Mid-Term Clinical and Radiological Outcomes After Kyphoplasty in the Treatment of Thoracolumbar Traumatic Vertebral Compression Fractures

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TitreMid-Term Clinical and Radiological Outcomes After Kyphoplasty in the Treatment of Thoracolumbar Traumatic Vertebral Compression Fractures
Type de publicationJournal Article
Year of Publication2018
AuteursGrelat M, Madkouri R, Comby P-O, Fahed E, Lemogne B, Thouant P
JournalWORLD NEUROSURGERY
Volume115
PaginationE386-E392
Date PublishedJUL
Type of ArticleArticle
ISSN1878-8750
Mots-clésKyphoplasty, Spine surgery, Thoracolumbar junction
Résumé

BACKGROUND: The management of thoracolumbar posttraumatic compression fractures varies widely among centers, and there is no real consensus as to the optimum approach. The objective of our retrospective study was to detect the progression of vertebral kyphosis in nonosteoporotic patients treated by balloon kyphoplasty (KPB) who presented with recent compression fractures of the thoracolumbar region. METHODS: In this retrospective study, we investigated the evolution of vertebral and regional kyphosis in 77 patients treated by KPB for compression vertebral fractures (Magerl A) between 2007 and 2011. All treated patients, even those lost to follow-up, were included in our statistical analysis. RESULTS: In the 77 patients, a 2.4 degrees deterioration of vertebral kyphosis (P = 0.0004) and a 4.5 degrees worsening of regional kyphosis (P < 0.0001) were observed at the end of the follow-up period. No statistical correlation between the worsened kyphosis and the deterioration of long-term pain was identified. The mean visual analog scale score was 2.5, associated with very lowdisability on functional scores. A3-2 and A3-3 fractures are characterized by worsening vertebral and regional kyphosis. CONCLUSIONS: The paucity of studies of posttraumatic vertebral compression fractures in the scientific literature explains the lack of consensus regarding the optimum treatment approach. Postoperative results with KPB favor vertebral and regional kyphosis stability. KPB remains indicated in this situation except in cases of for burst fracture.

DOI10.1016/j.wneu.2018.04.060