Vertebral Body Stenting: Early Results with a New Technique for the Treatment of Vertebral Compression Fractures
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- Category: Vol. 81, December 2013
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Vertebral Body Stenting: Early Results with a New Technique for the Treatment of Vertebral Compression Fractures, ESLAM E. ALY and MOKHTAR E. ABDEL AZEEM
Abstract
Background: Balloon kyphoplasty is an established min-imally invasive procedure to restore vertebral body height, and internally stabilize osteoporotic and/or cancer related vertebral compression fractures. In the same time there is a technique inherent problem with the amount of reduction; when filling the kyphoplasty balloons, an acceptable reduction is achieved in many patients. However, the resulting final reduction after cementing is about 25% lower due to the partial collapse after balloons deflation. In order to avoid this loss of reduction, a newer alternative technique has been introduced, based on the principles of balloon kyphoplasty and vascular stenting.
Study Design: A prospective consecutive cohort study of clinical and radiographic results after vertebral body stenting for treatment of vertebral compression fractures.
Objectives: To evaluate the safety and effectiveness of Vertebral body stenting as a new technique to treat symptomatic vertebral compression fractures.
Methods: A total of 3 3 elderly patients with 52 symptom-atic vertebral compression fractures were enrolled in a pro-spective study of Vertebral body stenting. Clinical outcomes were measured pre- and postoperatively using the visual analogue scale (VAS), Oswestry Disability Index (ODI) and ambulatory status (AS). All outcomes were assessed before the procedure, and at 1, 12, 24, and 36 weeks after the proce-dure.
Results: The median VAS scores went from 10.0 preop-eratively to 6 at one week post-operatively, to 5 at 12 weeks following the procedure and to 2 and 1 at 24 weeks and last follow-up, respectively. The pre-operative ODI score was 80 before the operation, improved to 45 at one week post-operatively, decreased to 35 at 12 weeks and to 22 and 18 at 24 weeks and last follow up, respectively. The ability to move independently and ease of ambulation significantly improved after the procedure (p<0.001). The median kyphosis angle was 15.0 degrees before the procedure and decreased by a median of 4.5 degrees after the operation.
Conclusions: Elderly patients with symptomatic vertebral compression fractures had rapid, significant, and sustained improvements in back pain, back function, and quality of life following Vertebral body stenting.