Kyphoplasty with Calcium Phosphate Cement (Calcibon®) in Osteoporotic Vertebral Fracture

Abstract

Study Design: A retrospective study\rObjectives: We analyzed clinical and radiological results to verify the efficacy of calcium phosphate cement in kyphoplasty for\rtreatment of osteoporotic vertebral fracture.\rSummary and Literature Review: Calcium phosphate is a biocompatible alternative to PMMA for vertebral augmentation in\rpainful osteoporotic vertebral fracture as it is osteoconductive, non-exothermic, and injectable.\rMaterials and Methods: We analyzed 45 cases treated from April 2005 to August 2006 with a minimum of 1 year follow-up.\rPreoperative and post operative pain scores (visual analogue scale), ambulatory status, and patient satisfaction were measured.\rAnterior vertebral height, as well as the status and size of cement were assessed radiologically preoperatively, postoperatively,\rand at 3 months and 1 year.\rResults: Pain scores (visual analogue scale) and ambulatory status improved significantly after kyphoplasty and remained\runchanged during follow-up. Overall patient satisfaction was 93%. Radiological findings showed that mean vertebral height\rwas significantly higher than preoperative (p�0.05). According to follow-up radiological finding, we divided cases into 4\rgroups: Group 1, 2; maintained vertebral height with minimal or some cement resorption; Group 3, 4; cement crack resorption\rand vertebral collapse. Group 1, 2 and Group 3, 4 had 38 patients (84%) and 7 patients(16%) respectively. Revision surgery was\rneeded in 3 cases (antero-posterior surgery in 2 cases of group 4, and decompression in 1 case of extravasation into the neural\rcanal).\rConclusions: Kyphoplasty with calcium phosphate may be a good alternative for treatment of osteoporotic vertebral fracture,\rbut non-union of the vertebral body with a large cleft showed a high risk of premature resorption and collapse of the vertebral\rbody. The presumed advantage over PMMA needs longer follow-up.