KYPHOPLASTY IN PATHOLOGICAL VERTEBRAL FRACTURES

Abstract

Aim: Presentation of the technique, the mistakes and the results of a new minimal invasive surgical procedure for reduction and augmentation of pathological fractures of the vertebrae in spine.

Patients and Methods: 12 patients (2 men / 10 women) with mean age 68 years (54–73) with pathological vertebral underwent kyphoplasty. The mean pain according to VAS was 7, 3 (6–10) and the mean follow up time is 8 months (5–14). 11/12 patients (20 vertebrae) had osteoporotic vertebral and 1/12 (1 vertebra) had metastatic lesion. 8/21 vertebrae were in thoracic spine and 13/21 in lumbar spine. In 20/21 the procedure was transcervical to the vertebra and in 1/21 was out of the cervix. 11/12 patients had kyphotic deformity in the plain x-ray and 18/21 vertebrae had decreased their height. To all patients was spilled PMMA.

Results: 10/12 patients referred degrease of their pain in the first 48 hours and 2/12 in the 5th postoperative day. Correction of the kyphotic deformity was observed in 11/12 and reduction of the reduction of the fracture was occurred in 16/21 vertebrae. Leakage of PMMA was occurred in 5/21 vertebrae; in 2/5 the leakage was in the canal, in 1/5 in the intervertebral space and in 2/5 out of the vertebrae. 1/12 patient 2 moths postperatively had another vertebral fracture in a lower vertebra that was deled again with kyphoplasty. None of the patients had neurological deficit postoperatively. According to Oswestry questionnaire all the patients referred return to all their before fracture daily activities.

Conclusions: Kyphoplasty in pathological vertebral fractures has as a result the immediate decrease of the pain and the return of the patient to his/her daily activities. Also there is correction of the kyphotic deformity decreases the possibility of a new vertebral fracture and the establishment of chronic back pain.