EVALUATION OF THE RESULT OF THORACIC LUMBAR KYPHOPLASTY

EVALUATION OF THE RESULT OF THORACIC – LUMBAR KYPHOPLASTY IN THANH NHAN HOSPITAL Phan Minh Trung, Ha Van Linh

Subject Osteoporotic vertebral compression fractures are a menace to the elderly generation causing diminished quality of life due to pain and deformity Kyphoplasty has become a popular tool to address painful thoracic and lumbar compression fractures.

Subject Since 2014, Kyphoplasty technique has been performed in Neurosurgery department of Thanh Nhan with inspirit outcomes. We carry out this study in order to: Evaluation of the results of Kyphoplasty in Thanh Nhan hospital

Objective 96 patient underwent kyphoplasty in Thanh nhan hospital from 5/2015 to 5/2017 Method Descriptive, retrospective study

Procedure 1. Patient in prone position

Procedure 2. Mark the target poins under flouroscope guidence

Procedure 3. Skin antiseptic by Povidone iod 10% and local anesthesie by lidocain 0, 2%

Procedure 5. Insert trocart to VB through pedicle under fluoroscope guidence

Procedure 6. Making tunel intra VB by drill needle for balloon and inflate the balloon to make a cavity

Procedure 7. Injecting cement in to VB through trocart

Procedure 8. Observe careffuly when injecting cement in real-time mode fluoroscope

RESULTS

1. Age <40 40 to <60 60 to <80 >= 80 Mean value Min: 28 yrs, Max: 91 yrs N 2 12 49 33 % 2, 1 12, 5 51 34, 4 67. 8 +/- 17. 5 2. Sex N % Female 77 80, 2 Male 19 19, 8

3. Trauma history Trauma N % Yes 87 90, 6 No 9 9, 4

4. Imaging Number of VCF N % Single 91 94, 8 Multi VB 5 5, 2 Level D 10 D 11 D 12 L 1 L 2 N=101 8 14 52 26 2 % 7 13, 9 51, 4 25, 7 2

VCF grade N=101 % Grade 1 65 64, 3 Grade 2 26 25, 8 Grade 3 10 9, 9 Marrowbone edema MRI Yes N=101 % 96 95 No 5 5

Lumbar N Ty lê % 0 0 Femur N Ty lê % 0 0 -2, 5 < T-score < -1 13 13, 5 26 27, 1 T-score < -2, 5 83 86, 5 70 72, 9 Tô ng 96 100 T-score -1 < T-score

5. Surgery Ø volume of cement injected: min 2, 5 ml, max 6, 5 ml, mean volume 4 +/- 1, 25 ml Trocart N=101 % Single 17 16, 8 Two 84 83, 2

VAS pre op, post op and 3 months follow up

Complications N=101 % 9 11 Venous extravasation 2 2 2 Allergic 0 Infection 0 Mortality 0 Cement leakage Disc Spine canal Out of VB All complications are asymptomatic

Conclusion Kyphoplasty is an effective tool to treat pain caused by thoracolumbar vertebral compression fractures. The complication rate of kyphoplasty is dramatically lower than in alternative open instrumented procedures, and the immediate pain reduction is significantly greater in kyphoplasty compared to conservative treatment.

Thanks for your attention