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Clin Neurol Neurosurg. 2019 May;180:101-105. doi: 10.1016/j.clineuro.2019.03.029. Epub 2019 Apr 1.

Early versus late percutaneous kyphoplasty for treating osteoporotic vertebral compression fracture: A retrospective study.

Author information

1
Department of Orthopedics, First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, China.
2
Department of Orthopedics, First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, China. Electronic address: zhuyuedr@163.com.
3
Department of Orthopedics, First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, China. Electronic address: yuanwei_dr@163.com.

Abstract

OBJECTIVE:

Osteoporotic vertebral compression fracture (OVCF) is a common disease in the aged population that can greatly affect the quality of life. Percutaneous kyphoplasty (PKP) has become a mainstream approach for treating OVCF, but the optimal surgical timing for treating OVCF with PKP remains controversial. In the current study, we retrospectively studied patients with OVCF that underwent PKP, and aimed to find out whether surgical timing could affect the clinical and radiological outcomes.

PATIENTS AND METHODS:

We retrospectively studied 62 patients who underwent PKP for OVCF. Patients were divided into 2 groups based on the timing of PKP: operation within 4 weeks (group A) and operation later than 4 weeks (group B). VAS, ODI, height of fracture vertebra, restored height rate, local kyphosis angle and complications were assessed preoperatively and throughout the follow-up.

RESULTS:

There were 36 cases (58 fracture vertebra) in the group A and 26 cases (40 fracture vertebra) in the group B. There was no significant difference between the two groups regarding to the demographic data before surgery. In terms of the VAS and ODI, no statistical difference was observed before operation, after operation and at the 6th month follow-up between the two groups. The HRR after operation and at the 6th month follow-up in the group A was 17.5 ± 5.3% and 10.5 ± 3.7%, and that in the group B was 7.2 ± 3.2% and 3.6 ± 1.1%, and there is significant difference between the two groups (p < 0.05). The LKA (preoperatively / post-operatively / 6th month follow-up) was -12.7°, -7.3°, -11.4° in the group A and -17.6°, -14.4°, -16.1° in the group B. There was significant difference between the two groups at all the time points for local kyphosis angle (p < 0.01), with a lower rate of subsequent vertebral fracture in the group A (p < 0.05).

CONCLUSION:

Both surgical timings of PKP showed similar outcomes in terms of the VAS and ODI. Early PKP could result in better restoration of vertebral body height and reduced rate of subsequent fracture compared to late PKP.

KEYWORDS:

Clinical outcome; Height restoration; Kyphoplasty; Kyphosis; Osteoporotic vertebral fracture; Surgical timing

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