Clinical and radiological comparison of unipedicular versus bipedicular balloon kyphoplasty for the treatment of vertebral compression fractures.

SUMMARY: To evaluate the efficacy of unipedicular kyphoplasty in the treatment of patients with osteoporotic vertebral compression fractures, we compared the pre- and postoperative clinical and radiological results in the unipedicular and bipedicular kyphoplasty groups. The clinical and radiological results of unipedicular kyphoplasty were as good as those of bipedicular kyphoplasty. INTRODUCTION: The purpose of this study was to evaluate the efficacy of unipedicular kyphoplasty in the treatment of patients with osteoporotic vertebral compression fractures. We compared the pre- and postoperative compression ratios (CRs), kyphotic angles (KAs), and visual analogue scale (VAS) scores of the patients in the unipedicular and bipedicular kyphoplasty groups. The results showed that the clinical and radiological results of unipedicular kyphoplasty were as good as those of bipedicular kyphoplasty. Percutaneous balloon kyphoplasty is a therapeutic option for patients with painful osteoporotic vertebral compression fractures (VCFs). Due to the relatively high-risk nature of the patient population, complications such as myocardial events, seizures, agitation, or dyspnea may occur and render completion of the procedure imprudent. We analyzed the clinical and radiological results of unipedicular and bipedicular balloon kyphoplasty for the treatment of vertebral compression fractures. METHODS: We retrospectively reviewed the records of 45 patients who underwent balloon kyphoplasty for the treatment of VCFs between January 2005 and April 2008. A unipedicular approach was used in 15 patients and a bipedicular approach was used in 30 patients. The CR, KA, and 100-point VAS score for pain were measured pre- and postoperatively in each patient. RESULTS: There was no significant difference in restoration of the CR (p = 0.376) and KA (p = 0.888) between the unipedicular and bipedicular kyphoplasty groups. The patients in the unipedicular group showed greater improvement in VAS score than those in the bipedicular group (p < 0.001). There were no postoperative complications, such as nerve injury or pedicle fracture, in either of the two groups. CONCLUSION: The clinical and radiological results of unipedicular balloon kyphoplasty for the treatment of VCFs were as good as those of bipedicular balloon kyphoplasty. Thus, unipedicular balloon kyphoplasty can be used as an alternative treatment for patients with VCFs.

The relationship between sagittal spinopelvic parameters and the degree of lumbar intervertebral disc degeneration in young adult patients with low-grade spondylolytic spondylolisthesis.

We investigated the relationship between spinopelvic parameters and disc degeneration in young adult patients with spondylolytic spondylolisthesis. A total of 229 men with a mean age of 21 years (18 to 26) with spondylolytic spondylolisthesis were identified. All radiological measurements, including pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis, sacral inclination, lumbosacral angle (LSA), and sacrofemoral distance, were calculated from standing lateral lumbosacral radiographs. The degree of intervertebral disc degeneration was classified using a modified Pfirrmann scale. We analysed the spinopelvic parameters according to disc level, degree of slip and disc degeneration. There were significant positive correlations between the degree of slip and pelvic incidence (p = 0.009), sacral slope (p = 0.003) and lumbar lordosis (p = 0.010). The degree of slip and the LSA were correlated with disc degeneration (p < 0.001 and p = 0.003, respectively). There was also a significant difference between the degree of slip (p < 0.001) and LSA (p = 0.006) according to the segmental level of disc degeneration.