Instability of the Vertebrae Remains following Balloon Kyphoplasty

Abstract

Study Design Retrospective cohort study. Objectives The mechanism underlying the pain relief observed following balloon kyphoplasty (BKP) to vertebral compression fractures is reported to involve stabilization of the fractured vertebrae. However, whether fixation of the vertebrae was achieved immediately after BKP has not been investigated. The purpose of this study was to assess fixation of the vertebrae immediately after BKP and whether the instability was related to visual analog scale (VAS) scores. Methods Thirty-eight patients with vertebrae that were evaluated on lateral roentgenkymography within 1 week after BKP were recruited. Instability was defined as a cleft observed between the cement and end plate of the vertebra in the supine position that disappeared in the sitting position, and the posterior wall height of the vertebra was reduced in the sitting position. Results Instability of the vertebrae immediately after BKP was observed in 17 cases. VAS scores improved in all cases, and no significant differences were observed with or without instability. Conclusions The mechanism of rapid pain relief following BKP was not strong fixation but some degree of stabilization or other factors. We suggest that more research is needed about the mechanism of pain relief following BKP in the future.

Does an osteoporotic vertebral fracture treated by balloon kyphoplasty successfully achieve bone union during the follow-up? A retrospective study with a minimum 2-year follow-up

“…It was previously reported that instability of the vertebrae remained in 45% of cases immediately after BKP. 10 In this study, 9 vertebrae (25%) exhibited instability at the final follow-up examination. Attention should be paid to this finding in order to avoid the development of complications due to remaining instability.…”

“…Past literature previously reported that instability remains after balloon kyphoplasty. 10 Ohba et al 12 reported that instability of the treated vertebrae after balloon kyphoplasty caused paraparesis. In addition, Kim et al 11 reported that the incidence of recompression in treated vertebrae was 12.5%.…”

“…However, because the stabilization of the fractured vertebrae is generally considered to be the mechanism underlying the pain relief observed following BKP, these past studies did not examine the dynamics of instability after BKP. Past literature previously reported that instability of the vertebrae persists after BKP, 10 and some reports have described the recompression of the treated vertebral body after BKP. 11 Furthermore, paraparesis has been reported to occur due to instability after BKP.…”

Osteoporotic Thoracolumbar Vertebral Fractures With Neurological Deficit Treated by Balloon Kyphoplasty Augmented with Newly Developed Minimally Invasive Posterior Hook Stabilization

“…The focal kyphosis angle between the higher endplate of the upper vertebral body and the lower endplate of the lower vertebral body was measured as previously reported [ 8 , 16 ]. The ratio of occupation by bony fragments of the spinal canal was calculated as the ratio of the bony fragment diameter to the adjacent normal canal diameter on mid-sagittal MR images, as previously reported [ 5 ].…”

“…Although the BKP procedure can support the anterior vertebral elements, the past literature previously reported that instability remains after BKP [ 8 ]. Spinal stability is ensured by the stability of each of the anterior and posterior elements.…”