Percutaneous balloon kyphoplasty, a good minimally invasive surgical option for osteoporotic thoracolumbar compression fracture

Md Anowarul Islam,Khandaker Hafijur Rahman,Manish Shrestha,Santosh Batajoo,Dipendra Mishra

doi:10.3329/bsmmuj.v11i2.36627

Abstract

<p>The aim of this study is to evaluate balloon kyphoplasty as a surgical option for osteoporotic thoracolumbar compression fracture. The study was conducted on 30 patients from January 2014 to December 2017. The anterior vertebral height, kyphotic angle and functional evaluation by Oswestry disability index (ODI) and visual analogue scale (VAS) score were recorded preoperatively, immediate post-operatively at 3, 6, 12 months and yearly then on. All patients showed improvement in mean kyphotic angle from 16.4 ± 3.5 to 5.6 ± 1.7 post-operatively and 8.4 ± 1.6 at final follow-up. There was significant increase in mean anterior vertebral height from 51 ± 7.3% before surgery to 75.5 ± 7.4% at one day after surgery and 71.2 ± 3.2% at the last follow-up. There was significant improvement in mean VAS score from 8.1 ± 0.9 before surgery to 2.2 ± 0.4 at one day, and 2.4 ± 0.3 at final follow-up. The improvement in patients’ ODI score after surgery from 71.4 ± 3.4 to 26.0 ± 4.8 at one day and 21.2 ± 5.5 at final follow-up was noted. The mean operating time was 45.5 ± 15.5 min for each vertebra. Within first day of surgery improvement in pain relief and mobility was experienced by all patients. The orthopedic balloon ruptured in one patient and it was replaced then procedure was continued with no complications. There were no neurological complications in all cases and there was no infections and any occurrence of symptomatic pulmonary embolism. In conclusion, balloon kyphoplasty is a good minimally invasive procedure where along with reduction of pain and disability there is also restoration of sagittal alignment post-operatively.</p>

Highlights

Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture.[1]
Thirty patients with symptomatic osteoporotic vertebral compression fractures between January 2014 to December 2017 who underwent balloon kyphoplasty in Bangabandhu Seikh Mujib Medical University and other private hospitals around Dhaka were included in the study
This study shows results of balloon kyphoplasty in treatment of osteoporotic vertebral compression fracture

Summary

Introduction

Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture.[1] Vertebral compression fracture is the leading cause of morbidity and disability in the elderly.[2,3,4] Acute pain due to vertebral compression fracture may subside over period of weeks or months it is not uncommon that chronic pain is seen in number of cases leading to significant disability.[5] Chronic pain may be due to incomplete healing with progressive vertebral collapse, spinal deformity leading to altered spinal kinematics or development of pseudoarthrosis at the involved level. Being less traumatic and less risk for elderly patients these are considered good option than open procedures which is limited to cases with spinal instability and/or neurological deficit.[18, 19]

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Conclusion