Kyphoplasty for osteoporotic fractures with spinal canal compromise

Objective: To explore the feasibility and clinical outcome of kyphoplasty in the treatment of osteoporotic fractures with canal compromise. Methods: A total of 16 patients with osteoporotic fractures with canal compromise without neurological deficit were attempted to be treated by kyphoplasty. During kyphoplasty, modified techniques including staged bone cement injection and dynamic fluoroscopic monitoring were used. Pain was measured using the self-reporting Visual Analogue pain Scale (VAS) preoperatively, postoperatively and in the final follow-up. Disability was measured using the Oswestry Disability questionnaire (ODI) preoperatively, postoperatively and in the final follow-up. The height of the compromised vertebral body, the kyphotic angle and the spinal canal compromise were measured preoperatively, postoperatively and in the final follow-up. Results: Operations were completed smoothly, with the exception of one patient with less cement leakage but without clinical symptom occurred. Relief of pain was achieved after kyphoplasty. The mean VAS score of these patients decreased from 8.1 ± 1.2 pre-operatively to 2.7 ± 0.6 post-operatively (P<0.05). And it maintained at 2.9 ± 0.8 in the final follow-up. The ODI score before kyphoplasty was 66.3 ± 6.7. It decreased to 35.8 ± 2.9 post-operatively (P<0.05). It maintained at 37.1 ± 3.2 in the final follow-up. The height of anterior vertebrae (Ha) were restored from (63.5 ± 11.6)% to (86.3 ± 12.6)%, the height of midline vertebrae (Hm) restored from (74.1 ± 17.3)% to (84.3 ± 7.5)%, the kyphotic angle from 22.7 degree ± 6.8 degree to 8.5 degree ± 6.8 degree. In the final follow-up, maintenance of the height restoration and kyphotic deformity correction was observed. After kyphoplasty, the spinal canal compromise was restored from (20.1 ± 4.1)% to (17.8 ± 1.3)% (P>0.05). In the final follow-up, the spinal canal compromise was (14.4 ± 3.1)%. Conclusion: Kyphoplasty is a relatively safe and effective method for the treatment of osteoporotic fractures with canal compromise without neurological deficit. (authors)