gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

3-years experience with Balloon-Kyphoplasty for the treatment of painful osteoporotic compression fractures

Ballon-Kyphoplastie zur Behandlung von schmerzhaften, osteoporotischen Kompressionsfrakturen: Ergebnisse nach 3 Jahren Erfahrung

Meeting Abstract

  • corresponding author M. Stoffel - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • I. Wolf - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • F. Ringel - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • C. Stüer - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn
  • B. Meyer - Department of Neurosurgery, Friedrich-Wilhelms-University, Bonn

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc10.05.-12.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0148.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Stoffel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

For painful osteoporotic fractures refractory to conservative treatment, minimally invasive stabilizing procedures like vertebroplasty and kyphoplasty have become established. Thereby, kyphoplasty even allows the stabilisation of fractures with retropulsed posterior wall. We report our prospectively analyzed 3 years experience with this novel technique.

Methods

In 89 consecutive kyphoplasty procedures 138 osteoporotic vertebral fractures (from D6-L5) with/without narrowing of the spinal canal were treated in 81 patients under general anaesthesia. The patients (median age: 74 y.) presented with a median duration of symptoms of 35 days on admission. Pre- and postinterventional radiographs (x-ray, CT) as well as Karnofsky, and visual analogue pain scores 3 days post-op were compared to evaluate the immediate success of the operation. For long-term follow-up the SF-36 health survey was used.

Results

The Karnofsky score improved from 52±20 (mean±SD, pre-op) to 72±16 (post-op). Simultaneously, pain scores (VAS) decreased from 73±19 (pre-op) to 23±16 (post-op). The procedure led to a partial restoration of vertebral body height by reducing the median sagittal index (measure of kyphosis) from 10±10 to 7±9°. In none of our patients, the fracture induced narrowing of the spinal canal was deteriorated by the operation. Radiographic asymptomatic cement leakage occurred as follows: 27 times into the paraspinal space, 14 times into the spinal canal, and 5 times into the disc space. Operative morbidity included one transient and one permanent neurological deficit. The patients’ health increased from 24 (physical component score) and 43 (mental component score), respectively, to 35 and 58 on the dichotomised SF-36 during the follow-up (mean: 15 months). During that time, 6 patients suffered from subsequent osteoporotic fractures in the adjacent levels and 1 patient in a non-adjacent level.

Conclusions

Balloon-kyphoplasty is a safe, quick and easy method that results in immediate clinical improvement of mobility and pain relief and slightly reduces the kyphotic deformity of the fractured vertebral body. Above that, it leads to longer lasting improvement of the patients’ physical and mental health. However, it does not seem to decrease the risk of adjacent level fracture compared to the natural history.