Kyphoplasty For The Treatment Of Type-A3.1 Painful Osteoprotic Thoracolumbar Burst Fractures Without Neurologic Deficit

[Objective]To explore the feasibility and clinical outcome of using kyphoplasty for the treatment of type-A3.1 painful osteoporotic thoracolumbar burst fracture without neurological deficit.[Methods]From January 2007 until October 2010, forty patients with type-A3.1 painful osteoporotic thoracolumbar burst fracture without neurological deficit underwent kyphoplasty. Pain was measured using self-reporting visual analogue scale(VAS) preoperatively, postoperatively and at the last follow-up. Disability was measured using the Oswestry Disability Indexes(ODI) preoperatively, postoperatively and at the last follow-up. The anterior, central, posterior heights of the compromised vertebral body, the kyphotic angle and the spinal canal compromise were measured preoperatively, postoperatively and at the last follow-up.Comparisons of variance data between preoperatively, postoperatively and at the last follow-up were analysed by repeated measures analysis of variance.[Results]Mean VAS score decreased from 8.2±0.9 preoperatively to 3.0±0.8 postoperatively (P<0.05),and was maintained at 3.2±0.7 at the last follow-up.The ODI score varied from 71.7%±8.8% preoperatively to 35.1%±5.5% postoperatively(P<0.05),and was maintained at 36.0%±4.8% at the last follow-up.Postoperatively,the height of anterior vertebrae was restored from 63.1%±14.9% to 79.4%±13.0%(P<0.05),the height of midline vertebrae was restored from 58.0%±15.2% to 79.0%±11.2%(P<0.05),the height of posterior vertebrae was restored from 86.4%±7.2% to 91.9%±6.1%(P<0.05),the kyphotic angle was corrected from 16.4°±9.7°to 11.6°±7.4°(P<0.05),and the spinal canal compromise changed from 26.3%±5.0% to 26.0%±5.0%(P>0.05).No significant differnce was noted in maintenance of the height restoration and kyphotic deformity correction between postoperatively and at the last follow-up.Detective difference of spinal canal compromise was found in postoperatively and at the last follow-up.[Conclusions]Kyphoplasty is an alternative minimal invasive treatment of type-A3.1 painful osteoprotic thoracolumbar burst fractures without neurologic deficit.