Selective unilateral percutaneous balloon kyphoplasty with viscosity gradient cement injection for kyphosis and scoliosis induced by osteoporotic vertebral compression fractures

Objective To evaluate the feasibility and therapeutic effects of selective unilateral percutaneous balloon kyphoplasty by injection of multi-viscosity bone cement in the treatment of kyphosis and scoliosis induced by senile osteoporotic vertebral compression fractures (OVCF). Methods The clinical data of 16 cases of OVDF (17 vertebral bodies) in our hospital between June,2013 and October,2015 were analyzed retrospectively.Preoperative CT and X-ray showed that vertebral bodies were with anterior and lateral vertebral compression fractures,and spine with kyphosis and scoliosis.The unilateral percutaneous balloon kyphoplasty was conducted by the concave side of vertebral compression.Balloon was inflated in order to re-expand the vertebral body and to create a void in its spongy bone.The gradient viscosity of bone cement was slowly injected under fluoroscopic guidance to ensure there was no leakage of cement outside of the vertebral body.The operative time and frequency of X-ray imagining were documented.Visual Analogue Pain Scale (VAS) and Oswestry Disability Index (ODI) were used to assess fracture-related pain and patient's disability.The preoperative and postoperative radiographic parameters were compared. Results The mean operative time was 29.6 min (25-43 min),the average number of fluoroscopy was 18.6(13-21).The mean kyphosis and scoliosis (Cobb angle) and injured vertebral height (front and central part) was improved significantly (P<0.05).The difference in VAS and ODI scores before and after the operation was significant (P<0.01).The procedure-related complications such as epidural cement leakage or neural damage were not demonstrated in the study. Conclusion Selective unilateral percutaneous balloon kyphoplasty with viscosity gradient cement injection is a simple,safe and effective minimally invasive procedures for scoliosis and kyphosis caused by osteoporotic thoracolumbar compression fractures.It can accurately restore and fix the fractured vertebra.The multi-viscosity bone cement can strength the injured vertebra and reduce the epidural cement leakage,with less number of fluoroscopy.