Closed reduction and levering manipulation in vertebroplasty

Abstract

Objective To discuss the effects of closed reduction and levering manipulation on ver-tebral height restoration and kyphosis correction in vertebroplasty for osteoporotic compression fractures. Methods From January 2005 to June 2007, a total of 38 patients with osteoporotic vertebral compression fractures were treated with vertebroplasty. In closed reduction, a transfixion pin was used to lever the collapsed vertebral endplate through the pedicle. Before and after surgery, pain relief and functional improvement were evaluated using a visual analogue scale (VAS) and the Oswestry' s disability index (ODI). Changes in ver-tebral height and kyphotic angle and distribution of bone cement in the vertebral body were observed by Lee's method. Results All patients were followed up for 6 to 24 (average, 13.4) months. The average VSA scores were reduced from preoperative 8.6±2.3 to postoperative 3.8±2.6. The average ODI scores reduced from preoperative 64.8% to postoperative 48.7%. The differences were of statistical significance. The average increase in vertebral body height was 5.8 mm anteriorly, 6.6 mm centrally, and 1.0 mm posteriorly. The mean reduction in the kyphosis angle was 9.7 degrees. The percentages of restoration of vertebral height were 54.6% at the anterior border, 58.1% at the center, and 46.5% at the posterior border. The differences were of sta-tistical significance between preoperation and postoperation. Conclusion Closed reduction and levering manipulation is effective in vertebroplasty for osteoporotie vertebral compression fractures. Key words: Osteoporosis; Spinal fractures; Vertebroplasty; Closed reduction