Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits.

摘要

STUDY DESIGN: Retrospective single-center consecutive case series with 2-year follow-up. OBJECTIVES: To examine patients who underwent kyphoplasty for long-lasting clinical and radiologic effects, including changes in vertebral body shape. SUMMARY OF BACKGROUND DATA: Kyphoplasty is the minimally invasive reduction and stabilization of vertebral body fractures, resulting in pain relief and improved physical function as described in our previously published 1-year outcomes report (J Neurosurg 2003;98:36-42). METHODS: Safety (complications and cement extravasation) was monitored in all 117 patients (151 fractures) treated through December 2001. Preoperative and postoperative visual analog scale pain scores, analgesia usage, and ambulatory status were compared in 65 of these patients with at least a 2-year follow-up. Anterior, midline, posterior vertebral body heights, and height ratios from this cohort were assessed before surgery, immediately postoperatively, and after 2 years of follow-up. RESULTS: Painscores, patient ability to ambulate independently and without difficulty, and need for prescription pain medications improved significantly (P < 0.001) after kyphoplasty, and remained unchanged or improved at 2 years postoperatively. Vertebral heights significantly (P < 0.003) increased at all postoperative intervals, with >or=10% height increases in 90% of fractures. Morphometric height ratios for treated fractures also significantly increased (P < 0.001): 0.67 +/- 0.24 to 0.79 +/- 0.17 and 0.63 +/- 0.16 to 0.83 +/- 0.11. Asymptomatic cement extravasation occurred in 11.3% of fractures, and during the follow-up, additional fractures occurred in previously untreated levels at a rate of 4.5% per year. There were no kyphoplasty related complications. CONCLUSIONS: Kyphoplasty markedly improves pain and function, and results in significant vertebral height restoration and normalization of morphologic shape indexes that remain stable for at least 2 years following treatment.