The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture

Young-Do Koh; Jong-Seok Yoon; Sung-Il Kim

doi:10.12671/jkfs.2008.21.1.57

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Koh, Yoon, and Kim: The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture

Original Article

Journal of the Korean Fracture Society 2008; 21(1): 57-61.

Published online: 31 January 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.1.57

The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture

Young-Do Koh, M.D., Jong-Seok Yoon, M.D., Sung-Il Kim, M.D.

Department of Orthopedic Surgery, Ewha Womans University School of Medicine, Seoul, Korea.

Address reprint requests to: Young-Do Koh, M.D. Department of Orthopedic Surgery, Mokdong Hospital, Ewha Womans University, School of Medicine, 911-1, Mok 6-dong, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-5564, Fax: 82-2-2642-0349, ydkoh@ewha.ac.kr

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To study which factors affect the deformity correction of vertebral body during kyphoplasty procedure.

Materials and Methods

25 osteoporotic vertebral compression fractures were treated with balloon kyphoplasty from October 2006 to May 2007. Lateral radiographs were taken at 5 different stages with preoperative lateral decubitus position, after placing the patient in prone position on an operation table, after inflating balloon, after deflation and removal of the balloon, after inserting the cement. Then we analyzed the compression ratios and kyphotic angles of the vertebral bodies in each stage.

Results

Placing the patient in prone position showed significant postural reduction in kyphotic angle and restorement of the anterior and middle body height. The inflation of the balloon demonstrated significant reduction of kyphotic angle and restorement of the anterior and middle body height. After the deflation, anterior and middle body height has decreased significantly. After the deflation, the kyphotic angle and the anterior and middle body heights were not restored signigicantly compared with those of initial prone position.

Conclusion

Vertebral height and kyphotic angle were partially recovered by inflating the balloon, but the correction was lost after deflating the balloon. Statistically, the body deformity was not restored significantly after deflating the balloon compared with that of intraoperative prone position. Therefore, we concluded that, in kyphoplasty of osteoporotic compression fractures, the postural reduction is the most important factor in deformity correction of fractured vertebral bodies.

Keywords: Osteoporotic vertebral compression fracture, Balloon kyphoplasty, Kyphotic deformity

Figures and Tables

Fig. 1

Positioning of the patient on the operating table throughout the operative procedure.

Fig. 2

(A) Preoperative lateral radiograph was taken at lateral decubitus position.

(B) Prone position restored some vertebral height and reduced some kyphotic angle.

(C) Ballooning the bone tamp.

(D) Deflation the bone tamp and loss of restored vertebral height.

(E) Inseting the cement under fluoroscopic guidance.

Fig. 3

Measurement of kyphotic angle, anterior VB height, middle VB height, Posterior VB height Kyphotic angle is the angle between the line As-Ps and Ai-Pi. To minimize possible magnification effects, vertebral height were reported as fractions of referent height. Anterior body height (%)=2Ma/Sa+Ia, Middle body height (%)=2Mm/Sm+Im, Posterior body height (%)=2Mp/Sp+Ip.

Table 1

Summary of results

Values are given as mean: comparisons by T-test. IBT: Inflatable bone tamp, VB: Vertebral body. ^*p<0.001, ^†0.001<p<0.01, ^‡0.01<p<0.05, ^§p>0.05, ^∥p>0.05 for prone position vs. deflation of IBT, ^¶p<0.005 for preoperative vs. cementing, ^**p>0.05 for preoperative vs. cementing.

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