D. M. Self1, J. Amburgy2, J. Mooney2, M. R. Chambers2 1University Of Alabama at Birmingham,School Of Medicine,Birmingham, Alabama, USA 2University Of Alabama at Birmingham,Department Of Neurosurgery,Birmingham, Alabama, USA
Introduction:
Kyphoplasty is a minimally invasive surgery developed to restore height and reduce pain associated with vertebral compression fractures. However, there is minimal data on the association of vertebral height restoration or injected cement volume with patient outcomes. The objective of this analysis is to determine whether height restoration or injected cement volume following Kyphoplasty is associated with improvements in pain, disability, and quality of life.
Methods:
Fifty-Nine Medicare-eligible patients with 1 to 3 painful VCFs between T5 and L5 due to osteoporosis or cancer underwent kyphoplasty. Anterior, middle, and posterior heights of vertebral bodies were measured pre/post-operatively utilizing computerized lateral thoracic and/or lumbar x-rays. The total volume of bone cement injected (left side + right side volumes) were recorded for each patient. Additionally, patient outcomes with EQ5D, VAS and ODI were compared pre- and post-operatively. Pearson correlations as well as linear regression models were derived for association of total cement volume with patient outcomes.
Results:
For VAS, ODI, and EQ5D improvements, neither Pearson correlations (r= 0.042, 0.167, and 0.091), respectively, nor multiple linear regression models (R²= 0.002, 0.029, 0.023), respectively, reveal either a correlation or an association with total cement volume. Additionally, neither Pearson correlations (r coefficients ranging from 0.001-0.152) nor linear regression models (R² values ranging from 0.0002-0.1133) reveal either correlation or association between anterior, middle, or posterior vertebral body height improvements with VAS, ODI or EQ5D improvements.
Conclusion:
This is the largest known study to assess associations of vertebral body height improvements and cement volumes with patient outcomes. Most patients improved regardless of the vertebral height improvements or cement volumes injected.