Unilateral Controlled Balloon Percutaneous Kyphoplasty For Osteoporotic Vertebral Compression Fractures

Aims: To explore the method and clinical efficacy of unilateral controlled balloonpercutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs)in elderly patients.Methods: Two hospitals took part in this study: the First Affiliated Hospital of SoochowUniversity and the People’s Liberation Army Five Three Two Hospital. The clinical data of37patients with osteoporotic vertebral compression fractures (41vertebral bodies,including8fresh fractures and33old fractures) from February2009to July2012wereanalyzed retrospectively. All patients were treated by unilateral controlled balloon..Therewere6male and31female in this study. The mean age of the patients was75.8±8.45years(range from59to83years). All affected vertebral bodies were thoracolumbar vertebrae. In2cases the fracture involved2vertebral bodies. And in one case the fracture involved3centrums. All patients were treated by the controlled balloon percutaneous kyphoplasty.The surgical instruments (bone cement injector and polymethylmethacrylate bone cement)were provided by Changzhou Bailong Company. Patients were evaluated with Genant’ssemiquantitative assessment before surgery. The controlled balloon percutaneouskyphoplasty was guided by the C-arm X-ray machine during operation. The pressure ofballoon and the perfusion of bone cement were adjusted while operating in order tocompass the object of low-pressure bone cement perfusion. Image data were observedduring and after surgery to avoid the leakage of bone cement. Scores of the OswestryDisability Index (ODI) and the Visual Analogue Scale (VAS) were collected before surgeryand during follow up. The matched t-test was used to evaluate the efficacy of thecontrolled balloon percutaneous kyphoplasty.Results: All operations were successful. The mean surgical time was52.65±2.76minutes (range from35to113minutes). No leakage of bone cement or pulmonary embolismhappened in this study. The distribution of bone cement was satisfactory. The meanperfusion of bone cement was4.68±2.17ml (range from1.5to7.0ml).Patients hadbedside walk wearing waist clothing from the third day after operation. Thirty sevenpatients got follow up for a mean time of2.35±0.67months (range from2.5to4.2months).The latest X-ray images showed no further collapse of vertebral body or neighboringvertebral fractures. The ODI was （38.43±5.78）%at the final follow-up, there was asignificant difference between postoperatively and at the final follow-up(t=13.58, P<0.05).And the VAS was3.14±0.61at the final follow-up, there was also a significant differencebetween postoperatively and at the final follow-up (t=20.69, P<0.05).Conclusion: The unilateral controlled balloon percutaneous kyphoplasty is a safe andeffective procedure for osteoporotic vertebral compression fractures.It can relieve thelumbodorsal pain immediately,and reduce the risk of the bone cement leakage.