title: [Radiofrequency kyphoplasty combined with posterior fixation in the treatment of burst fractures].
abstract: OBJECTIVE
  Radiofrequency kyphoplasty is an advancement of the balloon kyphoplasty and offers comparable results with a shorter operation time and a lower risk of cement leakage. This prospective study investigates the outcome of radiofrequency kyphoplasty in combination with posterior fixation by a cement-augmented screw system. Accordingly, statistical analyses of the treatment data were performed.
  
  
  METHODS
  19 patients (mean age: 74.5 ± 7.2 years) with osteoporotic vertebral burst fractures were included in the study. All of them required a surgical intervention for treating the fracture. Thereby, the vertebrae were augmented by radiofrequency kyphoplasty and a posterior fixation by cement-augmentable screws was performed. To evaluate the effectiveness and safety of the procedure, pain was measured with the visual analog scale (VAS) and functional impairment was analysed by measuring the Oswestry disability index (ODI). Furthermore, a radiographic analysis of the anterior and medial height of the vertebrae and the degree of kyphosis were undertaken. All data were recorded preoperatively, 3 to 4 days postoperatively, 3 months postoperatively and 6 months postoperatively and any additionally occurring cement leakage was documented.
  
  
  RESULTS
  The treatment showed a significant reduction of pain and improvement of the functional impairment at the 3 to 4 days postoperative evaluation (pVAS < 0.001, pODI < 0.001). The further follow-ups demonstrated an ongoing improvement of the VAS and ODI from each measurement to the next (pVAS_post-3 M < 0.001, pVAS_3 M-6 M = 0.17, pODI_post-3 M < 0.001, pODI_3 M-6 M = 0.004). The height of the vertebrae was significantly improved after the surgery (p_anterior < 0.001, p_medial < 0.001) and reduced slightly from follow-up to follow-up, but still remained higher than the preoperative value. The degree of kyphosis was also significantly improved after the surgery (p < 0.001), whereby a significant deterioration was shown at the following examinations (p_post-3 M = 0.023, p_3 M-6 M = 0.016). But even as the height decreased the degree of kyphosis was still improved in relation to the preoperative values. During the surgery cement leakage occurred in 3 cases (15.79 %).
  
  
  CONCLUSIONS
  Radiofrequency kyphoplasty is a safe and effective procedure for the treatment of vertebral compression fractures in combination with the use of posterior fixation by cement-augmentable screws with an acceptable rate of cement leakage.
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: T
authors.initials: T
authors.lastname: Jansen
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: R
authors.initials: R
authors.lastname: Bornemann
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: L A
authors.initials: LA
authors.lastname: Otten
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: K
authors.initials: K
authors.lastname: Kabir
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: D
authors.initials: D
authors.lastname: Wirtz
authors.affiliation: Medical Consulting, ARTIMED, Kassel.
authors.forename: K
authors.initials: K
authors.lastname: Sander
authors.affiliation: Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn.
authors.forename: R
authors.initials: R
authors.lastname: Pflugmacher
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D050815:Fractures, Compression / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D058498:Kyphoplasty / Q000379:methods*; D008297:Male; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome