Abstract
Objective
Osteoporotic thoraco‐lumbar burst fractures with serious pain are very common, and the optimal treatment of burst fractures without any neurological deficits has not yet been properly codified. The objective of this study was to evaluate prospectively the clinical effects and pain relief of unilateral percutaneous kyphoplasty (PKP) on osteoporotic thoraco‐lumbar burst fractures.
Methods
46 patients with osteoporotic thoraco‐lumbar burst fractures were treated by PKP in our hospital from January 2016 to January 2017. The height of posterior wall (HPW), the height of anterior wall (HAW)and kyphotic angle (KA) were measured via x‐ray radiographs before surgery, one day after surgery and at final follow‐up. Visual analogue scale (VAS) score and the oswestry disability index (ODI) score were evaluated preoperatively, post‐operatively and at final follow‐up. All the patients with osteoporotic thoraco‐lumbar burst fractures were treated by unilateral PKP. Radiological evaluation (anteroposterior and lateral x‐ray radiographs and CT) were performed.
Results
All patients were followed up, and the mean follow up was 28.8 ± 7.0 months. The preoperative HAW was 20.1 ± 2.3 mm, and the HAW was significantly improved to 22.9 ± 2.4 mm after operation (p < .05), and at the final follow up, the HAW was 19.9 ± 2.1 mm, which was lower than the post‐operative HAW. The HPW was also significantly corrected after surgery (p < .05). There were no significant differences between postoperative HPW and the HPW at the final follow up(p > .05). The KA was significantly corrected after operation(p < .05), but relapse occurred at the final follow‐up, and at the final follow‐up, the average of KA was 19.4 ± 1.6 degree. The VAS and ODI were significantly improved at the final follow up compared to the preoperative period (p < .05). Cement leakage was found in 8 patients, and adjacent vertebral fracture was found in 2 patients.
Conclusions
Our present results showed that unilateral PKP acquired satisfactory treatments effect and pain relief in the management of osteoporotic thoraco‐lumbar burst fractures. Meticulous evaluation of preoperative images and careful repetitious injection of cement are important to prevent the cement leakage.
from Wiley: European Journal of Pain: Table of Contents https://ift.tt/35RPnpv
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