Journal of Pain Research (Aug 2022)
The Value of Dynamic Fracture Mobility in Determining the Optimum Operation Choice for Acute Osteoporotic Vertebral Compression Fracture
Abstract
Hu Ren, Tao Feng, Yaning Hu, Guangqing Yao, Dahai Yu, Jianhui Cao Department of Orthopedic Surgery, Shijiazhuang People’s Hospital, Shijiazhuang, People’s Republic of ChinaCorrespondence: Jianhui Cao, Department of Orthopedic Surgery, Shijiazhuang People’s Hospital, Shijiazhuang, Hebei, 050000, People’s Republic of China, Email [email protected]: This retrospective study aimed to verify whether the use of a balloon in balloon kyphoplasty (BKP) could offer a higher degree of vertebral height restoration and deformity correction than percutaneous vertebroplasty (PVP) after adjustment for preoperative dynamic fracture mobility. We expect that this research will help surgeons to determine the optimum operation choice (PVP or BKP) for treating osteoporotic vertebral compression fractures (OVCFs).Patients and Methods: We evaluated retrospectively 262 patients who were treated by PVP or BKP for acute, single-level OVCF at our institution from July 2015 to July 2019. According to the presence or absence of dynamic fracture mobility, the patients were divided into two groups: mobile group and fixed group. We compared the changes in the vertebral height and kyphotic angle for PVP and BKP, respectively, within each group.Results: In the mobile group, the anterior vertebral height restoration (BKP group, 8.73± 5.27%; PVP group, 2.96± 1.59%), middle vertebral height restoration (BKP group, 7.58± 5.18%; PVP group, 2.74± 1.24%) and kyphotic angle correction (BKP group, 4.41± 4.46°; PVP group, 1.38± 1.60°) due to percutaneous vertebral augmentation technique itself were more obvious in BKP group compared with PVP group (P 0.05).Conclusion: The use of a balloon in BKP could offer greater kyphosis correction, higher vertebral body height restoration, and lower cement leakage rate than PVP if a fractured vertebral body existed dynamic mobility. However, all these advantages of BKP over PVP are not obvious and could be overrated for a fixed fracture exhibited no mobility. BKP is recommended for a fractured vertebral body with dynamic mobility. PVP is suggested for a fixed fractured vertebral body with no mobility as it produces similar capability of vertebral height restoration, kyphosis correction, and cement leakage as BKP.Keywords: dynamic fracture mobility, optimum operation choice, osteoporotic vertebral compression fracture, balloon kyphoplasty, percutaneous vertebroplasty
