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Abstract
Objective:
Percutaneous vertebroplasty is a minimally invasive procedure to relieve or decrease pain in patients with osteoporotic compression fractures. However, vertebroplasty in the osteoporotic burst fracture patients with preoperative canal encroachment are still being debated, because it can aggravate spinal canal encroachment. The objects of this study is evaluation of the changes in spinal canal narrowing after percutaneous vertebroplasty.
Methods:
Inclusion criteria was osteoporotic bursting fracture patients with 5 to 20% canal encroachment (less than 5 mm). Exclusion criteria included pathological fractures, unstable vertebral fractures involving the posterior column, and severe neurological deficit. We measured the changes in spinal canal narrowing by pre- and postoperative computed tomography. Degree of canal encroachment was measured as the distance between the imaginary line along the posterior margin of the bony fragment and the maximal anterior imaginary line of the spinal canal in the axial CT scan.
Results:
This study was based on 10 patients (1 male and 9 female; age range, 52-89 years; mean age, 75 years). The mean decrease in the compression rate of the vertebral body height was 14.4% (43.4% to 29%). The mean decrease in the kyphotic angle was 4.3° (11.7° to 7.4°). The mean preoperative canal encroachment were 3.5 mm and postoperative canal encroachment was 3.7 mm, respectively. The mean preoperative VAS score was 4.3 and postoperative VAS score was 1.4.
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FIGURE 1.
A: 73-year-old female patient had a burst fracture of T12 on initial plain film. B: magnetic resonance image T2 weighted image shows the collapsed vertebra with canal encroachment. C: After the percutaneous vertebroplasty, the height of the vertebral body was increased and kyphotic angle was decreased. D: Encroachment of the bone fragment was measured in the axial plane by using a distance from the line between the posterior margin of the bony fragment and maximal anterior imaginary line of the spinal canal in axial computed tomography scan. E: After the percutaneous vertebroplasty, there is no exacerbation with canal encroachment.
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