Turkish Neurosurgery
Is Balloon Kyphoplasty Effective for Bone Remodeling of AO-Type A3–4 Fractures at the Thoracolumbar Junction
Inan Uzunoglu1, Gokhan Gurkan1, Baran Taskala2, Ilker Deniz Cingoz3, Murat Atar4, Ismail Kaya3, Kazim Ayberk Sinci5, Yusuf Kenan Cetinoglu6, Nurullah Yuceer1
1Katip Celebi Unıversity Ataturk Training and Research Hospital, Department of Neurosurgery, İzmir,
2Istanbul Basaksehir Cam And Sakura State Hospital, Department of Neurosurgery, Istanbul,
3Usak University School of Medicine, Department of Neurosurgery, Usak,
4Sultan Abdulhamid Han Training and Research Hospital, Department of Neurosurgery, Istanbul,
5Katip Celebi Unıversity Ataturk Training and Research Hospital, Department of Radiology, Izmir,
6Batman Training and Research Hospital,, Department of Radiology, Batman,
DOI: 10.5137/1019-5149.JTN.36660-21.2

Aim:Vertebral compression fractures (VCF) occur most commonly at the thoracolumbar junction (TLJ). Balloon kyphoplasty (BKP) is an effective method of bone remodeling in these cases. In this study, we evaluate the parameters that affect bone retropulsion and restoration in TLJ VCF without neurological deficits. Material and Methods:Thirty-one of Frankel E and AO A3–4 type VCFs fractures at the TLJ, with bone retropulsion into the spinal canal, from 2017 to 2020, were evaluated retrospectively. Data was gathered on patient demographics and medical histories. Measurements of anterior vertebral heights, posterior vertebral heights, local kyphotic angles, spinal cord area, and bone retropulsion into the spinal canal (BRC) were evaluated preoperatively, early postoperatively, and late postoperatively. Results:In those patients who underwent early surgery (<4 weeks postfracture), a significantly greater increase in anterior vertebral heights was seen between early postoperative and preoperative measurements than in patients who underwent late surgery (>4 weeks postfracture) (p = 0.016). At the six-month follow-up, a significantly greater decrease in local kyphotic angle measurements was seen in patients over 65 years of age than those under 65 (p = 0.023). Comparison of local kyphotic angles between sexes revealed a significant decrease in measurements at follow-up in female patients (p = 0.029). Both early postoperative and late postoperative local kyphotic angle measurements of patients with a body mass index (BMI) ≥25 were significantly lower than those of patients with a BMI <25 (p = 0.012). Conclusion:The restoration of vertebral angles and heights with the maximum level of BKP can effectively reduce BRC.

Corresponding author : Inan Uzunoglu