The Management Of The Adjacent Segment Fracture After Percutaneous Kyphoplasty

Objective:To discuss the management of the adjacent segment fracture after percutaneous kyphoplasty (PKP) for the osteoporotic vertebral compression fracture (OVCF).Methods:14cases of the adjacent OVCF after PKP,4male and10female. The age was79-85years old, the mean age was81±3.2years old. The interval time was10-32monthes after initial PKP, the mean was17±6.2months. The fracture levels was1cease in T10,2cases in T11,3cases in T12,6cases in L1and2cases in L2.9cases were located in the caudal adjacent level and5cases in cranial levels. Except for6cases, the others had no trauma. All cases got the MRI and fresh fracture was identified. PKP was used in all cases. The X-rays was used to observe the distribution of the bone cement in postoperative and follow-up. The VAS was used to evaluate the pain improvement. Results:PKP was performed in all cases, the volume of bone cement was3.5-5.8ml. the mean was4.8±0.5ml. the duration was20-70min, the mean was43.4±15min. there was no nerve injury. The preoperative VAS was7.3-9.1, the mean was8.3±1.6. the VAS in first postoperative day was2.2-4.8, the mean was3.2±2.2, and the last follow-up was2.6-5.3, the mean was3.5±1.2. There was no fracture observed in adjacent levels during the follow-up.Conclusion:The risk of fracture in adjacent level was Increased after initial PKP. The PKP was effective in the management of adjacent OVCF after PKP.