Is there a stable vertebral height restoration with the new radiofrequency kyphoplasty? A clinical and radiological study

Abstract

Purpose: The aim of this study is to evaluate whether radiofrequency kyphoplasty can restore vertebral body height in osteoporotic vertebral fractures and whether restoration of vertebral height correlates with decreased pain.

Methods: In a prospective study from December 2010 to October 2011, 25 patients underwent RF kyphoplasty for 30 fresh osteoporotic vertebral fractures. The parameter demographics, pain relief, restoration of vertebral body height (mean vertebral body height, kyphosis angle, anterior/posterior edge height) and all complications were recorded.

Results: Mean age of patients was 73.8 ± 9.6 (range, 55-83); time from initial painful fracture to treatment was 3.0 weeks ± 1.2; average operative time was 23.5 min (range, 15-41). Average pain index score decreased significantly from 69 ± 8.5 preoperatively to 34.4 ± 5.9 postoperatively (p < 0.001), and to 30 ± 6.3 (p < 0.001) after 3 months. Mean vertebral body height, anterior edge height and kyphosis angle showed significant increases postoperatively and at 3-month follow-up (p < 0.05). In two vertebrae (6.6 %), minimal, asymptomatic cement leakage occurred in the upper disc. After 2 months, one new fracture (3.3 %) was identified in the directly adjacent segment that was also successfully treated with radiofrequency kyphoplasty. There was a preliminary correlation between mean vertebral body height elevation and cement volume (r = 0.533).

Conclusion: Radiofrequency kyphoplasty achieves rapid and lasting improvement in clinical symptoms. There was stable restoration of vertebral body height with a mean cement volume of 3.0 ml ± 0.6. There was no correlation between restoration of vertebral body height and pain relief.