Preoperative radiological findings as predictors of poor outcome in patients with osteoporotic vertebral fractures after percutaneous balloon kyphoplasty

DOI
  • Kotaka Shinji
    Orthopaedic and Microscopic Spine and Spinal Cord Surgery Center, Hiroshima City Asa Citizens Hospital
  • Fujiwara Yasushi
    Orthopaedic and Microscopic Spine and Spinal Cord Surgery Center, Hiroshima City Asa Citizens Hospital
  • Ota Ryo
    Orthopaedic and Microscopic Spine and Spinal Cord Surgery Center, Hiroshima City Asa Citizens Hospital
  • Hashiguchi Naofumi
    Orthopaedic and Microscopic Spine and Spinal Cord Surgery Center, Hiroshima City Asa Citizens Hospital
  • Manabe Hideki
    Orthopaedic and Microscopic Spine and Spinal Cord Surgery Center, Hiroshima City Asa Citizens Hospital

Bibliographic Information

Other Title
  • 骨粗鬆性椎体骨折に対するballoon kyphoplastyの術前画像所見から予測する予後不良因子の検討

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Description

<p>Introduction: With aging the population, the patients with osteoporotic vertebral fracture have been increasing. previously, conservative treatment is considered the standard treatment for osteoporotic vertebral fracture. Balloon kyphoplasty as a new method is minimally invasive surgery that are widely used for painful osteoporotic vertebral fractures. While balloon kyphoplasty is effective for most patients, not effective for some patients.</p><p>Aim: The aim of this study is to find predictors of poor outcome in patients with percutaneous balloon kyphoplasty for osteoporotic vertebral fractures by preoperative radiological findings.</p><p>Materials and Methods: Between June 2011 to March 2018, 145 consecutive patients were diagnosed osteoporotic vertebral body fracture and underwent balloon kyphoplasty at our institution. Inclusion criteria were as follows: dynamic radiographic examination in lateral view and MR examination were performed before surgery; and follow up period is more than a year. Of the 145 patients initially selected, 66 were included in the study. They were divided into 2 groups. A total of 47 patients (group A) improved in symptoms by balloon kyphoplasty. A total of 19 patients (group B) didn't improved in symptoms by balloon kyphoplasty.</p><p>Results: The average of local kyphotic angle was 14.5±12.5° in group A and 14.9±10.0° in group B, respectively. The average of vertebral instability 6.9±5.0° in group A and 5.3±4.0° in group B, respectively. The presence of intravertebral effusion were 15 patients (31.9%) in group A and 13 patients (68.4%) in group B, respectively. The differences were statistically significant for the presence of intravertebral effusion, but not the local kyphotic angle and the vertebral instability.</p><p>Conclusion: The presence of intravertebral effusion in preoperative MR examination is predictor of poor outcome in patients with percutaneous balloon kyphoplasty for osteoporotic vertebral fractures. Intravertebral effusion cause a gap between bone tissue and bone cement, and consequently micromotion of the gap between those is the cause of pain.</p>

Journal

  • Journal of Spine Research

    Journal of Spine Research 11 (12), 1318-1322, 2020-12-20

    The Japanese Society for Spine Surgery and Related Research

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