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DOI: 10.1055/s-0043-123832
Retrospektiver Vergleich der Wirbelkörperaufrichtung nach Ballonkyphoplastie vs. Radiofrequenzkyphoplastie
Vertebral Body Height after Balloon Kyphoplasty vs. Radiofrequency KyphoplastyPublikationsverlauf
Publikationsdatum:
25. Januar 2018 (online)
![](https://www.thieme-connect.de/media/zfo/201803/lookinside/thumbnails/10-1055-s-0043-123832_ou5251-1.jpg)
Zusammenfassung
Hintergrund Neben schmerztherapeutischer Wirkung zielt die Kyphoplastie auf eine Aufrichtung osteoporotisch frakturierter Wirbelkörper (WK) ab. Ein neueres Verfahren ist die Radiofrequenzkyphoplastie (RFK). Unklar ist, wie gut sich mit dieser Methodik im Vergleich zur älteren Ballonkyphoplastie (BKP) wieder eine anatomische WK-Aufrichtung erreichen lässt. Ziel unserer retrospektiven Studie war daher der Vergleich beider Verfahren bez. der Grund-/Deckplattenwinkel post- vs. präoperativ.
Patienten und Methoden Anhand prä- und postoperativer Stehend-Röntgenaufnahmen wurden bei 87 Probanden (46 BKP und 41 RFK) bzw. 142 kyphoplastierten WK (67 BKP und 75 RFK) die Winkel von Grund- zu Deckplatte bestimmt. Hauptzielgröße war der Grad der Aufrichtung (Δpost−prä) bei der BKP vs. RFK. Außerdem wurden für die Bestimmung des sagittalen Alignments die angrenzenden gesunden Segmente ausgemessen.
Ergebnisse Sowohl bei der BKP (BKPprä: 11,5 ± 6,0°, BKPpost: 6,2 ± 4,6°, p < 0,001) als auch RFK (RFKprä: 9,9 ± 6,2°, RFKpost: 6,3 ± 4,4°, p < 0,001) kam es zu einer signifikanten Aufrichtung. Es zeigte sich im Verfahrensvergleich aber eine bessere Aufrichtung in der Gruppe BKP im Vergleich zur RFK (Δpost−prä BKP: − 5,3 ± 4,4°, Δpost−prä RFK: − 3,6 ± 4,4°, p = 0,03). Kein Verfahren führte aber im umgebenden Wirbelsäulensegment zu einer signifikanten Änderung des Winkels (Segment BKPprä: 13,8 ± 8,0°, Segment BKPpost: 12,5 ± 9,2°, p = 0,638; Segment RFKprä: 18,8 ± 14,3°, Segment RFKpost: 15,0 ± 13,2°, p = 0,330).
Schlussfolgerung Es konnte eine signifikant bessere Aufrichtung des Kyphosewinkels durch die BKP erreicht werden, wobei beide Verfahren für sich betrachtet zu einer hochsignifikanten Verbesserung des Kyphosewinkels geführt haben. Im angrenzenden Wirbelsäulensegment ist die Auswirkung auf den messbaren Winkel nicht signifikant ausgeprägt, sodass das Alignment durch den Eingriff tendenziell weniger beeinflusst wird.
Abstract
Background Kyphoplasty is used to alleviate pain and to restore the initial height of osteoporotic vertebral fractures (OVF). One of the most recent procedures is radiofrequency-targeted vertebral augmentation (RFTVA). We investigated whether restoration with this method is similar and as adequate as with the established procedure of balloon kyphoplasty (BKP), as assessed by the anatomical height of the vertebral body. The aim of our study was to compare the intravertebral angles (base-endplate) post- and preoperatively with these two procedures.
Patients and Methods The base and endplate angles were measured on 142 vertebral bodies treated by kyphoplasty (67 BKP and 75 RFTVA), on the basis of pre- and postoperative X-rays in the upright position in 87 volunteers (46 BKP and 41 RFTVA). The main object was to detect the degree of correction (Δpost−preop) with BKP compared to RFTVA. Furthermore, the sagittal alignment of the adjacent heathy levels were measured.
Results Significant correction was detected with both BKP (BKPpre: 11.5 ± 6.0°, BKPpost: 6.2 ± 4.6°, p < 0.001) and RFTVA (RFTVApre: 9.9 ± 6.2°, RFTVApost: 6.3 ± 4.4°, p < 0.001). Potential correction was greater with BKP than with RFTVA (Δpost−pre BKP: − 5.3 ± 4.4°, Δpost−pre RFK: − 3.6 ± 4.4°, p = 0.03). Neither procedures gave a significant change in the sagittal angle in the adjacent segment (segment BKPpre: 13.8 ± 8.0°, Segment BKPpost: 12.5 ± 9,2°, p = 0.638; Segment RFTVApre: 18,8 ± 14,3°, Segment RFTVApost: 15.0 ± 13.2°, p = 0.330).
Conclusion BKP gave significantly better correction, even though both methods were able to restore significant improvement in the kyphotic angle. In the adjacent levels, correction of the sagittal angle was not significant, although the influence of the intervention on alignment tended to be less.
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