Study Design: A prospective radiographic analysis of 25 consecutive patients with a total of 43 osteoporotic vertebral compression fractures (VCF's) who were sequentially evaluated for postural and balloon reduction.
Objectives: To test the hypothesis that positional maneuvers utilized in vertebroplasty are statistically inferior to kyphoplastic balloon tamps for the reduction of low energy VCF's.
Summary of Background Data: Kyphoplasty has been shown to restore vertebral height and sagittal alignment. Proponents of vertebroplasty have recently demonstrated that many VCF's are mobile and positional correction used for vertebroplasty can lead to clinically significant height restoration.
Methods: Preoperative standing and lateral radiographs of the fractured vertebrae were compared with prone cross-table lateral radiographs with the patient in a hyper-extension position and on pelvic and sternal rolls. Following positional manipulation patients underwent a unilateral balloon kyphoplasty. Postoperative standing radiographs were evaluated for percent of height restoration related to positioning and balloon kyphoplasty.
Results: In the central portion of the vertebrae, the percent restoration with extension positioning was 10.4%, median=11.1%, and after balloon kyphoplasty was 57.0%, median=62.2 (p<0.001). Thus, kyphoplasty provided an additional 46.5% restoration from the positioning alone. With operative positioning, 51.2% of VCF's had >10% restoration of the central portion of the vertebral body as compared with 90.7% after balloon kyphoplasty (p<0.002). Conclusion: Although this study supports the concept that many VCF's can be moved with the positioning, maneuvers utilized in vertebroplasties, balloon kyphoplasty enhanced the height reduction >5 fold over the positioning maneuver alone and accounted for over 75% of the ultimate reduction. If height restoration is the goal, kyphoplasty is clearly superior in most cases to the vertebroplasty positioning maneuver alone.
Disclosure Information:
Faculty Member's Name: Joseph M. Lane, MD
Grants/Research Support: Kyphon, Inc.
See more of Poster Abstracts: Osteoporosis - Treatment
See more of The Sixth International Symposium on Osteoporosis: Current Status and Future Directions