Clinical and radiological comparison of unipedicular versus bipedicular balloon kyphoplasty for the treatment of vertebral compression fractures

• Published in: Osteoporosis international 2009-10, Vol.20 (10), p.1717-1723
• Main Authors: Song, B.-K, Eun, J.-P, Oh, Y.-M
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Comparative studies; Diseases of the osteoarticular system; Endocrinology; Female; Fractures; Fractures, Compression - complications; Fractures, Compression - diagnostic imaging; Fractures, Compression - surgery; Humans; Injuries of the limb. Injuries of the spine; Kyphoplasty; Kyphoplasty - methods; Kyphosis - diagnostic imaging; Kyphosis - etiology; Kyphosis - surgery; Male; Medical sciences; Medical treatment; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Osteoporosis; Osteoporosis. Osteomalacia. Paget disease; Osteoporotic Fractures - complications; Osteoporotic Fractures - diagnostic imaging; Osteoporotic Fractures - surgery; Osteoporotic vertebral compression fracture; Pain Measurement - methods; Radiography; Retrospective Studies; Rheumatology; Spinal Fractures - complications; Spinal Fractures - diagnostic imaging; Spinal Fractures - surgery; Spine; Traumas. Diseases due to physical agents; Treatment Outcome; Vertebra
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-009-0872-7

Summary To evaluate the efficacy of unipedicular kyphoplasty in the treatment of patients with osteoporotic vertebral compression fractures, we compared the pre- and postoperative clinical and radiological results in the unipedicular and bipedicular kyphoplasty groups. The clinical and radiological results of unipedicular kyphoplasty were as good as those of bipedicular kyphoplasty. Introduction The purpose of this study was to evaluate the efficacy of unipedicular kyphoplasty in the treatment of patients with osteoporotic vertebral compression fractures. We compared the pre- and postoperative compression ratios (CRs), kyphotic angles (KAs), and visual analogue scale (VAS) scores of the patients in the unipedicular and bipedicular kyphoplasty groups. The results showed that the clinical and radiological results of unipedicular kyphoplasty were as good as those of bipedicular kyphoplasty. Percutaneous balloon kyphoplasty is a therapeutic option for patients with painful osteoporotic vertebral compression fractures (VCFs). Due to the relatively high-risk nature of the patient population, complications such as myocardial events, seizures, agitation, or dyspnea may occur and render completion of the procedure imprudent. We analyzed the clinical and radiological results of unipedicular and bipedicular balloon kyphoplasty for the treatment of vertebral compression fractures. Methods We retrospectively reviewed the records of 45 patients who underwent balloon kyphoplasty for the treatment of VCFs between January 2005 and April 2008. A unipedicular approach was used in 15 patients and a bipedicular approach was used in 30 patients. The CR, KA, and 100-point VAS score for pain were measured pre- and postoperatively in each patient. Results There was no significant difference in restoration of the CR (p = 0.376) and KA (p = 0.888) between the unipedicular and bipedicular kyphoplasty groups. The patients in the unipedicular group showed greater improvement in VAS score than those in the bipedicular group (p < 0.001). There were no postoperative complications, such as nerve injury or pedicle fracture, in either of the two groups. Conclusion The clinical and radiological results of unipedicular balloon kyphoplasty for the treatment of VCFs were as good as those of bipedicular balloon kyphoplasty. Thus, unipedicular balloon kyphoplasty can be used as an alternative treatment for patients with VCFs.