Unipedicular Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures: Early Results

Abstract

Unipedicular (unilateral) extrapedicular kyphoplasty is both a safe and efficacious alternative to the traditional bipedicular kyphoplasty for the treatment of painful osteoporotic VCFs. As a technique, it is faster, less expensive, and involves less radiation exposure for the surgical suite personnel.

Comparison of unilateral versus bilateral balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures

“…Papadopoulos et al reported that unilateral BKP can effectively alleviate pain and restore vertebral height, without coronal wedging. 4 The retrospective study by Song et al found no obvious difference in the degree of improvement of vertebral compression and angular kyphosis between unilateral and bilateral BKP; however, the degree of pain relief in the unilateral group was better than that in the bilateral group, which may be related to the difference in pain intensity before surgery. 10 In this study, both unilateral and bilateral BKP achieved satisfactory results for patients with OVCF and patients were significantly improved compared to before surgery.…”

“…3 Consequently, scholars have attempted to apply unilateral BKP in the treatment of patients with OVCF to obtain better efficacy. 4 Theoretically, compared with bilateral BKP, unilateral BKP involves less radiation exposure and thus less radiation damage, shortens the operating time, and reduces the risk of complications caused by the vertebral pedicle puncture by 50%. To compare the efficacy of unilateral BKP with that of bilateral BKP in the treatment of OVCF, we conducted a retrospective study using data from January 2008 to January 2010 in our hospital.…”

Subsequent Vertebral Fractures Post Cement Augmentation of the Thoracolumbar Spine

“…[15][16][17] It is widely used in osteoporotic vertebral compression fractures, with numerous studies showing its effectiveness as a form of pain control and preventing further vertebral collapse. [1][2][3][4]8,11,18,19 Studies showed that it provides nearly immediate pain relief in over 80% of cases, thus allowing patients to mobilize postoperatively. 2,3,20 From 2009 to 2010, 3 randomized controlled trials concluded that there was no superiority of vertebroplasty over nonsurgical management, or over a sham procedure.…”

“…However, its complications including cement leaks, soft tissue hematoma, osteomyelitis, and radiculopathy are uncommon. 4,[26][27][28][29] In a meta-analysis of complications, Lee et al reported that medical complication rate was 0.4% and 1.6% for vertebroplasty and kyphoplasty, respectively, whereas procedure-related complication was 3.8% and 0.6% for vertebroplasty and kyphoplasty, respectively. 30 Papanastassiou et al reported both surgical vertebroplasty and kyphoplasty were safe, with only occasional cases of symptomatic cement extravasations in the postvertebroplasty patients.…”

“…2,3 It is also used to augment vertebral compression fractures, preventing their further collapse, which leads to worsening kyphosis of the spine. [4][5][6][7] A known complication of this procedure is subsequent vertebral fractures, which results in more vertebral levels requiring cement augmentation. [8][9][10][11] The ability to predict such complications and identify at-risk vertebra avoids unnecessary morbidity and serves to guide management.…”