Clinical Outcome Of PKP For Middle And Upper Thoracic Osteoporotic Severe Vertebral Compression Fracture

Objectives:To investigate the clinical outcome of Percutaneous Kyphoplasty(PKP)for middle and upper thoracic(above T6)osteoporotic severe vertebral compression fracture(SVCF).Methods:30 patients with middle and upper thoracic osteoporotic SVCF treated by PKP between January 2013 and March 2016 were analyzed retrospectively.The patients included 10 males and 20 females,with a mean age of 72 years(61~87 years).A total of 34 vertebrae was involved in this group including T3 in 2,T4 in 4,T5 in11 as well as T6 in 17.The mean rate of loss of vertebral height was 59%(40.5%~82.6%).The comparison of scores for pain severity,Oswestry disability Index(ODI),mobility,vertebral compression ratio and kyphosis angle of pre-and postoperative as the assessment criteria,the clinical outcome were applied to statistical analysis.Results:Surgery was performed successfully on all the patients.Bila teral transpedicular approach was used in 23 cases and unilateralextrape dicular approach in 7 cases.All patients were completedly in followed u p from 6 months to 39 months(averaged,18.5 months).Compared with the preoperative result,pain severity,ODI and mobility showed statistical significance at 1 day,1 month and last follow-up postoperatively(P<0.05).Vertebral compression ratio and kyphosis angle also restored sign ificantly after operation(P<0.05).The cement leakage observed on radiographs included slight leakage to the spinal canal(1case),the intradiskal space(4 case)and the paravertebral soft tissues(8 cases),but no associated clinical symptoms occurred.No other serious complications such as pulmonary embolism,rib or pedicle fracture,pneumothorax was found.Two patients(6%)occurred new fracture(not the adjacent or surgical vertebrae)within 6 months.Conclusions:For middle and upper thoracic SVCF,PKP can alleviate back pain and mobility effectively,restore vertebral height and kyphosis angle significantly.PKP is a safe and effective treatment in rational surgical position and puncture approach.