Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures

Study Design. A prospective consecutive cohort study of clinical and radiographic outcomes after kyphoplasty for treatment of osteoporotic vertebral compression fractures. Objectives. To measure changes in spinal deformity, activity level, and pain after kyphoplasty treatment. Summary of Background Data. Pain and kyphosis caused by osteoporotic vertebral compression fractures adversely affect quality of life and survival. Kyphoplasty involves the inflation of a balloon bone tamp, percutaneously placed in a fractured vertebral body, followed by deposition of bone cement into the resulting cavity. Previous reports indicate that kyphoplasty improves patient function and restores height of collapsed vertebral bodies, but limited data about the effects of kyphoplasty on spinal sagittal alignment are available. Methods. Twenty-nine patients with osteoporotic vertebral compression fractures who did not respond to medical therapy were treated by kyphoplasty. These patients underwent 37 operations to treat 61 vertebral compression fractures between T6 and L5. Sagittal alignment was analyzed from standing radiographs (pre- and postkyphoplasty). Patient surveys were used to assess pain relief, improvement in activity, and satisfaction with the surgical procedure. Results. In this cohort, a mean of 8.8degrees ( range 0-29degrees) of correction of local spinal kyphosis was achieved with kyphoplasty. Thirty of 52 fractures ( 17 patients) were considered reducible and had >5degrees of correction, with a mean improvement in sagittal alignment of this population of 14.2degrees. Patient surveys revealed significant pain reduction within the first week after surgery and improved activity levels for a majority of patients. Conclusions. Kyphoplasty improves physical function, reduces pain, and may correct kyphotic deformity associated with vertebral compression fractures.