Treatment of Thoracolumbar Osteoporotic Vertebral Compression Fractures with Vertebral Body Stenting: A Prospective Study

Abstract

IntroductionBalloon kyphoplasty is a procedure to stabilize osteoporotic and/or cancer related VCFs. However, there is a technique inherent problem with the amount of reduction; when filling the balloons, an acceptable reduction is achieved. However, the resulting final reduction after cementing is ~25% lower due to the partial collapse after balloons deflation. To avoid loss of reduction, a newer technique has been introduced, based on the principles of balloon kyphoplasty and vascular stenting. MethodsA prospective cohort study of clinical and radiographic results after vertebral body stenting(VBS) for treatment of vertebral compression fractures(VCFs). To evaluate effectiveness of VBS as a new technique to treat symptomatic VCFs. A total of 33 patients with 52 symptomatic VCFs were enrolled in a prospective study of VBS. Clinical outcomes were measured pre- and postoperatively using the visual analogue scale (VAS), Oswestry Disability Index (ODI) and ambulatory status (AS). All outcomes were assessed before the procedure, and at 1, 12, 24, and 36 weeks after the procedure. ResultsThe median VAS scores went from 10.0 preoperatively to 1.0 at last follow-up. The pre-operative ODI score was 80 preoperatively, improved to 18 at last follow up. The ability to move independently and ease of ambulation significantly improved after the procedure (P ˂ 0.001). The median kyphosis angle was 15.0 degrees preoperatively and decreased by a median of 4.5 degrees postoperatively. ConclusionsPatients with symptomatic VCFs had significant improvements in back pain, function, and quality of life following VBS. The results of percutaneous vertebral body stenting in osteoporotic fractures may encourage surgeons in future to widen the indications and use these techniques to successfully restore anterior column in traumatic non-osteoporotic fractures in conjunction with posterior instrumentation.