Factors Affecting Kyphotic Angle Reduction in Osteoporotic Vertebral Compression Fractures with Kyphoplasty

Abstract

This article describes the independent factors that affect kyphotic angle reduction in the treatment of osteoporotic vertebral compression fractures with kyphoplasty. Between January 2008 and September 2011, one hundred twenty-six patients with a single-level osteoporotic compression fracture who underwent kyphoplasty were evaluated for a minimum of 1 year postoperatively. Nine independent variables related to patient characteristics (age, sex, bone mineral density [BMD], and body mass index), fracture characteristics (fracture level, fracture age, and preoperative kyphotic angle), and surgical variables (total injected cement volume and cement leakage) were assessed. Kyphotic angle reduction was the dependent variable. Univariate and multivariate linear regression analyses were used to determine the factors associated with kyphotic angle reduction.Significant improvements occurred in mean anterior vertebral height variation, middle vertebral height variation, kyphotic angle, and visual analog scale and Oswestry Disability Index scores immediate postoperatively and at final follow-up compared with the preoperative values. Univariate analyses indicated correlations between kyphotic angle reduction with BMD, fracture age, preoperative kyphotic angle, and cement volume. The final multiple linear regression model resulted in a formula that accounted for 23.3% of the variability in kyphotic angle reduction: preoperative kyphotic angle (b=0.260; P=.002), BMD (b=-0.249; P=.004), and fracture age (b=-0.226; P=.009). Kyphoplasty is a safe and effective treatment for osteoporotic compression fractures.

Vertebroplasty and kyphoplasty for the treatment of thoracic fractures in osteoporotic patients: a finite element comparative analysis

“…Clinical experience has demonstrated a high incidence of VCF affecting the thoracolumbar spine (1)(2)(3)(4)(5)(6)(7). Two surgical techniques are mainly used: VP consolidates the fracture by cement injection, while KP tries to restore VB height inflating a balloon before augmentation.…”

“…Vertebral compression fractures (VCFs) are one of the most frequent consequences of osteoporosis and occur mainly in the thoracolumbar junction (1)(2)(3)(4)(5)(6)(7).…”

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ORIGINAL ARTICLEallows the restoration of the VB height, using the mechanical action of a balloon inserted with a catheter before injecting the cement. These techniques have good outcomes in the short-term: there is a decrease in pain, as quantified with visual analog scale (VAS) scores, and a low rate of complications (1,2,4,5,(7)(8)(9). Moreover, KP improves the wedge angle (2°-8°) and the VB height (2-8 mm) (2,4,5,8).

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“…These techniques have good outcomes in the short-term: there is a decrease in pain, as quantified with visual analog scale (VAS) scores, and a low rate of complications (1,2,4,5,(7)(8)(9). Moreover, KP improves the wedge angle (2°-8°) and the VB height (2-8 mm) (2,4,5,8). However, it is difficult to determine which technique is more effective, mainly because KP is more recent than VP, and long-term clinical follow-ups are not available yet.After these treatments, a new VCF is often reported (3%-52% of cases).…”

Controversial Issues in Kyphoplasty and Vertebroplasty in Osteoporotic Vertebral Fractures

“…Published studies either report equivalence of procedures [29, 30, 32, 34–40, 46] or superiority of KP [31, 41, 42]. Since those parameters may better reflect the efficacy of the procedures compared to pain scales (i.e., VAS), they should be strictly scrutinized in future trials; indeed pain measurements frequently represent variations (pain with or without medications, positional/maximal/nocturnal/average pain, etc.)…”