Analysis of Results of Kyphotic Deformity Reduction Using Puncture Vertebroplasty and Stenoplasty in Patients with Traumatic Compression Fractures of Thoraco-Lumbar Localization

Abstract


Correction of posttraumatic deformity and stabilization of injured segment play an important role in treatment and complication prevention after traumatic compression vertebral body fractures. Possibilities of deformity reduction using vertebroplasty and a combination of distractive titanium cage with insertion of bone cement into vertebral body (stenoplasty) are not well studied. Retrospective comparative analysis of clinical efficacy and degree of kyphotic deformity reduction using puncture vertebroplasty (1 st group, n=15) and stenoplasty (2 nd group, n=15) in patients with traumatic A1 compression fractures of thoraco-lumbar vertebral bodies was performed. Severity of pain syndrome (VAS) and degree of injured segment deformity (kyphotic angle and wedge-shaping index) were assessed. In both groups surgical intervention resulted in marked pain reduction but in long-term period it was less significant for 2 nd group (p=0.0035). Postoperatively kyphotic angle median and wedge-shaping index changed statistically significant in 2 nd group from 12.60 (10.50; 13.40) to 2.50 (1.90; 3.20) (p=0.0015) and from 25.3% (22.8; 26.7) to 9.3% (8.9; 11.4) (p=0.0022), respectively and not significantly in 1 st group from 13.10 (11.40; 14.30) to 12.90 (11.20; 14.00) (p= 0.93) and from 26.5% (24.0; 28.8) to 25.9% (23.8; 28.4) (p=0.86), respectively. Progression of posttraumatic kyphosis in late postoperative period was noted in 1 st group (P M Ü=0.042) but not in 2nd group (P =0.58). In traumatic A1 compression fractures stenoplasty enabled to perform kyphotic deformity correction in the early period of spinal injury, to achieve significantly greater reduction of kyphotic angle and to preserve the result in remote postoperative period as compared to puncture vertebroplasty

About the authors

V. A Byval’tsev

Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch, Russian Academy of Medical Science, Irkutsk, Russia

Email: byval75vadim@yandex.ru

A. A Kalinin

Railway Clinical Hospital, Irkutsk, Russia


V. A Sorokovikov

Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch, Russian Academy of Medical Science, Irkutsk, Russia


E. G Belykh

Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch, Russian Academy of Medical Science, Irkutsk, Russia


S. Yu Panasenkov

Railway Clinical Hospital, Irkutsk, Russia


E. G Griror’ev

Scientific Center of Reconstructive and Restorative Surgery, Siberian Branch, Russian Academy of Medical Science, Irkutsk, Russia


References

  1. Бывальцев В.А. Метастазы шейного отдела позвоночника: способы коррекционного лечения. Клиническая неврология. 2008; 4: 30-3.
  2. Бывальцев В.А., Барза П., Сухомель П., Будорин Ф.А., Сороковиков В.А. Приоритетность использования вертебропластики в лечение симптоматических гемангиом позвоночника. Хирургия позвоночника. 2008; 2: 41-7.
  3. Aksiks I., Vestermanis V., Karklins E. et al. Pain relief after vertebroplasty in patients with osteoporotic and metastatic vertebral compression fractures and hemangiomas. Int. Proc. of 13th World Congress of Neurological Surgery. 2005: 37-40.
  4. Chiras J., Depriester C, Weill A, Sola-Martinez M.T., Deramond H. Percutaneus vertebral surgery. Technics and indications. J. Neuroradiol. 1997; 24: 45-59.
  5. Hoffman R.T., Jakobs T.F., Wallnofer A., Reiser M.F., Helmberger T.K. Percutaneus vertebroplasty: indications, contraindications, technique. Radiologe. 2003; 43: 709-17.
  6. Barr J.D., Barr M.S., Lemley T.J. McCann R.M. Percutaneus vertebroplasty for pain relief and spinal stabilization. Spine (Phila Pa 1976). 2000; 25 (8): 923-8.
  7. Philips F.M., Paul R., Lieberman I.H. Kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures. Advances in osteoporotic fracture management. 2001; 1: 7-11.
  8. Li X., Yang H, Tang T., Qian Z., Chen L., Zhang Z. Comparison of kyphoplasty and vertebroplasty for treatment of painful osteoporotic vertebral compression fractures: twelve-month follow-up in a prospective nonrandomized comparative study. J. Spinal Disord. Tech. 2012; 25 (3): 142-9.
  9. McGirt M.J., Parker S.L., Wolinsky J.P., Witham T.F., Bydon A., Gokaslan Z.L. Vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: an evidenced-based review of the literature. Spine J. 2009; 9 (6): 501-8.
  10. Ghofrani H., Nunn T., Robertson C., Mahar A., Lee Y., Garfin S. An evaluation of fracture stabilisation comparing kyphoplasty and titanium mesh repair techniques for vertebral compression fractures: is bone cement necessary? Spine (Phila Pa 1976). 2010; 35 (16): 768-73.
  11. Upasani V.V., Robertson C., Lee D., Tomlinson T., Mahar A.T. Biomechanical comparison of kyphoplasty versus a titanium mesh implant with cement for stabilization of vertebral compression fractures. Spine (Phila Pa 1976). 2010; 19: 1783-8.
  12. Matějka J., Zeman J., Belatka J., Matějka T., Nepras P. Vertebral body augmentation using a vertebral body stent. Acta Chir. Orthop. Traumatol. Cech. 2011; 78 (5): 442-6.
  13. Rotter R., Martin H., Fuerderer S. Gabl M., Roeder C., Heini P., Mittlmeier T. Vertebral body stenting: a new method for vertebral augmentation versus kyphoplasty. Eur. Spine J. 2010; 19 (6): 916-923.
  14. Boger A., Heini P., Windolf M., Schneider E. Adjacent vertebral failure after vertebroplasty: a biomechanical study of low-modulus PMMA cement. Eur. Spine J. 2007; 16 (12): 2118-25.
  15. Dragan S.F., Urbacski W., Ϊywirski B., Krawczyk A., Kulej M., Dragan S.J. Kyphosis correction after vertebro- plasty inosteoporotic vertebral compression fractures. Acta Bioeng Biomech. 2012; 14 (4): 6S-9.
  16. Magerl F., Aebi M., Gertzbein S.D. Harms J., Nazarian S. A comprehensive classification of thoracic and lumbar injures. Eur. Spine J. 1994; S (4): 184-201.
  17. Бывальцев В.А., Сороковиков В.А., Белых Е.Г., Арcентьева Н.И. Использование шкал и анкет в вертебрологии. Неврология и психиатрия им. С.С. Корсакова. 2011; 9 (III): 51-6.
  18. McLain R.F., Sparling E., Benson D.R. Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. A preliminary report. J. Bone Joint Surg. Am. 199S; 75 (2): 162-7.
  19. Korovessis P.G., Baikousis A., Stamatakis M. Use of the Texas Scottish Rite Hospital Instrumentation in the treatment of toraco-lumbar injures. Spine (Phila Pa 1976). 1997; 22: 882-8.
  20. Бывальцев В.А., Сороковиков В.А. Диагностика и современные методы лечения позвоночных гемангиом. Хирургия позвоночника. 2008; 4: 42-6.
  21. Voggenreiter G. Ballon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures. Spine (Phila Pa 1976). 2005; 30 (24): 2806-12.
  22. Зарецков В.В., Сумин Д.Ю., Арcениевич В.Б., Лихачев С.В., Зуева Д.П., Артемов Л.А. и др. Вертебропластика при повреждениях тел поясничных позвонков у пациентов с остеопорозом. Хирургия позвоночника. 2011; 3: 26-30.
  23. Anselmetti G.C., Manca A., Hirsch J., Montemurro F., Isaia G., Osella G. et al. Percutaneous vertebroplasty in osteoporotic patients: an institutional experience of 1,634 patients with long-term follow-up. J. Vasc. Interv. Radiol. 2011; 22 (12): 1714-20.
  24. Omidi-Kashani F., Hasankhani E.G., Akhlaghi S. Golhasani-Keshtan F. Percutaneus vertebroplasty in symptomatic hemangioma versus osteoporotic compression fracture. Indian J. Orthop. 2013; 47 (3): 234-7.
  25. Ender S.A., Wetterau E., Ender M., Kbhn J.P., Merk R., Kayser R. Percutaneous stabilization system osseofix® for treatment of osteoporotic vertebral compression fractures - clinical and radiological results after 12 months. PLoS One. 2013; 8 (6): e65119.
  26. Klezl Z., Majeed H., Bommireddy R., John J. Early results after vertebral body stenting for fractures of the anterior column of the thoracolumbar spine. Injury. 2011; 42 (10): 1038-42.
  27. Friedrich H.C., Friedrich H.J., Kneisel P., Drumm J., Pitzen T. Balloon kyphoplasty improves back pain but does not result in a permanent realignment of the thoracolumbar spine. Cent Eur. Neurosurg. 2011; 72 (4): 176-80.
  28. Hai Y., Chen X.M., Wu J.G., Liu Y.Z., Zhou L.J., Zou D.W. Kyphoplasty for treatment of non-osteoporotic thoracolumbar compressive fractures: analysis of 17 cases. Zhonghua Yi Xue Za Zhi. 2006; 86 (43): 3035-8.
  29. Shin J.J., Chin D.K., Yoon Y.S. Percutaneous vertebro- plasty for the treatment of osteoporotic burst fractures. Acta Neurochir. (Wien). 2009; 151 (2): 141-8.
  30. Rho Y.J., Choe W.J., Chun Y.I. Risk factors predicting the new symptomatic vertebral compression fractures after percutaneous vertebroplasty or kyphoplasty. Eur. Spine J. 2012; 21: 905-11.
  31. Дуров О.В., Шевелев И.Н., Тиccен Т.П. Вертебропластика при лечении заболеваний позвоночника. Вопросы нейрохирургии им. Н.Н. Бурденко. 2004; 2: 21-6.
  32. www.alphatecspine.com/products/vcf/osseofix.asp
  33. Макиров С.К., Гончаров Н.Г., Голубев В.Г., Вacильев В.В., Амин Ф.И., Зураев О.А и др. Стентопластика в комбинации с биорезорбируемым цементом при переломах тел позвонков. Хирургия позвоночника. 2013; 1: 15-20

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Copyright (c) 2014 Byval’tsev V.A., Kalinin A.A., Sorokovikov V.A., Belykh E.G., Panasenkov S.Y., Griror’ev E.G.

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