Comparison of the Results of Balloon Kyphoplasty Performed at Different Times after Injury

Oh, Gun Soek; Kim, Hyeun Sung; Ju, Chang Il; Kim, Seok Won; Lee, Seung Myung; Shin, Ho Seong

doi:10.3340/jkns.2010.47.3.199

Cited by 9 publications

(12 citation statements)

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“…Two additional retrospective studies on 72 and 99 patients who were treated with kyphoplasty also reported better restoration in patients who were treated within 2 months after injury. However, one study only reported absolute numbers for each group itself, but did not statistically examine if the differences between the groups were significant and therefore did not allow any reliable conclusions [22]. The other study only reported a better preservation of the anterior vertebral and kyphotic angle in the early group, but did not find significant absolute differences [23].…”

Section: Discussionmentioning

confidence: 98%

Influence of operative timing on the early post-operative radiological and clinical outcome after kyphoplasty

et al. 2020

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Purpose To clarify the relationship between operative timing and the early post-operative radiological and clinical outcome after kyphoplasty. Methods We conducted a retrospective cohort study including patients who underwent kyphoplasty of a single vertebra. Patients were divided into three groups (acute [< 2 weeks], subacute [2–6 weeks] or chronic [6–51 weeks]) based on the interval between fracture and surgery. The relative vertebral body height (VBH) and local kyphotic angle (LKA) of the fractured vertebra (measured on plain radiographs) as well as pain and use of analgesics were compared pre- and post-operatively (day 2) and between the groups. Results A total of 230 patients (100 with acute, 91 with subacute and 39 with chronic fractures) with fractures from T4 to L5 were included. In all groups, there was a significant post-operative improvement in the anterior (8.9–12.9%) and middle (10.7–13.4%) VBH (all groups: p < 0.001), LKA (acute: 3.8°, p < 0.001; subacute: 4.3°, p < 0.001; chronic: 1.7°, p = 0.046) and pain. The use of analgesics significantly decreased post-operatively in the acute and subacute groups, but did not significantly change in the chronic group. Patients from acute (p = 0.042) and subacute (p = 0.027) groups showed significantly better post-operative correction of the LKA than the chronic group. Conclusion Kyphoplasty is effective for vertebral height restoration as well as pain relief for both acute, subacute and chronic fractures. However, the achievable correction of the fracture-related local kyphosis decreases significantly after 6 weeks. Therefore, we recommend making a final decision about conservative vs. operative treatment within 6 weeks to ensure better height restoration in surgically treated patients.

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Section: Discussionmentioning

confidence: 98%

Influence of operative timing on the early post-operative radiological and clinical outcome after kyphoplasty

et al. 2020

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“…In a reverse conclusion, a long conservative treatment attempt might actually reduce the benefit of a subsequent kyphoplasty and cause sustained postural disadvantages to the patient as fracture consolidation hinders LKA restoration. However, there is no consistent data available yet regarding the influence of surgical timing on vertebral height restoration [20][21][22] . www.nature.com/scientificreports www.nature.com/scientificreports/ Apart from the radiographic benefits of the operation, we also observed a significant pain reduction in our patients postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Kyphoplasty Restores the Global Sagittal Balance of the Spine Independently from Pain Reduction

Pumberger

Schitz

Bürger

et al. 2020

Sci Rep

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Kyphoplasty is the standard surgical treatment of vertebral compression fractures. We aimed to clarify the influence of kyphoplasty on the sagittal profile as well as the relation between posture improvement and pain relief. For this purpose, we evaluated various radiological parameters of the sagittal profile on whole spine standing radiographs of 73 Patients with a single vertebral fracture treated by kyphoplasty. The key outcome was the postoperative change of the sagittal vertical axis (SVA). Additionally, clinical parameters including pain scores on visual analogue scale (VAS) and use of analgesics were obtained from medical records. pre-and postoperative radiological as well as clinical parameters were compared. Additionally, the correlation between changes of SVA and changes of local kyphotic angle (LKA) or VAS was examined. The clinical parameters as well as various radiographic parameters (SVA, LKA, Gardner, Cobb) improved significantly postoperatively. The improvement of SVA correlated significantly with the correction of the LKA but not with postoperative pain relief. We conclude that kyphoplasty helps to restore the global sagittal balance of the spine after vertebral fractures. the correction of the sagittal profile seems to depend on the correction of the local kyphotic angle but does not correlate with postoperative pain relief.

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“…Infact, as soon as the balloon is deflated, there is often a new total or partial vertebral body collapse. [232425262728] This has led to new devices creation. They allow the vertebral height recovery.…”

Section: Discussionmentioning

confidence: 99%

New perspective for third generation percutaneous vertebral augmentation procedures: Preliminary results at 12 months

Vanni

Pantalone

Bigossi³

et al. 2012

J Craniovert Jun Spine

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Introduction:The prevalence of osteoporotic vertebral fractures (OVF) increased in the last years. Compression fractures promote a progressive spine kyphosis increase, resulting in a weight shift and anterior column overload, with OVF additional risk (domino effect). The aim of this study is to evaluate the OVF treatment outcome using Spine Jack®, a titanium device for third generation percutaneous vertebral augmentation procedures (PVAPs).Materials and Methods:From February 2010, a prospective randomized study was performed examining 300 patients who underwent PVAP due to OVF type A1 according to Magerl/AO spine classification. Patients enrolled in the study were divided in two homogenous groups with regards to age (65-85 years), sex, and general clinical findings. Group A included 150 patients who underwent PVAP using Spine Jack® system; the second, group B (control group), included 150 patients treated by conventional balloon kyphoplasty. Patients underwent a clinical (visual analogue scale and Oswestry disability index) and radiographic follow-up, with post-operative standing plain radiogram of the spine at 1, 6, and 12 months. The radiographic parameters that were taken into account were: Post-operative anterior vertebral body height, pre-operative anterior vertebral body height, cephalic anterior vertebral body height, and caudal anterior vertebral body height.Results:Compared to the Spine Jack® group, the kyphoplasty group required a little longer operation time (an average of 40 min–group A vs. 45 min–group B, P < 0.05) and a greater amount of polymethylmethacrylate (4.0 mL–group A vs. 5.0 mL–group B, P < 0.05;). The post-operative increase in vertebral body height was greater in the Spine Jack® group than in the kyphoplasty group (P < 0.05).Discussion:PVAP are based on the cement injection into the vertebral body. Vertebroplasty does not allow the vertebral body height recovery. Balloon kyphoplasty allows a temporary height restoration. Spine Jack® has some new features compared to other systems: It is equipped with a mechanical and not a hydraulic opening control; this ensures a gradual and controlled vertebral fracture reduction.Conclusions:In our study, we demonstrated that the third generation PVAP with Spine Jack® is able to determine a safe vertebral body height restoration compared to the conventional balloon kyphoplasty.

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Comparison of the Results of Balloon Kyphoplasty Performed at Different Times after Injury

Cited by 9 publications

References 9 publications

Influence of operative timing on the early post-operative radiological and clinical outcome after kyphoplasty

Influence of operative timing on the early post-operative radiological and clinical outcome after kyphoplasty

Kyphoplasty Restores the Global Sagittal Balance of the Spine Independently from Pain Reduction

New perspective for third generation percutaneous vertebral augmentation procedures: Preliminary results at 12 months

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