Safety of Balloon Kyphoplasty in the Treatment of Thoracic Osteoporotic Vertebral Compression Fractures in Vietnamese Patients

다국어 초록 (Multilingual Abstract)

Background: The evidence for the efficacy and safety of balloon kyphoplasty (BKP) in treating the Vietnamese patients is sparse. There is no convincing evidence regarding BKP’s efficacy in Vietnamese patients, especially in the patients with thoracic osteoporotic vertebral compression fractures (VCFs). This article aims to evaluate the outcomes of restoring the body height of the compressed thoracic vertebrae in patients undergoing BKP.
Methods: We prospectively enrolled 65 consecutive patients with thoracic VCFs (73 vertebrae) due to osteoporosis who were treated with BKP between June 2018 and May 2019.
Results: A trocar was inserted through the pedicle in 84.9% (62/73) and beside the pedicle in 15.1% (11/73). The mean amount of mixed cement injected was 4.1 ± 1.1 mL (range, 1.5–7 mL). Cement leakage was radiographically confirmed in 30.8% of 65 patients. Among patients with complications caused by cement extravasation, the leakage was through the anterior margin of the vertebrae in 15.4%, through the vertebral disc in 12.3%, and through the posterior margin of the vertebrae in 3.1%. In the last 3.1% of patients, there was no clinically notable lesions of the nerve roots or spinal cord. The mean visual analog scale score decreased significantly from 7.3 ± 1.1 preoperatively to 3.3 ± 0.6 at 24 hours after surgery, and then to 1.2 ± 1.1 at 3 months after surgery (p < 0.01). The mean reduction in Cobb angle measured on standing radiographs after treatment was 3.7°, showing statistical significance (p < 0.01).
Conclusions: BKP is a minimally invasive treatment effective for immediate pain relief, early motor rehabilitation, and humpback correction. The present study provided convincing evidence to support the use of BKP by spine surgeons and clinical specialists in treating osteoporotic thoracic VCFs in Vietnamese patients.

참고문헌 (Reference)

1 Hulme PA, "Vertebroplasty and kyphoplasty : a systematic review of 69 clinical studies" 31 (31): 1983-2001, 2006

2 Ge Z, "Uniextrapedicular kyphoplasty for the treatment of thoracic osteoporotic vertebral fractures" 36 (36): e1020-e1024, 2013

3 Xiong J, "Treatment of osteoporotic compression fracture of thoracic/lumbar vertebrae by kyphoplasty with SKY bone expander system" 13 (13): 270-274, 2010

4 Boszczyk BM, "Transcostovertebral kyphoplasty of the mid and high thoracic spine" 14 (14): 992-999, 2005

5 Ge J, "The clinical effect of kyphoplasty using the extrapedicular approach in the treatment of thoracic osteoporotic vertebral compression fracture" 131 : e284-9, 2019

6 Silverman SL, "The clinical consequences of vertebral compression fracture" 13 (13): S27-S31, 1992

7 Galibert P, "Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty" 33 (33): 166-168, 1987

8 Varacallo MA, "Osteoporosis and its complications" 98 (98): 817-831, 2014

9 Edidin AA, "Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population" 26 (26): 1617-1626, 2011

10 Marcucci G, "Kyphoplasty and vertebroplasty in the management of osteoporosis with subsequent vertebral compression fractures" 7 (7): 51-60, 2010

11 Kasper DM, "Kyphoplasty" 27 (27): 172-184, 2010

12 Weycker D, "Hospitalizations for osteoporosis-related fractures : Economic costs and clinical outcomes" 5 : 186-191, 2016

13 Baz AB, "Efficiency of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures" 62 (62): E49-E54, 2016

14 Lavelle WF, "Effect of kyphoplasty on survival after vertebral compression fractures" 8 (8): 763-769, 2008

15 Robinson Y, "Complications and safety aspects of kyphoplasty for osteoporotic vertebral fractures : a prospective follow-up study in 102 consecutive patients" 2 : 2-, 2008

16 Eck JC, "Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures : a meta-analysis of the literature" 8 (8): 488-497, 2008

17 Do MH, "Clinical and subclinical characteristics and evaluation of results of the application of kyphoplasty in osteoporotic patients with vertebral compression fractures" Hanoi Medical University 2009

18 Macnab I, "Chapter 14. Pain and disability in degenerative disc disease" 20 : 193-196, 1973

19 Voggenreiter G, "Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures" 30 (30): 2806-2812, 2005

20 Medical Advisory Secretariat, "Balloon kyphoplasty : an evidence-based analysis" 4 (4): 1-45, 2004

21 Phillips FM, "An in vivo comparison of the potential for extravertebral cement leak after vertebroplasty and kyphoplasty" 27 (27): 2173-2179, 2002

22 Kalteis T, "Acute tissue toxicity of PMMA bone cements" 142 (142): 666-672, 2004