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Incidence of adjacent vertebral fractures in patients treated with balloon kyphoplasty: two years' prospective follow-up.
MedLine Citation:
PMID:  17050364     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To evaluate the long-term outcomes of 37 patients with 60 osteoporotic vertebral fractures, located in the thoracic and lumbar spine, treated with balloon kyphoplasty. MATERIAL AND METHODS: Fourty-two patients (15 males and 27 females) with 67 osteoporotic vertebral fractures were treated with balloon kyphoplasty. We were able to have 2-year follow-up of 37 patients with 60 treated vertebrae. Baseline fracture rate in these 37 patients was 1.9 (60 fresh fractures and 11 old fractures already healed). Symptomatic levels were identified by correlating the clinical presentation with conventional radiographs, computed tomography (CT), and/or magnetic resonance imaging (MRI). During the 2-year follow-up, reduction in pain was determined. The effects on pain symptoms were measured on a self-reported visual analog scale (VAS) and the Oswestry score was documented to assess disability. Radiographic scans were performed pre- and postoperatively, and after 3, 6, 12, and 24 months. The vertebral height and endplate angles were measured to assess the restoration of the sagittal alignment. RESULTS: The median pain scores (VAS) decreased significantly from pre- to post-treatment as did the Oswestry Disability Score (P<0.05). This improvement was maintained at 2-year follow-up. In eight patients (21.6%) (five female, three male), an adjacent fracture occurred in 11 vertebrae (18.3%) within 3 weeks to 22 months of follow-up (after 22 months no adjacent fracture occurred). This makes an annualized refracture rate of 10% (18.3/22 x 12). In three patients the adjacent fractures were asymptomatic. Five patients with symptomatic adjacent fractures (eight vertebrae) wanted to be treated again with balloon kyphoplasty. Clinically asymptomatic cement leakage occurred in nine of 67 vertebral bodies (13.4%). During 2-year follow-up, this surgical technique demonstrated restoration and stabilization of the height of the vertebral body. CONCLUSION: Balloon kyphoplasty is an effective, minimally invasive procedure for the stabilization of osteoporotic vertebral fractures, leading to a statistically significant reduction of pain status.
R Pflugmacher; R-J Schroeder; C K Klostermann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  47     ISSN:  0284-1851     ISO Abbreviation:  Acta Radiol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-19     Completed Date:  2006-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  830-40     Citation Subset:  IM    
Centrum für Muskuloskeletale Chirurgie and Abteilung für Strahlenheilkunde, Universitätsmedizin Berlin, Charité, Campus Virchow-Klinikum, Berlin, Germany.
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MeSH Terms
Aged, 80 and over
Follow-Up Studies
Fractures, Spontaneous / physiopathology,  therapy*
Magnetic Resonance Imaging
Middle Aged
Osteoporosis / complications*
Pain Measurement
Prospective Studies
Tomography, X-Ray Computed
Treatment Outcome

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