Treatment Of Osteoporotic Vertebral Compression Fractures With Percutaneous Kyphoplasty Assistanted By Closed Reduction

PURPOSE To investigate the feasibility and efficacy of percutaneous kyphoplasty assistanted by closed reduction for treatment of osteoporotic vertebral compression fracture. Methods There were 36 cases cases with 44 vertebral bodies. All the patients had a refractoriness back pain, without symptom of nervous lesion. Preoperative X ray showed vertebral compression changes and osteoporotic changes, CT showed no significant rupture of the posterior wall of vertebral body, MRI showed vertebral fractures were fresh (T1-weighted images showed low signal, T2-weighted images showed high signal). We adapted percutaneous kyphoplasty assistanted by closed reduction to treat osteoporotic vertebral compression fractures since 2005. According to preoperative and postoperative plain standing lateral radiographs, to estimate vertebal height and kyphotic angle, the postoperative vertebal height restoration and kyphotic angle correction were analysed. As well as it improves the patients situation in postoperative pain (VAS score) and activity score compared with the preoperative. RESULTS The total 36 operations were done successfully, a single segment of the average operative time was about 40 min, paravertebral leakage of filling materials occurred in 6 patients,and there was no neurological symptoms development. Postoperative back pain(in 24h) were significantly alleviated in all patients. Follow-up 6 to 24 months, an average of 13.1 months, all patients were no neurological symptoms or other complications occur. Pre-operative,24h and 1 year post-operative pain intensity (VAS score) wer:8.38±0.54,2.14±0.61,2.57±0.67, respectively. The anterior,the middle and posterior vertebal height were restored by (57.2±26.3)%, (46.5±19.3)%, (49.6±23.3)%, respectively, and kyphotic angle was corrected by (56.9±24.1)%. (Compared with the preoperative, P＜0.05).CONCLUSION Percutaneous kyphoplasty assistanted by closed reduction for treatment of osteoporotic vertebral compression fracture is an efficacious and simple method, and is able to restore the vertebal height and kyphotic angle in postions of fractured vertebrae.