[Radiofrequency kyphoplasty - an innovative method for the treatment of vertebral compression fractures - comparison with conservative treatment].
OBJECTIVE
An evaluation of treatment protocols was used to expand the documentation of efficacy and safety of radiofrequency kyphoplasty (RFK). Additionally, a comparison of this new and innovative procedure with conservative treatment was carried out.


METHODS
Patients with painful osteoporotic vertebral fractures according to the common findings in an orthopaedic university hospital were included in the comparison study in which the indication for surgical intervention action according to the DVO guidelines was interdisciplinary confirmed. For the comparison group, patients with the same clinical and radiological findings were recruited who rejected a surgical intervention. For surgery, the StabiliT® Vertebral Augmentation System for a radiofrequency kyphoplasty by the company DFine was used. The cement was injected with a "multiplex controller". Thus, the results of the new method were compared to those of a group that was treated conservatively.


RESULTS
The radiofrequency kyphoplasty (n = 114) resulted in an average decrease of VAS scores by almost 60 mm, which increased during the follow-up. Similarly, the Oswestry scores showed a marked improvement by 46 % points after 6 weeks. The mean increase in vertebral body height was 2.8 mm after radiofrequency kyphoplasty. In the conservatively treated group only very small changes compared to the initial findings were registered during the 6-week observation period. Accordingly, 33 of 67 patients decided after 6 weeks for surgery, which led to corresponding improvements (VAS, Oswestry, vertebral body height). Noteworthy is the low rate of cement leakage in the radiofrequency kyphoplasty group of 6 % (n = 7).


CONCLUSIONS
Radiofrequency kyphoplasty offers a secure superiority over conservative treatment regarding clinical efficacy. In addition, the fractured vertebrae can be better targeted and erected, a longer processing time of the cement is ensured, a high interdigitation of the cement with the bone is guaranteed, the rate of cement leakage is low, the risk of radiation for the surgeon is minimised, and the operation time is shortened.
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn. rahel.bornemann@googlemail.com
R
R
Bornemann
K
K
Kabir
L A
LA
Otten
M
M
Deml
E M W
EM
Koch
D C
DC
Wirtz
R
R
Pflugmacher
D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D005260:Female; D050815:Fractures, Compression / Q000453:epidemiology* / Q000628:therapy*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D058498:Kyphoplasty / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D016103:Spinal Fractures / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome