title: Balloon kyphoplasty for osteoporotic spinal fractures with middle column compromise.
abstract: BACKGROUND
  Balloon kyphoplasty (BKP) is an effective method for osteoporotic vertebral compression fractures. However osteoporotic spinal fractures with middle column compromise are mentioned as a relative contraindication to BKP. Thus we investigated the safety and efficacy of BKP in the treatment of osteoporotic spinal fractures with middle column compromise but without neurological deficit.
  
  
  METHODS
  In this retrospective study, 45 patients who suffered osteoporotic fractures with middle column compromise but without neurological deficits were treated by BKP from May 2007 to December 2010. The final follow-ups were finished during the time of July 2011-September 2011. The mean follow-up period was 20.2 months. The height of the compromised vertebral body, the kyphotic angle and spinal canal compromise were measured before surgery, one day after surgery, and at the final follow-up. A visual analogue scale (VAS) and the Oswestry disability index (ODI) were chosen to evaluate pain and functional activity.
  
  
  RESULTS
  The mean VAS and ODI scores improved significantly from pre- to post-operation (p<0.05), and this improvement was sustained at the final follow-up. The mean anterior vertebral body height ratio improved from 57.6%± 11.8% preoperatively to 86.2%± 12.2% postoperatively (p<0.05), so did the mean middle vertebral body height ratio. The kyphotic angle improved from 16.3° ± 3.7° preoperatively to 9.3° ± 2.6° postoperatively (p<0.05). At final follow-up, BKP stabilised vertebral height and prevented further kyphotic deformity. While there were no differences in spinal canal compromise between pre-operation and one day after surgery (p>0.05), there was a significant difference from the measurement at the final follow-up (p<0.05).
  
  
  CONCLUSIONS
  BKP is a safe and effective method for osteoporotic spinal fractures with middle column compromise but without neurological deficit. Spontaneous remodelling of the spinal canal also occurs after BKP.
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
authors.forename: Minfeng
authors.initials: M
authors.lastname: Gan
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zou
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
authors.forename: Xuesong
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
authors.forename: Genlin
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China. Electronic address: suzhouspine@126.com.
authors.forename: Huilin
authors.initials: H
authors.lastname: Yang
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058498:Kyphoplasty / Q000379:methods; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D012189:Retrospective Studies; D013116:Spinal Cord / Q000503:physiopathology; D016103:Spinal Fractures / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Kyphoplasty; Osteoporosis; Spinal canal compromise