John Dabis, Hani Abdul-Jabar, Matt Smith and Michael Kotrba

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Presentation transcript:

Extended Indications for Balloon Kyphoplasty – use of the curette to treat Vertebra Plana John Dabis, Hani Abdul-Jabar, Matt Smith and Michael Kotrba Croydon University Hospital Spinal Unit BASS, Norwich 2013

AIM Describe a surgical technique to restore anterior, middle and posterior vertebral body height in vertebra plana Does vertebra plana correction lead to improved kyphotic angles? And does this lead to better outcomes?

Methods Retrospective review Between 2010-2013 – 148 procedures (single - multi-level) Calculated kyphotic angles Short term outcomes SF-36 and VAS Inclusion criteria All vertebra plana fractures

Calculation of Kyphotic angle

Kyphotic angle and Outcome summary Pre op angle Pre op VAS Post op angle Post op VAS 12 month SF36 Patient A 29 7 4 3 82 Patient B 34 9 12 2 88 Patient C 38 10 6 5 * Patient D 26 8 4.5 Patient E Patient F 31 90 Patient G 27 11.5 Patient H 68 Patient I 75 Patient J 35

Surgical Technique

Discussion Kyphoplasty: indications, contraindications and technique Masala S, Fiori R, Massari F, Simonetti G. Radiol Med. 2005 The main contraindications are coagulation disorders, unstable fractures or complete vertebral collapse (vertebra plana).

Evidence Balloon kyphoplasty for vertebra plana with or without osteonecrosis S Becker, A Tuschel, A Chavanne, J Meissner, M Ogon Journal of Orthopaedic Surgery 2008 Preliminary results with modified techniques of balloon kyphoplasty for vertebra plana, traumatic fractures and neoplasms Becker S, Meissner J, Bartl R, Bretschneider W, Ogon M Acta Orthop Belg. 2006

Conclusion Vertebra plana is not a contraindication to balloon kyphoplasty The use of the curette is critical in determining the direction of the balloon tamp passage