Quality of life after kyphoplasty and vertebroplasty for the treatment of osteoporotic vertebral compression fractures

Objective: This study investigates the clinical outcomes in relation to the quality of life after kyphoplasty and vertebroplasty for the treatment of osteoporotic vertebral compression fracture (VCFs). Materials and methods: A painful osteoporotic VCFs can be a significant burden for petients and their families, impairing physical function and quality of life1. Kyphoplasty and vertebroplasty are new minimally invasive techniques that have been developed to help stabilize the fractured vertebra and decrease the pain and improve the function of individuals debilitated by painful osteoporotic VCFs2,3,4,5. Eighty-five osteoporotic VCFs were treated during forty-two kyphoplasty procedures and forty-three vertebroplasty procedures in fifty-nine patients who did not respond to medical therapy. Symptomatic levels were identified by correlating the clinical data with radiographs and, in presence of two adjacent collapses vertebral body, with MRI findings demonstrating edema in the symptomatic levels. Fractures presenting for>3 months were included in the vertebroplasty group, whereas fractures presenting for < 3 months were included in the kyphoplasty group. Outcome data were obtained by comparing preoperative and latest postoperative SF-36 and visual analogic scale (VAS) data and the statistical analyses wer done using Wilcoxon signed-rank tests and Mann-Whithney test. A P value of < 0.01 was deemed significant. Results: Patient surveys revealed significant pain reduction within the first week after surgery and improved activity levels for a majority of patients. The SF-36 scores showed a significant improvement and the VAS score showed a significant reduction for both procedures. Cement extravasation was seen at 7.6% of patients treated with kyphoplasty procedures and at 14% of patients treated with vertebroplasty procedures, both without clinical complications. Conclusions: Kyphoplasty and vertebroplasty, performed in appropriately selected osteoporotic patients with painful vertebral fractures, are promising addition to current medical treatment. These procedures improves physical function and reduces pain. Vertebroplasty has the advantage of being a relatively fast and inexpensive procedure, kyphoplasty is associated with increased cost and surgical time but offers the potential to improve spinal alignment if it is carried out within six-eight weeks from the collapse.