Influence of operative timing on the early post-operative radiological and clinical outcome after kyphoplasty.

Eur Spine J

Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery, Chariteplatz 1, 10117, Berlin, Germany.

Published: October 2020

Purpose: To clarify the relationship between operative timing and the early post-operative radiological and clinical outcome after kyphoplasty.

Methods: We conducted a retrospective cohort study including patients who underwent kyphoplasty of a single vertebra. Patients were divided into three groups (acute [< 2 weeks], subacute [2-6 weeks] or chronic [6-51 weeks]) based on the interval between fracture and surgery. The relative vertebral body height (VBH) and local kyphotic angle (LKA) of the fractured vertebra (measured on plain radiographs) as well as pain and use of analgesics were compared pre- and post-operatively (day 2) and between the groups.

Results: A total of 230 patients (100 with acute, 91 with subacute and 39 with chronic fractures) with fractures from T4 to L5 were included. In all groups, there was a significant post-operative improvement in the anterior (8.9-12.9%) and middle (10.7-13.4%) VBH (all groups: p < 0.001), LKA (acute: 3.8°, p < 0.001; subacute: 4.3°, p < 0.001; chronic: 1.7°, p = 0.046) and pain. The use of analgesics significantly decreased post-operatively in the acute and subacute groups, but did not significantly change in the chronic group. Patients from acute (p = 0.042) and subacute (p = 0.027) groups showed significantly better post-operative correction of the LKA than the chronic group.

Conclusion: Kyphoplasty is effective for vertebral height restoration as well as pain relief for both acute, subacute and chronic fractures. However, the achievable correction of the fracture-related local kyphosis decreases significantly after 6 weeks. Therefore, we recommend making a final decision about conservative vs. operative treatment within 6 weeks to ensure better height restoration in surgically treated patients.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00586-020-06491-8DOI Listing

Publication Analysis

Top Keywords

operative timing
8
timing early
8
early post-operative
8
post-operative radiological
8
radiological clinical
8
clinical outcome
8
influence operative
4
outcome kyphoplasty
4
kyphoplasty purpose
4
purpose clarify
4

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!