Treatment of typical amyelic somatic fractures with kyphoplasty and calcium phosphate cement: a critical analysis

Purpose Vertebroplasty and more recently kyphoplasty are recognized as techniques in the treatment of osteoporotic vertebral fractures and in case of pathological fracture like in secondary tumors. The recent introduction of calcium phosphate cement (CPC) that offers, at least theoretically, an osteointegrative capacity, absent in polymethyl methacrylate (PMMA), has generated interest for its use in the treatment of traumatic fractures (type A) even in young patients. Methods In this study, type A fractures without neurological signs were treated. A total of six male patients, of age between 21 and 55 years (mean age 38 years), were included. Fracture treatment was performed with kyphoplasty with balloon (Kyphon) and injection of calcium phosphate cement for a total of seven procedures. Results The results were evaluated according to the regional kyphosis angle and the local kyphosis angle. The postoperative X-ray control showed an average improvement of the regional kyphosis angle of 7.4 degrees; however, this value was reduced by an average of 6.6 degrees after 45 days with regard to the postoperative control. The local kyphosis angle showed an average improvement of 9 degrees at the postoperative control with an average worsening of 9.2 degrees in the control after 45 days. Conclusions While kyphoplasty with the use of CPC in the treatment of type A traumatic fractures was effective in the treatment of pain, it has not been so far effective concerning the maintenance of the reduction obtained intra-operatively and its osteointegrative effect.