JOURNAL ARTICLE

Efficacy of Postural Reduction of Vertebral Compression Fracture with Extension Lateral Radiograph Prior to Vertebroplasty

Jae Jun Yang, Ki Hyoung Koo, Kyunghwi Kim, Sehan Park
World Neurosurgery 2020 August 1
32750516

OBJECTIVE: This retrospective comparative study aimed to evaluate the efficacy of postural reduction of vertebral compression fracture (VCF) using the hyperextension posture prior to vertebroplasty (VP) METHODS: Sixty-five consecutive patients who underwent VP were retrospectively reviewed. Thirty patients who underwent passive expansion of compression fracture prior to VP (postural reduction vertebroplasty [PRV] group) were compared with 35 patients who underwent in situ vertebroplasty (ISV group). Patient characteristics, complications, local kyphosis angle (LKA), Cobb's angle (CA), sagittal index (SI), anterior body height (ABH), and posterior body height (PBH) were assessed.

RESULTS: LKA and SI significantly improved from preoperative measurements at the final follow-up in the ISV and PRV groups. ABH significantly improved only in the PRV group and ABH improvement at the final follow-up was significantly greater in the PRV group. However, there were no significant differences in LKA, CA, SI, ABH, and PBH at the final follow-up. Within the subgroup analysis of patients with preoperative ABH ≤15 mm, ABH and amount of ABH improvement at the final follow-up was significantly greater in the PRV group.

CONCLUSION: Hyperextension postural reduction demonstrated superior ABH improvement. It also demonstrated higher ABH at the final follow-up when performed on patients with preoperative ABH ≤15 mm. Although routine hyperextension postural reduction should be carefully approached, postural reduction using SELR would provide a more effective VBH restoration in patients with moderate collapse of VCF with ABH ≤15 mm.

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