Percutaneous balloon kyphoplasty in the treatment of painful vertebral compression fractures: effect on local kyphosis and one-year outcomes in pain and disability

Abstract

Background and purpose: The aim of the study was to determine the effectiveness of percutaneous balloon kyphoplasty for treatment of compressive vertebral fractures.

Materials and methods: A retrospective analysis was conducted on 24 patients with 58 symptomatic vertebral fractures treated by balloon kyphoplasty. Visual Analogue Pain Scale (VAS) and Oswestry Disability Index (ODI) were used to assess fracture-related pain and patient's disability: preoperatively and within 12-months follow-up. Following the procedures to evaluate the change of vertebral deformity, the angle of local kyphosis was measured.

Results: Preoperative VAS score was 6.54, at discharge it significantly regressed in 95.8% of patients. The overall VAS score at discharge was 1.25 and within 12 months decreased to 0.26. Preoperative ODI score was 50%, at follows-up in all patients it decreased, ranging from 21% to 10%. Reduction of local kyphosis was achieved in 30 (51.7%) vertebrae by average 4.3°. In 9 (37.5%) patients kyphosis of all augmented vertebrae was reduced, in 7 (29.2%) patients procedures reduced kyphosis in part of augmented vertebrae and in 8 patients (33.3%) kyphosis remained unchanged. Asymptomatic complications included cement leak in 10 (17%) vertebrae and intraoperative rupture of 4 (4%) balloons.

Conclusions: Rapid significant pain relief after kyphoplasty followed by long-term pain release and disability reduction obtained in all patients was most probably the result of vertebral augmentation. The correction of local kyphosis had no influence on the outcome.

Keywords: Kyphoplasty; Kyphosis; Osteoporosis; Pain; Vertebral compression fracture.