Screws; D002404:Catheterization; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D050815:Fractures, Compression / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011446:Prospective Studies; D011859:Radiography; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
D001843:Bone Cements