Assessment of percutaneous vertebroplasty and kyphoplasty.

Abstract

Objective To evaluate the results, indication and complication of percutaneous vertebroplasty(PVP) and percutaneous kyphoplasty(PKP). Methods From February 2000 to February 2008, 178 patients were treated for symptomatic vertebral haemangioma, osteolytic neoplasm, or osteoporotic fractures, including PVP for 115 cases and PKP for 63 cases. Results 1) There were 16 patients of symptomatic haemangioma, and 14 underwent PVP while the other 2 cases were performed PKP. No evident cement leakage was found, and excellent or good results were obtained in 87.5% of them. 2) For the 68 patients of osteolytic neoplasm, posterior wall of vertebrae wall was involved in 28 cases, and all of them were treated with PVP. Cement leakage was detected in 27.9% patients with CT. However, there were only 2 patients of epidural leakage experienced transitory radicular pain. At the latest follow up, the excellent and good rate of results was 70.6%. Forty-three patients were followed for an average of 10 months. Although pain relief was still obvious in 34 cases, there were 9 patients complained recurrence of pain due to the deterioration of the tumor. 3) For the 94 patients of osteoporotic fracture, posterior vertebral wall was involved in 29 cases. All of them, 33 cases were treated with PVP while the other 61 cases were dealt with PKP. Cement leakages were detected in 18.2% patients for PVP, and 9.8% patients for PKP, but no clinical symptom was complained. For PKP, the reduction of anterior vertebral body height averaged 34.2%, and correction of Cobb angle averaged 3.3~, while no evident reduction was detected for PVP. Excellent or good results were obtained in 92.6% of patients, while no significant difference was found between PVP and PKP. Sixty-four patients were followed for an average of 3 years. Two patients with PKP encountered adjacent vertebral fracture, which was treated by another PKP with good results, and the clinical results were sustained in the others. Conclusion The indications of PVP or PKP mainly consist of symptomatic haemangioma, osteolytic neoplasm and osteoporotic fracture. The similar satisfactory clinical results can be obtained and sustained after these two procedures. For osleoporotie fractures, PKP can produce void in the vertebral body and reduce the cement leakage, however, only partially restore vertebral body height. Key words: Spinal fractures; Spinal puncture; Neoplasms