Surgical outcome of percutaneous kyphoplasty for vertebral compression fracture with different bone mineral density

Objectives:To investigate the clinical variation of percutaneous kyphoplasty(PKP) in treating vertebral compression fracture with different bone mineral density(BMD).Methods:Between March 2008 and November 2009,76 patients(32 males and 44 females,average age:63.1 years,range:50-81 years) suffering from single level of vertebral compression fracture and undergoing PKP in our institute were retrospectively reviewed.The bone mineral density of lumbar was measured by dual-energy X-ray absorptiometry.According to the T-score,the patients were divided into 3 groups:group A(osteoporosis group,33 cases),group B(bone loss group,26 cases) and group C(normal bone group,17 cases).The visual analogue scale(VAS),Oswesty disability index(ODI),vertebral height restoration and complications were used to evaluate the surgical outcome.Results:All patients reached quick back pain relief without neurological deficit and instrument failure.All patients had a follow-up of 1.5-2.7 years.Compared with pre-operation,the VAS score and ODI decreased significantly at 3 days after operation and final follow-up in 3 groups(P0.05),but no inter-group significant difference was noted(P0.05).When comparing the index of vertebral average height and local Cobb′s angle pre-and post-operation,each group had a significant recovery(P0.05).Group A had a higher striking vertebral height restoration rate(65.3%) than group B(57.9%) and C(54.2%)(P0.05).A total of 8 patients had bone cement leakage during operation,that 2 in group A(6.06%),3 in group B(11.54%) and 3 in group C(17.65%),there was no statistical difference among the 3 groups at cement leakage rate.One patient was complicated with pulmonary embolism due to cement leakage in group A,which was resolved after correspondent intervention.During the follow-up,2 adjacent vertebral fractures were found in group A,both of them recovered after an extra PKP treatment.Conclusions:PKP can provide an effective and safe therapeutic effect for vertebral compression fracture with different bone mineral density.Patients who have a lower BMD will get a better vertebral height restoration and Cobb′s angle rectification.However,patients who have the complication of osteoporosis should pay more attention to the adjacent vertebral fracture after the PKP procedure.