Abstract
Vertebral compression fractures often result in pain and vertebral deformity. We compared 2 different balloon kyphoplasty techniques both using intraoperative curettage. Adults 50 years of age or older with osteoporosis and 1 acute VCF were randomized to undergo bilateral BKP in which the curette was used first (n = 57) followed by inflatable bone tamps or in which IBTs were used first, followed by curettage and a second IBT inflation (n = 55). Mean procedure duration was 33.5 and 36.8 minutes, and fluoroscopy duration was 3.8 and 3.7 minutes for the CF and IBTF groups, respectively. Two-thirds of VCFs were wedge-shaped, and one-half had dynamic mobility. Anterior height restored postoperatively was 2.28 mm (95% CI, 1.49-3.08 mm; P < .001) and 2.78 mm (95% CI, 1.89-3.66 mm; P < .001) for CF and IBTF groups, representing ∼35% and 39% of lost height restored, but group differences were not significant (P = .4). Intraoperative anterior height gain attributed to dynamic mobility was 2.96 mm (95% CI, 1.92-4.00 mm; P < .001) and 3.05 mm (95% CI, 2.10-4.00 mm; P < .001); additional height attributed to IBT inflation was 1.09 mm (95% CI, 0.77-1.41 mm; P < .001) and 1.25 mm (95% CI, 0.68-1.82 mm; P < .001), representing a 37% and 41% increase. There was no significant height loss on IBT removal and cementation. Both groups had improved pain and ambulation. Asymptomatic leakage occurred in 15% of VCFs. There was 1 nonserious device-related hematoma (IBTF group). One new clinical VCF occurred in each group, but they were not device-related. Both techniques resulted in significant vertebral body height and pain improvement. Procedure and adverse event data demonstrated safe curette use in conjunction with balloon kyphoplasty procedures.
Highlights
ObjectivesThe overall objective of this study was to document the relative roles of postural reduction and systematic curette use, in combination with the IBT, in obtaining vertebral body anatomy height restoration during the balloon kyphoplasty procedure
BACKGROUND AND PURPOSEVertebral compression fractures often result in pain and vertebral deformity
Both techniques resulted in significant vertebral body height and pain improvement
Summary
The overall objective of this study was to document the relative roles of postural reduction and systematic curette use, in combination with the IBT, in obtaining vertebral body anatomy height restoration during the balloon kyphoplasty procedure
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