• Zhonghua yi xue za zhi · Sep 2013

    [Clinical outcomes of percutaneous kyphoplasty under local anesthesia for osteoporotic vertebral compression fractures].

    • Xiu-tong Fang, Fang Yu, Sheng-liang Fu, Guo-qiang Chen, Xiao-ming Yuan, Hong-chuan Li, Lin Zhang, Meng Yu, Qi Yao, Di Ai, Yu Shen, and Bin Wu.
    • Department of Orthopedics, Affiliated Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China. Email: fangxiutong@163.com.
    • Zhonghua Yi Xue Za Zhi. 2013 Sep 3;93(33):2654-8.

    ObjectiveTo analyze the clinical outcomes of percutaneous kyphoplasty under local anesthesia for osteoporotic vertebral compression fractures.MethodsIn this study, 76 elderly patients with osteoporotic vertebral compression fractures undergoing percutaneous kyphoplasty were followed up for 2-3.1 years. They were divided into 3 groups according to different ages: 60-69 yrs (A group), 70-79 yrs (B group) and 80- 91 yrs (C group). Pre- and post-operative and last follow-up evaluations were conducted. And the parameters of bone mineral density (BMD), kyphotic angle, change of visual analog scale (VAS), Oswestry disability index, average vertebral body height, complications and costs of hospitalization were recorded and analyzed.ResultsBMD decreased with advancing age and had statistical significance between three groups (P < 0.05). Three thoracic spine fractures and 6 lumbar spine fractures could not be detected with digital radiography and were observed only on magnetic resonance imaging (MRI). The pre-operative levels of visual analogue scale and Oswestry disability index increased in all groups.No statistical significance existed between A and B groups. But there was statistical significance between A or B and C groups (P < 0.05). Pre- and post-operative assessments showed that statistically significant improvements were found in visual analogue scale and Oswestry disability index in all groups (P < 0.05). And statistically significant improvements were found for the pre- and post-operative kyphotic angles and vertebral body heights in A, C group and B groups (P < 0.05). The sites for symptomatic leakage of cement included paravertebral vein (n = 2), intervertebral disc (n = 1) and paravertebral space (n = 2). Adjacent vertebral fracture occurred in 1 patient at 17 months and underwent percutaneous kyphoplasty. The mean operative duration was 28 minutes per vertebrae and the mean cost of hospitalization at RMB yuan 33 778.ConclusionAs a simple and safe procedure for osteoporotic vertebrae compression fractures, percutaneous kyphoplasty may relieve pain quickly, restore vertebral height, prevent further fractures and improve the patient's quality-of-life.

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