Clinical and Radiographic Results of Kyphoplasty with Mid-Term Follow-Up

Abstract

The goal of our retrospective case series is to understand better the demographics and outcomes of kyphoplasty in improving pain in insufficiency fractures that are non-responsive to conservative treatment, identify risk factors for recurrence of back pain due to new fractures or not, discern and understand the timing for symptom improvement after the procedure, and correlate the amount of vertebral height correction with clinical improvement. We hypothesized that kyphoplasty would be effective for pain management in vertebral compression fractures that have been refractory to clinical management. Eighty-one patients underwent kyphoplasty and were followed at two, four, and nine weeks and at one year. Demographics, clinical and radiographic outcomes, and risk factors for new fractures and other complications were analyzed. Maximal improvement in the VAS was seen at two weeks in 90% of our patients and at nine weeks 100% reached maximal improvement. At one-year follow up, recurrent or new onset back pain was noted in 27% of patients, while only 24% of had new vertebral fractures. Fractures at the adjacent level accounted for 50% of the new onset insufficiency vertebral fractures. Approximately 50% of patients had passed away or were not reachable at one year. Also, 50% of our osteoporotic compression fractures happened at the upper lumbar spine. Female sex was the only significant risk factor for subsequent new onset back pain. Male sex and lumbar fractures responded worse to the kyphoplasty treatment. Finally, the amount of radiographic reduction did not correlate with clinical outcomes. From the data analyzed from this case series, we found that kyphoplasty provides a safe and effective treatment for pain in patients with vertebral compression fractures.