Analysis of Results of Kyphotic Deformity Reduction Using Puncture Vertebroplasty and Stenoplasty in Patients with Traumatic Compression Fractures of Thoraco-Lumbar Localization

Abstract

Correction of posttraumatic deformity and stabilization of injured segment play an important role in treatment and complication prevention after traumatic compression vertebral body fractures. Possibilities of deformity reduction using vertebroplasty and a combination of distractive titanium cage with insertion of bone cement into vertebral body (stenoplasty) are not well studied. Retrospective comparative analysis of clinical efficacy and degree of kyphotic deformity reduction using puncture vertebroplasty (1 st group, n=15) and stenoplasty (2 nd group, n=15) in patients with traumatic A1 compression fractures of thoraco-lumbar vertebral bodies was performed. Severity of pain syndrome (VAS) and degree of injured segment deformity (kyphotic angle and wedge-shaping index) were assessed. In both groups surgical intervention resulted in marked pain reduction but in long-term period it was less significant for 2 nd group (p=0.0035). Postoperatively kyphotic angle median and wedge-shaping index changed statistically significant in 2 nd group from 12.60 (10.50; 13.40) to 2.50 (1.90; 3.20) (p=0.0015) and from 25.3% (22.8; 26.7) to 9.3% (8.9; 11.4) (p=0.0022), respectively and not significantly in 1 st group from 13.10 (11.40; 14.30) to 12.90 (11.20; 14.00) (p= 0.93) and from 26.5% (24.0; 28.8) to 25.9% (23.8; 28.4) (p=0.86), respectively. Progression of posttraumatic kyphosis in late postoperative period was noted in 1 st group (P M Ü=0.042) but not in 2nd group (P =0.58). In traumatic A1 compression fractures stenoplasty enabled to perform kyphotic deformity correction in the early period of spinal injury, to achieve significantly greater reduction of kyphotic angle and to preserve the result in remote postoperative period as compared to puncture vertebroplasty