Prospective clinical and radiological study.
To evaluate the impact of stand-alone acrylic kyphoplasty in the treatment of recent traumatic fractures of the thoracolumbar spine in young patients.
The management of fractures of the thoracolumbar spine without neurological deficit remains controversial. For a long time clinicians could only chose between functional treatment, orthopedic treatment, and traditional surgery. The recent advent of minimally invasive surgical techniques is an interesting alternative.
Fifty-four patients with a mean age of 45.8±18.2 years and who had recently sustained a fracture of the thoracolumbar junction were enrolled into the study. Balloon kyphoplasty was performed using acrylic cement. Radiologic assessments (computed tomography scans) and clinical assessments (including Visual Analog Scale and Oswestry Disability Index scores) were used to determine kyphoplasty success and measure patient recovery over 2 years.
Kyphoplasty reduced mean vertebral kyphosis from 12.8±5.0 degrees at trauma to 8.2±5.1 degrees at 2-year follow-up. Mean vertebral kyphosis was corrected by −5.7±4.7 degrees (P=0.0001) at the point of first verticalization, with no significant change at the 2-year follow-up visit (+1.1±4.3 degrees, P=0.1058). Kyphoplasty significantly augmented the height of the 6 anterior and intermediate segments. Maximum mean augmentation of intermediate vertebral height after 6 months was (11.6%±15.5%, P<0.0001). Patients tolerated the procedure well and 56% of them returned to work 3 months after kyphoplasty.
Kyphoplasty is safe and effective in the correction of nonosteoporotic fractures of the thoracolumbar junction in young patients, and remains stable for at least 2 years postsurgery.
Service de Chirurgie Orthopédique et Traumatologie, CHU de Poitiers, 2 rue de la Milétrie, 86000 Poitiers, France
The authors declare no conflict of interest.
Reprints: Mathieu Saget, MD, Service de Chirurgie Orthopédique et Traumatologie, CHU de Poitiers, 2 rue de la Milétrie, 86000 Poitiers, France (e-mail: firstname.lastname@example.org).
Received December 21, 2012
Accepted April 21, 2013