Preoperative scoring system for predicting early adjacent vertebral fractures after Balloon Kyphoplasty |
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| Authors: | Koji Matsumoto Masahiro Hoshino Keita Omori Hidetoshi Igarashi Hiromi Matsuzaki Yasuaki Tokuhashi |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, 30-1 Oyaguchikamimati, Itabashi-ku, Tokyo, 173-8610, Japan;2. Department of Orthopaedic Surgery, Sonoda Medical Institute Tokyo Spine Center, 2-5-10 Ikohoncyo Adati-ku, Tokyo, 121-0807, Japan;1. Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Aichi, Japan;2. Department of Spine and Spinal Cord, Fujita Health University, Aichi, Japan;3. Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Tokyo, Japan;1. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan;2. Sato Orthopedic Clinic, 5-4-1-16 Nakakasai, Edogawa-ku, Tokyo, 134-0084, Japan;3. Seisen Clinic, 191-1 Kakita, Shimizu-cho, Sunto-gun, Shizuoka, 411-0904, Japan;4. Tsuruta Orthopedic Clinic, 1241-6 Ushizuchoukatsu, Ogi city, Saga, 840-0306, Japan;5. Hashiguchi Orthopedic Clinic, 1-41-3 Komatsubara, Kagoshima city, Kagoshima, 891-0114, Japan;6. Hamamoto Orthopedic Clinic, 40-5 Johoku, Aoi-ku, Shizuoka city, Shizuoka, 420-0805, Japan;7. Fuji Orthopedic Hospital, 1-4-23 K|Nishiki-cho, Fuji city, Shizuoka, 417-0045, Japan;8. Yamanaka Orthopedic Clinic, 1-28-6 Shikiji, Suruga-ku, Shizuoka city, Shizuoka, 422-8036, Japan;1. Orthopaedic Research & Biotechnology Unit, The Children''s Hospital at Westmead, Sydney, NSW, Australia;2. Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia;1. Department of Othopaedic and Spine Surgery, Fukuoka Children''s Hospital, 5-1-1 Kashii Teriha, Higashi-ku, Fukuoka 812-0017, Japan;2. Department of Othopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan;3. Department of Othopaedic Surgery, Saga Handicapped Children''s Hospital, 2215-27 Kinryu, Kinryu-machi, Saga 849-0906, Japan;1. Department of Orthopedic, China-Japan Friendship Hospital, Peking Union Medical College, Chinese Academy of Medical College, Beijing, 100853, China;2. Department of Orthopedic, The 980th Hospital of Joint Logistic Support Force of PLA, China;3. Chinese PLA Institute of Otolaryngology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, 100853, China |
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| Abstract: | BackgroundAdjacent vertebral fracture (AVF) is a major complication following Balloon Kyphoplasty (BKP). There is no scoring system for predicting AVF using only preoperative elements. The purposes of this study were to develop a scoring system for predicting early AVF after BKP based on preoperative factors and to investigate the appropriate surgical indication for BKP.MethodsOf 220 patients who underwent BKP at a single institution since 2011, 65 patients over the age of 60 who had undergone a standing whole spine X-ray preoperatively were enrolled. Factors affecting the occurrence of early AVF were examined. A scoring system was created consisting of the factors exhibiting significant differences, and the correlation between the total score and the incidence of early AVF was investigated.ResultsTwenty of the 65 patients (30.8%) had early AVF. In a univariate analysis, age, previous vertebral fracture, pelvic tilt, and Local kyphosis significantly influenced early AVF. In a multivariate logistic regression analysis, age had an odds ratio of 1.136 (95% CI 1.001–1.289), previous vertebral fractures 4.181 (1.01–17.309), and Local kyphosis 1.103 (1.021–1.191). The scoring system was set as follows: ①Age (<75 years: 0 points(P), 75years≦: 1P), ②The number of previous vertebral fractures (0: 0 P, 1: 1P, 2: 2P, 3 or more: 3P), and ③Local kyphosis (<10°: 0P, 10°≦: 1P). There was a correlation between the total score and the incidence of early AVF (r = 0.812, 1P = 0.05). The incidence of early AVF was 6.4% (2 cases/31 cases) for a score of ≦1P and 54.5% (18 cases/33 cases) for a score of ≧2P.ConclusionsThere was a correlation between the total score and the incidence of early AVF. A score of 1 point or less may represent the appropriate surgical indication for BKP. |
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