ABSTRACT

Treatment goals of vertebra fractures by both conservative and surgical measures are anatomic reduction, prevention of spinal deformity, cessation of pain, restoration of vertebral height and provision of daily living activities of patients by providing stable fixation and early mobilization. In the current study, we presented the clinical and radiological results of ballon kyphoplasty which is a minimally invasive surgical technique and that was performed in thoracolumbar osteoporotic vertebra fractures and vertebral tumors in defined indications and discussed with the current literature.

We have evaluated 30 patients (36 vertebrae) who underwent balon kyphoplasty procedure due to acute and subacute osteoporotic vertebra fractures in GATA Orthopedics and Traumatology Clinic between the years 2002 and 2005. The preoperative physical examination of the patients showed no neurological involvement. The preoperative Pain Disability İndex and Oswestry Disability Questionarre values were recorded. The routine evaluation of vertebral column heigth from anteroposterior and lateral direct roentgenographies was also performed. In patients having pain and objective findings in the X-rays, magnetic resonance investigation of the spine was carried out routinely. The ballon kyphoplasty was performed in patients with osteoporotic vertebra fractures. All cases were allowed to mobilize in the immediate postoperative period and soft orthosis was used for postoperative 2 to 4 weeks. All patients also received medical treatment related with generalized osteoporosis.

The minimum follow-up period was 12 months and the average value was 16 months. The mean age of the patients was 65.5 years (range; 56 to 88). Sixteen (44.4%) of the lesions were in thoracic region whereas the remaining 20 (55.6%) were in the lumbar spine. The preoperative and postoperative measurements showed 46% loss and 85% restoration after operation in anterior column height and 60% loss and 85% restoration in middle column height. 71% correction in local kyphosis was seen. The improvement in pain visual scale and oswestry disability index from preoperative to postoperative state was statistically significabt at the end of 16 months follow-up (minimum of one year). In conclusion, kyphoplasty stabilizes osteoporotic vertebra fracture, decreases pain, restore vertebral wall height, prevents possible deormity formation, allows early mobilization, shortens the recovery time and thus increasing the patientʼs quality of life.