700,000 vertebral compression fractures occur in the US annually with over 90% caused by osteoporosis (1). A third of vertebral compression fractures cause chronic spinal pain. Percutaneous techniques such as kyphoplasty and vertebroplasty are useful in treating these fractures. Common contraindications to these procedures include planar fractures, radicular pain, fracture of posterior cortex, epidural disease and spinal cord compression (2,3).

Severe vertebral compression fractures resulting in vertebra plana can be associated with chronic axial pain. The mechanism involves movement of the fracture fragments with respiratory excursion and axial spine loading maneuvers. The abstract describes the use of balloon kyphoplasty to treat symptomatic planar vertebral fractures.

Methods:

We describe a series of 5 patients with planar vertebral compression fractures, successfully treated with percutaneous kyphoplasty. All patients were evaluated at the MD Anderson Cancer Center Pain Management Clinic. Patients with significant concordant spine pain were included. Preoperative imaging including spine MRI was performed to identify the symptomatic vertebral levels. Patients with recent compression fractures involving more that 70% height loss were included in this report. The patients were followed in the clinic post procedure and information was obtained about analgesic use, visual analogue pain scale score and functional activity.

Results:

Kyphoplasty of planar vertebral compression fractures was found to be both safe and effective in producing analgesia, reducing analgesic requirements and improving function. No significant complications such as infection, cement embolization or extravasation into the neural foramen or spinal canal were seen.

Discussion:

Kyphoplasty is a safe and effective technique for treatment of symptomatic planar vertebral compression fractures. The procedure is technically demanding and should only be attempted by skilled and experienced operators to avoid serious complications.