Introduction: The osteoporotic vertebral fracture is a pathology with an increasing incidence, being nowadays the most frequent osteoporotic fracture with an important sanitary cost. Parallel to these sanitary demands new surgical techniques, such as the vertebroplasty and the kyphoplasty, have been developed in order to improve the analgesic control, diminish the spinal angular deformities and improve the quality of life of patients. The purpose of this study is to describe our preliminary clinical and radiological results of a new system of kyphoplasty.

Material and Methods: Retrospective study in 18 patients diagnosed of vertebral fracture A1.1 and A1.2 (AO classification) at a single level, lumbar or lower thoracic (D10-12), with an integrity of the posterior wall, treated by kyphoplasty with stent (VBS^®, Synthes). The average age of the patients was 77,6 years (range, 69 – 87 years.). The average follow-up time was 7 months (range, 6 – 8 months). Presurgical and postsurgical plain X-ray films were taken to measure the height of the front, middle and posterior props, the regional saggital angle and Cobb’s saggital angle. A vertebral re-expansion measurement was defined as pre to post surgical difference in height of the middle prop. Pre and postsurgical VAS pain and analgesic-seizure medication were monitored and the average hospital stay was determined.

Results: 10 patients type A1.1 and 8 patients type A2.2. The average hospital stay was 48h (range, 24–72 h). Pre-surgically, the regional saggital angle was 14,45° (range, 9 –22°) and, postsurgically, 9,82° (5 –17°) (p < 0,05). Cobb’s saggital angle presurgical was 13,8° (range, 6°–30°) and postsurgically 8,94°(p < 0,05). No differents in the height of the front props were found. The vertebral re-expansion was 16,23 mm (range, 16–20 mm). Pain measured by VAS was 9,1 (range, 7–10), presurgical, and 4,9 (range, 2–7) postsurgical with a statistically significant decrease (p < 0,05). Only two cases of asymptomatic cement fugue were registered and no patient reintervention was necessary.

Conclusions: The VBS^® system is a useful alternative to the conventional surgical treatment of osteoporotic vertebral fractures, diminishing the need for taking analgesic medication and improving the radiographic parameters and producing a in the analyzed with a low level of morbi/mortality.

Introduction and Objectives: We analyzed the physical and health status of patients with ankle arthritis that underwent arthrodesis or total ankle replacement and determined which alternative provided a greater perception of improvement in quality of life and whether there was any difference in the perception of the patients that underwent either of these two procedures.

Materials and Methods: This is a comparative-prospective study in patients that underwent arthrodesis (16 cases) or total ankle replacement (14 cases) in which clinical-functional variables were assessed by means of the AOFAS score and quality of life was measured using SF-36 at 2 years of follow-up and this was compared with preoperative assessment.

Results: The study was carried out with 2 series of comparable patients, both surgical techniques showed a statistically significant improvement on clinical assessment and on quality of life assessment in comparison with preoperative status after 2 years of follow-up. The group of patients that underwent arthrodesis changed from mid-range AOFAS values of 37.12 to 45.62 (p=0.055) and mid-range SF-36 values of 32.96 to 46.25 (p=0.008). The group that underwent arthroplasties changed from mid-range AOFAS values of 33 to 62 (p=0.024) and mid-range SF-36 values of 33.62 to 59.84 (p=0.001). The improvement was statistically greater in the group that underwent arthroplasties than in the group that underwent arthrodesis (p=0.48 for AOFAS, and p=0.026 for SF-36)

Discussion and Conclusions: Both procedures are good treatment options, they ‘significantly improve patient’s status both clinically and in their perception of their health and quality of life. The medium term perception of quality of life and general health on the part of patients with ankle arthritis is better when they undergo ankle arthroplasty than when they undergo surgical fusion.