Purpose
Thoracolumbar vertebral compression fractures (VCFs) are a leading cause of kyphosis and related biomechanical complications, often resulting in chronic back pain and reduced function. Balloon kyphoplasty has been widely used as a minimally invasive intervention to provide pain relief and restore vertebral height. The SpineJack system is a relatively novel technique that introduces mechanical distraction, offering potentially enhanced vertebral restoration. This study aims to compare these two effective treatments for thoracolumbar fractures.
Materials and Methods
This study analyzed 30 patients with thoracolumbar VCFs surgically treated, using the Spine-Jack system (n=10) or balloon kyphoplasty (n=20). Back pain was evaluated as VAS pain score and functional disability was assessed with Oswestry Disability Index (ODI) preoperatively and immediately postoperatively. Radiological outcomes were measured on plain lateral X-rays, including vertebral height restoration, segmental kyphosis angle, and sagittal vertical axis (SVA). Complications, such as cement leakage and adjacent vertebrae fractures, were recorded. Continuous variables – with t-tests and categorical variables- with chi-square tests, were analyzed. P-value less than 0.05 was considered statistically significant.
Results
Both the Spine-Jack system and balloon kyphoplasty were effective in reducing back pain and improving patients’ function, with significant improvements in VAS and ODI scores. However, the Spine-Jack system demonstrated superior vertebral height restoration (85% vs. 72%, p=0.03) and segmental kyphosis angle correction (12° vs. 9°, p=0.032) when compared to balloon kyphoplasty. Complication rates were all low and comparable between the two groups.
Conclusions
Although the Spine-Jack system and balloon kyphoplasty are all effective for thoracolumbar VCFs, the Spine-Jack system offered superior radiological outcomes in selected cases. Further studies may explore their complementary roles in managing thoracolumbar VCFs.

Vertebral compression fracture is one of the most common osteoporotic fractures along with hip fractures. In some patients, pain was improved through conservative treatment including pharmaceuticals, bracing and physiotherapy. But it has been reported that conservative therapy is insufficient in many patients with vertebral compression fracture. Accordingly, interest in vertebroplasty has increased and many studies have been reported that vertebroplasty have therapeutic effects in acute vertebral compression fracture. On the other hand, some studies have been reported that the effect of vertebroplasty was not significant. So whether vertebroplasty is useful or not is still controversial. Therefore, in this review article, we will review open-label randomized controlled trials and blinded randomized controlled trials that provide high-level evidence and provide an opinion on which patients it is appropriate to perform vertebroplasty.

Introduction
We describe the complications that can occur after percutaneous vertebroplasty using bone cement for osteoporosis vertebral compression fracture. Main subject: The most common complication of percutaneous vertebroplasty is the leakage of bone cement. Leakage of bone cement has been reported variously and could leak into the spinal or neural foramen, adjacent intervertebral disc and soft tissues around the spine, and venous systems. The most serious complications are neurologic symptoms due to spinal cord and nerve root compression and complications associated with death due to heart and pulmonary embolism. In addition, recompression fracture or adjacent vertebral compression fracture might occur and various treatment methods have been proposed.
Conclusion
The complications that can occur after percutaneous vertebroplasty have been reported variously, including neurologic deficits due to the leakage of bone cement and lung and heart embolism. In addition, there is a possibility of recompression fracture or adjacent compression fracture. Therefore, you should be careful about percutaneous vertebroplasty. Finally, patients with many risk factors regarding complications of vertebroplasty would need close observation and follow-up.

When conservative treatment fails in the treatment of osteoporotic vertebral compression fractures, a minimally invasive procedure, such as percutaneous balloon kyphoplasty or vertebroplasty is performed. Among these, balloon kyphoplasty is known as an advantageous method for lower risk of cement leakage and greater correction effect of kyphosis and better sagittal balance correction. However, there are reports of various complications during and after procedure, and sometimes result in serious consequences. This paper reviews with previous literatures about the complications related to balloon kyphoplasty.

Purpose
To evaluate long term efficacy of percutaneous balloon kyphoplasty for osteoporotic compressive vertebral fracture.
Materials and Methods
Percutaneous balloon kyphoplasty was performed to 52 vertebral bodies, for 42 patients with compression fracture from March 2003 to October 2007. During observation, 32 patients (39 vertebral bodies) were followed over 5 years except 8 patients (19.0%) who have expired. Pre operational, post operational and final observational radiologic evaluation (vertebral height, compression ratio, kyphotic angle) and clinic evaluation(VAS score) were checked. And correlation with bone cement leakage, fracture of adjacent vertebral body, gender, age, bone mineral density and medication was analyzed.
Result
Average age was 71.3 years old and average observation period was 74.3 months. Average interval from injury to operation was 24.1 days. Vertebral compression ratio recovered 29.7% to 17.4% (12.3%), kyphotic angle improved 11.6 degree to 9.0 degree (2.6 degree) and there was no significant change until final observation. VAS score got better 7.60 to 3.57 (4.03) after operation. Bone cement leakage occurred in 5 cases (12.8%) and fracture of adjacent vertebral body occurred in 10 cases (25.6%), there was no correlation between two groups (p=1.000). Fracture of adjacent vertebral body showed meaningful correlation with bone mineral density only.
Conclusion
Percutaneous balloon kyphoplasty relieve the pain after compression fracture of vertebral body and is safe and efficient procedure to correct sagittal deformity. After 5 year follow up, the effect of procedure was maintained clinically. Bone cement leakage did not increase risk of fracture of adjacent vertebral body which occurred frequently in low bone mineral density.

Percutaneous vertebroplasty and balloon kyphoplasty are both safe and effective procedures in case of patients with osteoporotic vertebral compression fractures. The authors have already reported a new technique called lordoplasty using polymethylmethacrylate to manage vertebral osteoporotic compression fractures. The purpose and indication of lordoplasty do not differ from that of percutaneous vertebroplasty or balloon kyphoplasty. However, there are advantages of lordoplasty in terms of restoration of the wedge and kyphotic angle and cost-effectiveness compared with the other procedures mentioned above. For the advantages of lordoplasty, authors thereby introduce the detailed procedure of lordoplasty.

Purpose
Osteoporosis is an age-related systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone contents, with a consequent increase in bone fragility. In severe osteoporosis progressive collapse of multiple vertebrae is and unsolved problem. Medical treatment appears to be too slow to prevent the course. Recently, there are some reports on the results of the percutaneous vertebroplasty (VP) in treating the multi-level osteoporotic vertebral compression fractures (VCFs). we reviewed painful multi-level osteoporotic VCFs treated by percutaneous VP and assess the efficacy and safety of multiple percutaneous cement VP in the treatment of multi-level osteoporotic VCFs.
Materials and Methods
From January 2008 to August 2010, the clinical cases and radiographic records were reviewed retrospectively for 28 patients treated for the multi-level painful osteoporotic VCFs by percutaneous cement VP. Initially radiography and MRI of the spine were performed. Spine radiographs were repeated at post-operation, 1,3 months and final follow-up. The patient’s outcomes of demographic, clinical, radiologic and procedural data were analyzed and assessed using self-report and physiological measures. A t-test was used for means of VAS, anterior vertebral height and kyphotic angle. Statistical analysis was performed with the SPSS(Version 15.0.1, Chicago, Illinois). The p-values of < 0.001 were deemed significant.
Results
The back pain recorded using the VAS improved significantly in all cases, from 7.7±1.0(6-10), points preoperatively to 2.0±0.7(1-3) points postoperatively (p<0.001) and then 2.8±0.8(1-4) points at the follow-up (p<0.001). The anterior heights increased from 17.40±4.98 to 21.02±5.36 after VP procedures (p<0.001) and finally 19.49±5.28 (p<0.001). The kyphotic angle was 12.58º preoperatively and improved to 4.39º postoperatively, but kyphotic deformities became worse in 12.80º.
Conclusion
The vertebroplasty for patients with multiple osteoporotic vertebral compression fractures may improve pain and can be effective for preventing adjacent fractures, restoration of vertebral height and maintenance of sagittal alignment. Patients with multiple osteoporotic compression fractures have many comorbidity, the surgeon should be conscious to all procedure.

Purpose
To find the factors that affecting surgical outcome after vertebroplasty and kyphoplasty in osteoporotic compression fracture.
Materials and Methods
Pre-operative, post-operative, technical, radiological factors of patients who diagnosed osteoporotic compression fracture and treated with vertebroplasty or kypholasty during from January 2008 to December 2010, were compared by outcomes that acute and chronic back pain, refracture rate and maintenance of the reduction of body height.
Results
The period of acute pain after the operation was less than 3 days in groups of trauma( p=0.0262) and hospital treatment(p=0.0113) before the operation as pre-operative factors. When it comes to technical factors, the cases of vertebroplasty(p<0.0001), injection of cement(p=0.0053), the case without leakage of cement(p=0.007) and the case being under anesthesia (p<0.005)achieved statistical significance. In the groups who got conservative treatment less than 1 week (p=0.0119) and local anesthetics(p=0.0246), refractures occurred many times. The groups of non-trauma(p=0.0105), having had more than 30% compression(p=0.0244) and the group that prescribed bisphosphonate(p=0.0286) statistical significantly maintained restoration.
Conclusion
Conservative treatment in the hospital for more than 1 week before the operation, operation being under anesthesia and intake of bisphosphonate after the operation put positive effects on the outcome of vertebroplasty and kyphoplasty.