Chronic painful OVCFs should be candidates for KP, and there was no difference in pain relief when treated with either unipedicular or bipedicular KP.Although the bipedicular KP is more efficacious in vertebral height restoration in early stage, the unipedicular KP can maintain the same degree of the restored vertebral height in the long run.

No abstract

Purpose To evaluate the clinical efficacy, especially the pain reduction, of vertebroplasty and balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures (OVCFs). Methods Eighty-six patients with OVCFs were treated with vertebroplasty or balloon kyphoplasty. All patients were followed up for seven-36 months. Visual analog scale (VAS), vertebral height, and local kyphotic angle were evaluated at pre-operation, postoperation, and final follow-up. Results The VAS pain score decreased significantly after surgery in both kyphoplasty and vertebroplasty groups (p<0.001), and the improvement of VAS score had no significant difference between the two groups (p00.826). There was a significant difference in the improvement of vertebral height (p<0.001) and local kyphotic angle (p<0.001) between the two groups.

Background: Kümmell’s disease is a clinical syndrome characterized by a minor spinal trauma with a symptom-free period from months to years, followed by progressive painful kyphosis. Kyphoplasty and vertebroplasty have been introduced to treat Kümmell’s disease, and obtained good clinical results. Recently, delayed cement displacement was reported for Kümmell’s disease treated by cement augmentation alone. Some authors recommended internal fixation combined with cement injection for this particular condition. Objective: To evaluate and compare the clinical efficacy, especially the pain reduction, of 2 procedures (kyphoplasty alone versus short segmental fixation combined with vertebroplasty) in the treatment of Kümmell’s disease. Study Design: Retrospective evaluation and comparison of postoperative VAS scores and radiographic outcomes. Setting: Single center inpatient population. Methods: Two procedures, including conventional balloon kyphoplasty and short segmental fixation combined with vertebroplasty, were utilized for 54 patients with Kümmell’s disease. All patients were followed-up for 8 – 42 months. Visual analog scale (VAS), vertebral height, and local kyphotic angle were evaluated and compared for 2 groups before surgery, after surgery, and at final follow-up. Pearson correlation coefficients were calculated to assess the relationship between the decreased values of pain scores (VAS) and improvement of anterior vertebral height and local kyphotic angle. Results: For the KP group, the VAS pain score decreased significantly from 7.8 ± 0.9 before surgery to 3.3 ± 1.0 after surgery (P < 0.01), and 2.9 ± 0.9 at final follow-up (P < 0.01). The mean height of the anterior vertebral body increased from 14.8 ± 2.4 mm before surgery to 19.3 ± 2.1 mm after surgery (P < 0.01). The mean local kyphotic angle decreased from 22.7 ± 6.9° before surgery to 14.5 ± 5.3° after surgery (P < 0.01). For SSF + VP group, the VAS pain score decreased significantly from 7.2 ± 1.6 before surgery to 4.7 ± 1.3 after surgery (P < 0.01), and 3.5 ± 1.2 at final follow-up (P < 0.01). The mean height of the anterior vertebral body increased from 13.6 ± 2.5mm before surgery to 17.3 ± 2.7 mm after surgery (P < 0.01). The mean local kyphotic angle decreased from 24.7 ± 9.2° before surgery to 15.5 ± 6.2° after surgery (P < 0.01). No significant loss of correction of vertebral height and kyphosis was observed at follow-up. Improvement of VAS score had no correlation with improvement of vertebral height or local kyphotic angle. Asymptomatic cement leakage occurred in both groups. Limitations: Retrospective study with a relatively small sample size. Conclusions: This study showed that both balloon kyphoplasty alone and short segmental fixation combined with vertebroplasty for Kümmell’s disease were safe and effective. Improvement of VAS score had no correlation with improvement of vertebral height or local kyphotic angle. Comparatively, balloon kyphoplasty resulted in same the clinical outcomes with less complications. Key words: Kümmell’s disease, kyphoplasty, vertebroplasty, short segmental fixation, pain

Our objective was to study the changes in respiratory function of patients with osteoporotic vertebral compression fractures (OVCFs) after vertebroplasty and kyphoplasty. Thoracic kyphotic angle, local kyphotic angle, pain scores and pulmonary function parameters were measured in 38 older women with OVCFs before, three days after and three months after operation. Vital capacity, forced vital capacity and maximum voluntary ventilation significantly increased three days after operation (P<0.01), but only maximum voluntary ventilation went on to improve three months later (P<0.01); the thoracic kyphotic angle had a significantly negative correlation with vital capacity (vertebroplasty: r=−0.832; kyphoplasty: r=−0.546). In thoracic subgroups, the improvement of the local kyphotic angle and vital capacity had a remarkably positive correlation (vertebroplasty: r=0.778; kyphoplasty: r=0.637), and kyphoplasty could improve vital capacity more than vertebroplasty (P< 0.01). Vertebroplasty and kyphoplasty improve the lung function impaired by OVCFs, and kyphoplasty has a better effect in improving vital capacity for thoracic OVCFs.Résumé Le but de cette étude est d'étudier les modifications des fonctions respiratoires chez les patients ostéo-porotique présentant une fracture vertébrale en compression (OVCF) après vertébroplastie et kyphoplastie. Matériel et méthode : l'angle de cyphose thoracique, l'angle de cyphose au niveau du foyer de fracture, le score douleur, les fonctions pulmonaires ont été analysés chez 38 patientes âgées présentant une fracture de type OVCF et ceci avant l'intervention, trois jours et enfin trois mois après l'intervention. Résultat : la capacité vitale, et la ventilation ont été améliorées de façon significative 3 jours après l'intervention (p<0,01), la cyphose thoracique a également une corréla-tion significativement négative avec la capacité vitale (vertébroplastie r=B-0,832, kyphoplastie r=−0,546). Dans le sous groupe des fractures dorsales l'amélioration de l'angle cyphotique fracturaire et la capacité vitale sont positivement corrélés (vertébroplastie r=0,778 et kyphoplastie r=0,637), la vertébroplastie et la kyphoplastie améliorent les fonctions pulmonaires de ce type de fracture. La kyphoplastie a un meilleur effet sur la capacité vitale pour les fractures localisées au niveau du râchis thoracique.