Modified kyphoplasty for the treatment of osteoporotic vertebral compression fractures in combined with intravertebral clefts

LI Liang; ZHANG Jing-lin; GAO Hong-hui; YU Xue-zhong

doi:10.3969/j.issn.1009-4237.2013.06.021

Abstract：Objective To evaluate the feasibility and effectiveness of modified percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures combined with intravertebral clefts (IVC). Methods Between Feb.2008 and Nov.2011,31 patients with “intravertebral clefts” in osteoporotic vertebral frac-tures undergoing percutaneous kyphoplasty were retrospectively reviewed .The height of anterior and middle column and the posterior convex Cobb angle of the injured spine were measured on the lateral X -ray film in standing position preoperatively and at 3 days,6 months and 12 months postoperatively.The visual analogue scale (VAS) score was used to evaluate the pain relief and the Oswestry disability index (ODI) system was used to evaluate the improve-ment of daily activity function and disability preoperatively and at 3 days,6 months and 12 months postoperatively. Results All patients tolerated kyphoplasty successfully .One patient occurred intradiscal cement leakage after re-ceiving kyphoplasty,but without clinical symptoms.No re-fracture of the injured vertebrae or adjacent vertebral frac-ture occurred during the follow-up.There was significant difference in the VAS score between preoperatively and postoperatively (P<0.05),despite of no significant difference in the VAS scores at 3-day,6-month and 12-month follow-up(P>0.05).The ODI scores varied from 72.25 ±9.84 preoperatively to 24.55 ±5.01 postoperatively (P<0.05).This improvement in ODI scores was still present at 6-month and 12-month follow-up.Between preop-eratively and at 3 days postoperatively,there was significant difference in the height of anterior/middle column and the posterior convex Cobb angle (P<0.05),but no significant difference among 3 days postoperatively,6 months postoperatively and the final follow-up(P<0.05).Conclusion The modified PKP is an effective and safe way to treat osteoporotic vertebral compression fractures combined with intravertebral clefts (IVC).It is a good choice to prevent cement leakage and adjacent vertebral fracture .