RESULTS OF PERCUTANEOUS BALLOON KYPHOPLASTY WITH AN EXTRAPEDICULAR APPROACH FOR THE TREATMENT OF OSTEOPOROTIC THORACIC VERTEBRAL COMPRESSION FRACTURES

Văn Cường Vũ, Hồng Phong Phạm

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Abstract

Objective: To assess the results of percutaneous balloon kyphoplasty with an extrapedicular approach for the treatment of osteoporotic thoracic vertebral compression fractures. Subjects and Methods: descriptive prospective study of 48 patients with osteoporotic thoracic vertebral compression fractures treated by percutaneous balloon kyphoplasty with an extrapedicular approach at Viet Duc Hospital. Results: 48 patients (15 males, 33 females) with an average age of 68,41 ± 8,21 (range 64 – 93 years) diagnosed with osteoporotic thoracic vertebral compression fractures, treated by percutaneous balloon kyphoplasty with an extrapedicular approach. The rate of single vertebral fracture was 79,17%, and two-level fractures were 20,83%. Most patients had Grade 2 and Grade 3 fractures according to the OF classification, with rates of 68,9% and 27,7%, respectively. A total of 58 thoracic vertebrae were treated with cement augmentation, with an average volume of 3,06 ±1,26ml of cement injected per vertebral body. The rate of cement infiltration over two-thirds of the vertebral body was 62,1%, under one-third was 6,9%, and between one-third and two-thirds was 31,0%. The rate of cement leakage anterior to the vertebral body was 13,8%, into the intervertebral disc was 8,6%, and into the pre-vertebral vasculature was 3,4%. There was no correlation between the degree of vertebral collapse and postoperative outcomes. The average VAS score before cement injection was 7,22 ± 1,17; after 24 hours it was 1,67 ± 0,57; and at the follow-up examination it was 0,86 ± 0,16. According to MacNab's classification, postoperative outcomes were rated as good and fair in 95,8% of patients, and average in 4,2%, with no patients experiencing poor results. Conclusion: Percutaneous balloon kyphoplasty with an extrapedicular approach for the treatment of osteoporotic thoracic vertebral compression fractures is a safe treatment method with a low risk of complications, effectively providing rapid pain relief, improving motor function, and enhancing the quality of life for elderly patients.

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References

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