• Robert Pflugmacher, Anand Agarwal, Frank Kandziora, and Cyrus K-Klostermann.
• Charité-Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie, Campus Virchow-Klinikum, Augustenburgerplatz 1, Berlin, Germany. robert.pflugmacher@charite.de
• J Orthop Trauma. 2009 Feb 1; 23 (2): 126-31.

ObjectiveClinical and radiologic follow-up of patients with osteoporosis with painful, traumatic A3-type vertebral compression fractures in the thoracic and lumbar spine.DesignProspective study over the period of 1 year.SettingLevel I Trauma Center.Patients And InterventionTwenty-five patients with osteoporosis (14 women and 11 men) and painful, traumatic A3-type fractures were treated with Balloon Kyphoplasty in combination with a short-segment posterior fixation (using the Universal Spine System). Twenty-one patients returned for their 1-year follow-up visit. X-rays were taken preoperatively, postoperatively, and at 3, 6, and 12 months' follow-up to evaluate vertebral height and local Cobb angle. Pain was measured using the self-reporting Visual Analogue pain Scale (VAS). Disability was measured using the Oswestry Disability questionnaire (ODI).ResultsThe mean pain score (VAS) improved significantly from pretreatment to posttreatment from 7.8 +/- 2.2 (5.6-10) to 4.9 +/- 2.1 (2.8-8.0) (P < 0.001). It improved further to 2.9 +/- 1.4 (2.1-4.3) at 3 months and increased slightly after 1 year (3.8 +/- 1.9) (1.9-4.7). Limitation of daily activities (ODI) improved significantly from 88% (78-100) to 35% (15-48) at 3 months (P < 0.05). Improvement was maintained at 1 year at 36.5% (10-42). At 1-year follow-up, maintenance of the height restoration and kyphotic deformity correction was found.ConclusionsBalloon Kyphoplasty in combination with short-segment posterior instrumentation in traumatic A3 vertebral fractures led to a significant reduction in pain and disability. The combination of both surgical techniques was able to restore and maintain vertebral body height and correction of angular deformity. This technique might offer important safety advantages over an invasive anterior-posterior approach.

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