Abstract
BackgroundThis study was conducted to investigate the outcomes and complications of balloon kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in patients with rheumatoid arthritis (RA) and compare its radiological and clinical effects with OVCF patients without RA.MethodsNinety-eight patients in the RA group with 158 fractured vertebrae and 114 patients in the control group with 150 vertebrae were involved in this study. Changes in compression rate, local kyphotic angle, visual analog scale (VAS) and Oswestry disability index (ODI) scores, conditions of bone cement leakage, refracture of the operated vertebrae, and new adjacent vertebral fractures were examined after KP. In addition, patients in the RA group were divided into different groups according to the value of erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and whether they were glucocorticoid users or not to evaluate their influence on the outcomes of KP.ResultsKP procedure significantly improved the compression rate, local kyphotic angle, and VAS and ODI scores in both RA and control groups (p<0.05). Changes in compression rate and local kyphotic angle in the RA group were significantly larger than that in the control group (p<0.05), and patients with RA suffered more new adjacent vertebral fractures after KP. The outcomes and complications of KP from different ESR or CRP groups did not show significant differences. The incidence of cement leakage in RA patients with glucocorticoid use was significantly higher than those who did not take glucocorticoids. In addition, RA patients with glucocorticoid use suffered more intradiscal leakage and new adjacent vertebral fractures.ConclusionsOVCF patients with RA obtained more improvement in compression rate and local kyphotic angle after KP when compared to those without RA, but they suffered more new adjacent vertebral fractures. Intradiscal leakage and new adjacent vertebral fractures occurred more in RA patients with glucocorticoid use.Trial registrationRetrospectively registered.
Highlights
This study was conducted to investigate the outcomes and complications of balloon kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in patients with rheumatoid arthritis (RA) and compare its radiological and clinical effects with OVCF patients without RA
Demographic data, clinical features, and complications of KP between the RA and control groups Of all patients enrolled in the study, no serious complications such as massive hemorrhage, nerve root, spinal cord injury, postoperative pulmonary infection, and deep vein thrombosis occurred in all patients
Ninety-eight patients aged 71.31±5.49 years old in the RA group with 158 vertebrae and 114 patients aged 73.18±4.27 years old in the control group with 150 vertebrae were involved in this study
Summary
This study was conducted to investigate the outcomes and complications of balloon kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in patients with rheumatoid arthritis (RA) and compare its radiological and clinical effects with OVCF patients without RA. 50% post-menopausal women with RA had osteoporosis and RA patients in all age groups took higher risks of osteoporotic fracture than those without RA [1, 4]. Osteoporosis at epiphysis and irreversible bone destruction around the joints could occur in the early stage of RA, which followed by osteoporotic changes in the whole body and even osteoporotic fracture s[5]. Haugeberg et al demonstrated that the longer the course of RA, the higher the incidence of osteoporotic fracture of the deformed joint s[6]
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