Abstract
Recurrent fracture risk after kyphoplasty is inferior to vertebroplasty, but the risk is still eminent. The reduction of kyphosis is strongly related to the age of the fracture, therefore the reduction and the correction of the kyphosis varies. We investigated the indication of a prophylactic kyphoplasty of adjacent levels to the fracture site in order to decrease the postoperative refracture risk.
Study design: Prospective randomized clinical study, 2 groups: monosegmental kyphoplasty versus bi- or multi-segmental kyphoplasty with prophylactic level superior to the fracture. F/U 6 months with X-rays
Results: Group 1: monosegmental stabilisation: (20 pat. 4 male, 16 female, 27 levels). 5 refractures. 3 refractures adjacent to the kyphoplasty, 2 cases not related to the primary stabilisation.
In 2 cases cement leakage was seen as direct cause of the refracture.
Group 2: prophylactic stabilisation (28 pat. 4 male, 24 female, 63 levels, 29 prophylactic levels). 8 refractures, all adjacent to kyphoplasty. In 3 cases cement leakage as cause of recurrent fracture.
Conclusion: Refracture rates are in both groups similar (group 1: 25% refracture risk, group 2: 28% refracture risk). Therefore we do not see the need for a generalised prophylactic stabilisation of adjacent levels with kyphoplasty. It is crucial to avoid any leakage, which has a direct impact on the fracture rate, only in those cases we advise a prophylactic stabilisation at the leakage site. In general kyphoplasty is preferable to vertebroplasty due to the decreased leakage and embolism rate.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
