The Effect of Postural Correction and Subsequent Balloon Inflation in Deformity Correction of Acute Osteoporotic Vertebral Fractures

Abstract

ObjectiveTo determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction.MethodsA totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group.ResultsPostoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and 5.34° compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by 8.32° (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05).ConclusionIn acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.

A Retrospective Study to Evaluate the Effect of Dynamic Fracture Mobility on Cement Leakage in Percutaneous Vertebroplasty and Percutaneous Kyphoplasty in 286 Patients with Osteoporotic Vertebral Compression Fractures

“…Dynamic fracture mobility initially attracted attention because it implied complete corticocancellous disruption and allowed height recovery of the vertebra after postural reduction [ 25 , 26 ]. Liu et al reported that placement of the patient in prone hyperextended position produced a significant reduction of anterior vertebral height by 5.51±2.64 mm, middle vertebral height by 4.35±2.73 mm, and posterior vertebral height by 3.79±3.22 mm [ 27 ]. In turn, these vertebral height changes also aggravate damage to the peri-vertebral wall, thereby increasing the risk of cement leakage.…”

The Value of Dynamic Fracture Mobility in Determining the Optimum Operation Choice for Acute Osteoporotic Vertebral Compression Fracture

“…The supine position cannot reflect a real operative position. For these reasons, we adopted intraoperative prone cross-table lateral radiographs as a diagnostic tool for dynamic fracture mobility, which was recommended by Cawley et al 23 , 29 , 33 , 34 This positioning technique reduced provoked pain, advanced anterior vertebral height restoration, and supported vertebral deformities correction.…”