A comparison between dilator-kyphoplasty and SKy-bone expander kyphoplasty

Abstract

Objective To compare the clinical results of dilator-kyphoplasty (DKP) and SKy-bone expander kyphoplasty (EKP) . Methods From October 2004 to May 2008, 51 patients with vertebral osteoporotic compression fracture received DKP (29 vertebras) and EKP (27 vertebras). The operation time,bleeding volume, cement injection volume were recorded during operation. The patients' visual analogue scale (VAS) and Oswestry disability index (ODI) scores were evaluated before and after operation. The cement distribution and restoration of vertebral height and Cobb angle were observed post-operation. Results There were no significant differences in operation time or bleeding volume at every vertebra between the 2 groups ( P > 0. 05). The DKP group had a significantly larger cement injection volume of (5.7 ±0. 5) mL than the EKP group [(3.6 ± 1.6) mL] ( P < 0.05). The VAS and ODI scores were decreased significantly in both groups after operation ( P < 0.05) . The vertebral height and Cobb angle were restored in both groups after operation. Nine cases ( 11 vertebras, 40. 7% ) had cement leakage in the EKP group, but one case (one vertebrae, 3.4% ) did in the DKP group. Conclusions Both DKP and EKP are efficacious and safe in the treatment of vertebral compression fractures. The vertebral anterior height, middle vertebral body height, and Cobb angle can be all restored by both procedures. DKP may be better in restoration of the vertebral anterior height, middle vertebral body height, and Cobb angle. DKP may lead to less cement leakage than EKP. Key words: Osteoporosis; Spinal fractures; Thoracic vertebrae; Lumbar vertebrae; Surgical instruments