The Clinical Effect of Kyphoplasty Using the Extrapedicular Approach in the Treatment of Thoracic Osteoporotic Vertebral Compression Fracture

Abstract

To evaluate the clinical effect of kyphoplasty with the extrapedicular approach in the treatment of thoracic osteoporotic compression fractures, including upper, middle, and lower thoracic. From April 2014 to December 2016, 50 cases (55 vertebrae) of thoracic osteoporotic fractures were treated with balloon kyphoplasty using the extrapedicular approach. Symptomatic levels ranged from T3 to T12 and were confirmed based on medical history, physical examination, and medical imaging. Pain relief, restoration of vertebral anterior and median height, and kyphosis correction were retrospectively compared before and after operation by using the visual analogue scale and radiography, respectively. In addition, bone cement leakage location and complications were recorded. Operations were successfully performed in all the cases, with an average surgery time of 77 minutes and follow-up period of 15 months (range, 6-36 months). The visual analogue scale scores at 3 days after operation and final follow-up were significantly reduced (P < 0.05). The vertebral anterior margin and median height on radiography after surgery were significantly improved (P < 0.05), and the kyphosis was significantly corrected. Four cases had cement leakage but no other adverse events. No blood vessel or spinal cord puncture injury during surgery or blood vessel embolism, pulmonary embolism, or fat embolism after surgery was found. Extrapedicular kyphoplasty is safe and effective in treating thoracic osteoporotic vertebral compression fractures. It can rapidly relieve backache, restore the body height of the fractured thoracic vertebra, and correct kyphosis. In addition, it can improve patient quality of life.