ORIGINAL ARTICLES   

Journal of Neurosurgical Sciences 2005 December;49(4):147-53

Copyright © 2006 EDIZIONI MINERVA MEDICA

lingua: Inglese

Balloon kyphoplasty in traumatic fractures of the thoracolumbar junction. Preliminary experience in 12 cases

De Falco R., Scarano E., Di Celmo D., Grasso U., Guarnieri L.

Santa Maria delle Grazie Hospital ASL Na2, Pozzuoli, Naples

Aim. The purpose of this study was to assess the effectiveness and safety of Ballon Kyphoplasty as a new method of treatment for traumatic fracture of the thoracolumbar junction.
Methods. We treated twelve patients 8 patients male and 4 female. The average age was 47,3 years (22-75 years). The interested vertebrae and therefore the procedures have been 13 since in a patient two vertebrae have been treated. In 9 cases the interested vertebra was L1, in 2 cases L2 and one case D11 and D12. Following the classification of Magerl 9 fractures were of A1.2 fractures and one fracture respectively of type A1.3, A2.2, A2.3, A3.1. We have never placed indication to Balloon Kyphoplasty in the fractures of the type B and C, neither in the complete burst fractures (A3.2 and A3.3), neither in the fractures of the A1.1 type. Balloon Kyphoplasty has been carried out using the Kyphon system (Kyphon Inc. Sunnyvale, CA, USA). In the patients older than 50 years (7 cases) we have used polymethylmethacrylate (PMMA), as filling material, while in the patients younger than 50 years (5 in total), we have used Calcibon (Biomet, Inc.Warsaw, Indiana) in 4 cases and in one case a new material called KyphOs (Kyphon Inc. Sunnyvale, CA, USA). These last two types of material are made up of tricalcium phosphate that, although less manageable of the PMMA and less resistant initially, in the time it will be reabsorbed and osteointegrated.
Results. The method demonstrated swift pain relief associated with an evident augmentation in the resistance and restoration of the vertebral body’s physiological shape. No patient has worn a postoperative orthesis. In all the cases we obtained an optimal stabilization in the follow-up minimal to 4 months. In no case we observed a structural yielding of the vertebra.
Conclusions. Kyphoplasty is an effective, alternative, simple and safe treatment of traumatic fracture of the thoracolumbar junction.