Treatment of patients who have osteoporotic vertebral fractures evaluate effectivity of vertebroplasty and kiphoplasty procedures.

AIM OF THE STUDY: Among the fractures present secondary to osteoporosis, the vertebral fractures are the most commonly seen fractures and cause severe pain and functional impairment. This study aimed to evaluate the functional and radiologic efficacy of percutaneous vertebral augmentation procedures including vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral fractures.MATERIALS AND METHOD: Between January 2004 and September 2007, patients admitted to Gazi University Faculty of Medicine Department of Orthopaedics and Traumatology because of back pain evaluated and patients with osteoporotic vertebral fractures confirmed with physical examination and radiographic evaluation participated in the study. Patients who are still symptomatic despite of at least 4-6 weeks of conservative treatment and the patients with nonunion in the radiologic evaluation underwent either vertebroplasty or kyphoplasty procedure. 43 patients with adequate follow-up participated in this study. Total number of 48 vertebral segments underwent to vertebroplasty or kyphoplasty (22 patient 24 segment kyphoplasty and 21 patients 24 segment vertebroplasty). In the patients of kyphoplasty group 17 were women and 5 were men. Average age was 73 years (between 63-86 years). In the patients of vertebroplasty group 16 were women and 5 were men and the average age of this group was 74,7 years (between 65-87 years). The average follow-up period was 26 months (between 4?48 months).RESULTS: All patients are evaluated with visual analog scale and Oswestry disability index functionally and radiologically with anteroposterior and lateral views regarding sagittal index. Functional results with visual analog scale and Oswestry Disability Index revealed statistical significant better results between preoperative and postoperative periods in both vertebroplasty and revealed kyphoplasty groups (p<0,05). In radiologic evaluation while the group of vertebroplasty did not result any improvement in sagittal index, but in kyphoplasty group the sagittal index showed statistically significant improvement (p<0,05). Total complication rate was 4%. In one patient of vertebroplasty group and another patient in kyphoplasty group extravasation of cement to intervertebral disc space observed. In one patient in vertebroplasty group, 5 months after the procedure to L1 vertebra another fracture of adjacent L2 vertebra seen and treated again with vertebroplasty.CONCLUSIONS: This study showed as a result both vertebroplasty and kyphoplasty procedures are effective for the treatment of pain and recovery of functional impairments in the patients with osteoporotic vertebral fractures. Radiologic improvement with kyphoplasty is better because of the reduction of fracture in the corpus with special balloon. Although there is no correlation with clinical and radiological results and despite of the kyphoplasty that requires anesthesia and more expensive than vertebroplasty, the vertebroplasty technique could be the treatment of choice in for the osteoporotic vertebral fractures.KEY WORDS: Osteoporotic vertebral fractures, vertebroplasty, kyphoplasty, functional and radiologic results