Patients maintain post-kyphoplasty vertebral height improvements at two years

At two-year follow-up, 81% of patients walked independently - just 10% required narcotics.

Patients treated with balloon kyphoplasty for vertebral body fractures maintain improvements in pain and function for at least two years following surgery, a retrospective study shows.

John T. Ledlie, MD, and Mark B. Renfro, MD, neurosurgeons at Tyler Neurosurgical Associates in Tyler, Texas, analyzed clinical and radiological outcomes for 117 patients treated with kyphoplasty for 151 vertebral fractures. Of these, 77 patients (97 fractures) completed at least two years’ follow-up.

Most patients had osteoporotic spinal fractures that did not respond to conventional treatment involving pain therapy, bed rest and bracing prior to surgery. Nearly half of all fractures had at least a 50% collapse prior to treatment.

Vertebral heights significantly increased postoperatively (P<.003), with 90% of fractures increasing at least 10% compared to adjacent control vertebrae. Morphometric height ratios also significantly increased for treated fractures (P<.001). Patients maintained increases in vertebral height at two years follow-up and had a less than 5% rate of new symptomatic fractures per year, according to the study, published in the journal Spine.

Of the 77 patients evaluated at two years, only 2% could walk independently preoperatively and 81% required narcotic analgesics for pain. At one-week postop, 76% could walk without difficulty, 19% required narcotic analgesics and over 50% required no pain medication, according to a press release announcing the results.

Additionally, 68% of patients reported complete pain relief at one week, which increased to 86% at six months and to 90% at two years follow-up. Also, at two years follow-up, 81% of patients could walk independently, only 10% required narcotic pain medications and 80% required no pain medications.

No patients experienced any kyphoplasty-related complications, the authors noted.

“Our study shows that using balloon kyphoplasty to repair spinal fractures provides immediate and sustained improvements in function and mobility, a significant benefit for elderly patients,” Ledlie said in the press release.

“Prior to treatment, the vast majority of patients could not walk without assistance and required the strongest prescription medications to control pain. One week after the procedure, more than three-quarters of the patients could walk independently and without difficulty, and more than half no longer needed pain medication of any type,” he said.

For more information:
Ledlie JT, Renfro MB. Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits. Spine. 2006;31:57-64.