Abstract
Purpose
To retrospectively assess the optimal operating time for kyphoplasty as far as the
cement leakage during kyphoplasty is concerned.
Materials and methods
One hundred and six patients with a total of 117 osteoporotic vertebral compression
fractures (VCFs) were enrolled in our study. According to the time of kyphoplasty,
they were divided into two groups: group 1 (early operation group, who received the
operation within 14 days after fracture, n = 46) and group 2 (delayed operation group, who received the operation between 15 and
28 days after fracture, n = 71). Preoperative and postoperative visual analogue scale (VAS) and Oswestry Disability
Index (ODI) scores were compared 3 days after surgery within each group and between
the two groups. The radiographic outcomes were evaluated by the restoration rate (RR)
of the treated vertebrae. The outcome of cement leakage was assessed after surgery
using X-ray and computed tomography (CT) scans. Leaks of cement were classified into
three types: those via the basivertebral vein (type B), via the segmental vein (type
S) and through a cortical defect (type C).
Results
The mean VAS and ODI scores decreased significantly from pre-surgery to post-surgery
in each group, as did the RR (p > 0.05). There was no significant difference postoperatively on VAS and ODI scores (p > 0.05) between the two groups. However, significant differences were observed postoperatively
on RR (p = 0.045) and vertebrae with leakage (p = 0.038). In addition, there was a significant difference on leakage site of type C
between the two groups (p = 0.032).
Conclusion
Both early and delayed operations of kyphoplasty can achieve satisfactory clinical
and radiographic outcomes for osteoporotic VCFs. The risk of cement leakage during
kyphoplasty will decrease obviously in delayed operation; so delayed operation, perhaps
2 weeks after fracture, is more safe and optimal than early operation as far as cement
leakage is concerned, especially for vertebrae with cortical defects. But early operation
of kyphoplasty is more effective in vertebral height restoration.
Keywords
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Article info
Publication history
Accepted:
June 12,
2012
Identification
Copyright
© 2012 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
