Kyphoplasty for Osteoporotic Vertebral Compression Fractures:  Outcomes and Intradiscal Cement Leakage Type

Ahmadreza Reyhani Yassavoly; Taravat Yazdanian; Parisa Azimi; Alireza Bagheri; Zahra Farahzadi; Guive Sharifi

Kyphoplasty for Osteoporotic Vertebral Compression Fractures: Outcomes and Intradiscal Cement Leakage Type

Ahmadreza Reyhani Yassavoly

Abstract

Background: Kyphoplasty (KP) has been widely applied to treat painful osteoporotic vertebral compression fractures (VCFs).
However, knowledge about sequelae is still inadequate. This study aimed to assess outcomes following balloon KP in patients with
osteoporotic VCFs.
Methods: A total of 251 patients were included and classified into two groups: group A included 31 patients with braces for one
month after KP, and group B contained 220 patients without braces. Patients with intradiscal bone cement leakage were divided
into two groups according to spinal X-ray imaging with Round- type (n = 2) and Spike-type (n = 9). Operating efficacy was evaluated
via a comparison of the visual analog scale (VAS) and Oswestry Disability Index (ODI) before and after KP. Complications such as
adjacent vertebral fractures (AVFs) and remote vertebral fractures (RVFs) were observed.
Results: 361 vertebral bodies, including 153 thoracic vertebrae (42.4%) and 208 lumbar vertebrae (57.6%) were treated. Mean age of
patients was 73.3 [standard deviation (SD) = 6.4] years and 72.9% were women. Mean follow-up duration was 22.8 (SD = 13.2) months.
Operation average time was 35.2 (SD = 9.3) minutes. Average intraoperative fluoroscopy was 23.6 (SD = 9.8) times. Average volume of
bone cement injected into each vertebral body was 3.7 (SD = 0.9) ml. We observed 18 AVFs and nine RVFs within 1-31 months of
surgery. The remote fracture was 0% in group A and 4.1% in group B, which was also a statistically significant difference (P < 0.05). The
AVFs were 78% in group of Spike-type and 0% in group of Round-type, which shows a significant difference between the groups
(P < 0.05). All groups had significantly improved VAS and ODI at each follow-up time.
Conclusion: KP is an effective treatment for the management of osteoporotic VCFs, but it seems that intra-disc leakage with Spike-type
increases the risk of AVFs. We recommend patients wear braces for at least one month after KP to reduce pain and new fractures.

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Issue	Vol 11 No 2 (2025)
Section	Research Articles
Keywords
Kyphoplasty; vertebral compression fractures; intradiscal cement leakage; outcomes

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Reyhani Yassavoly A, Yazdanian T, Azimi P, Bagheri A, Farahzadi Z, Sharifi G. Kyphoplasty for Osteoporotic Vertebral Compression Fractures: Outcomes and Intradiscal Cement Leakage Type. J Orthop Spine Trauma. 2025;11(2):64-8.

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