Efficacy evaluation of percutaneous vertebroplasty via an extra-pedicular approach for osteoporotic compression fracture

Abstract

To evaluate the effects of relieving pains and restoring vertebral heights of percutaneous balloon kyphoplasty by extra-pedicular approach as a minimally invasive treatment in patients with painful osteoporotic vertebral compressive fractures (OVCF). A retrospective analysis was conducted for 96 consecutive patients. There were 64 females and 32 males with a mean age 67 years (range: 55 - 82). Symptomatic levels were identified by correlating their clinical presentations with the findings of magnetic resonance imaging (MRI). The interval between onset of symptoms and surgical intervention ranged from 2 days to 4 months. A total of 118 levels (56 thoracic, 62 lumbar) were treated in this cohort. Immediate and postoperative 3-month follow-up visits were conducted. Visual analog scale (VAS) pain scores, preoperative and postoperative anterior, midline vertebral heights for fractured vertebrae were measured on lateral radiographs to evaluate the procedural outcomes. There was swift pain relief associated with evident augmentation in weight-bearing resistance. Pain decreased from 8.1 to 2.1 points. Through kyphoplasty, the anterior, midline vertebral heights of 118 fractured vertebral bodies increased up to (75.83 ± 19.84)% and (71.23 ± 21.45)% respectively. None of them had worsening of fracture-induced narrowing of spinal canal. No device-related major complications occurred. Percutaneous kyphoplasty through an extra-pedicular approach results in immediate clinical improvement of mobility and pain relief. It safely increases vertebral body height and quickly returns geriatric patients to higher activity levels, increased independence and better quality-of-life. And its short-term outcomes are excellent.