Osteoporotic burst fracture with spinal canal compromise treated with percutaneous vertebroplasty

• Published in: Clinical neurology and neurosurgery 2010-10, Vol.112 (8), p.678-681
• Main Authors: Li, Chi-Huan, Chang, Ming-Chau, Liu, Chien-Lin, Chen, Tain-Shung
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Canal compromise; Contraindications; Humans; Lumbar Vertebrae; Male; Middle Aged; Minimally Invasive Surgical Procedures - methods; Neurology; Neurosurgery; Osteoporosis - complications; Osteoporotic burst fracture; Osteoporotic compression fracture; Spinal Fractures - etiology; Spinal Fractures - surgery; Spinal Stenosis - etiology; Spinal Stenosis - surgery; Thoracic Vertebrae; Treatment Outcome; Vertebroplasty; Vertebroplasty - methods
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2010.05.006

Abstract Objective There has been minimal literature reporting on results of osteoporotic burst fracture with spinal canal compromise treated with percutaneous vertebroplasty. Vertebroplasty for treatment of osteoporotic burst fracture is controversial. We want to clarify whether the osteoporotic burst fracture with spinal canal compromise is a contraindication to percutaneous vertebroplasty. To compare the clinical and radiological results between osteoporotic burst and compression fractures treated with percutaneous vertebroplasty. Patients and methods From 2005 through 2006, 23 osteoporotic burst fracture patients with asymptomatic spinal canal compromise and 41 osteoporotic compression fracture patients underwent percutaneous vertebroplasty. Pre- and post-operative pain scores, functional and radiographic results and complications were analyzed. Results The average canal compromise in study group was 15% (5–49%). The mean post-operative Oswestry Disability Index (ODI), Visual Analogue Score (VAS), kyphotic angle, vertebral body height measurement from the anterior, central and posterior part of the body are all significantly improved in both the study and control groups when compared to pre-operative data. However, there was no significant difference between study and control groups in pre- and post-operative ODI, VAS, kyphotic angle and improvement of body height. There were no significant differences ( P = 0.3797) in cement leakage rate between burst and compression groups (47.8% vs 36.6%). All the leakages were minor and without neurological deficit. The percentage of adjacent fractures in both groups also had no significant differences (39.1% in burst and 41.5% in compression group). Conclusions Osteoporotic burst fracture with asymptomatic spinal canal compromise is not a contraindication for percutaneous vertebroplasty. This procedure is suitable for both osteoporotic burst and compression fracture with careful surgical technique.