Secondary balloon kyphoplasty for new vertebral compression fracture after initial single-level balloon kyphoplasty for osteoporotic vertebral compression fracture

To explore the efficacy of secondary balloon kyphoplasty (BKP) for new vertebral compression fracture (NVCF) of previously non-fractured, non-treated vertebrae after previous BKP and to compare the therapeutic effect between patients with single-level adjacent NVCF and remote NVCF. We retrospectively studied patients with single-level NVCF after initial BKP in our hospital from January 2007 to August 2014. The mean follow-up time from secondary BKP was 13.78 +/- 3.18 (12-24) months. Visual analog scale (VAS) and Oswestry disability index (ODI) scores were assessed prior to the initial BKP, one day after initial BKP, prior to the secondary BKP, one day after the secondary BKP, and at last follow-up. Kyphotic angle and vertebral heights were also compared for secondary BKP. Data were compared between patients with adjacent NVCF and remote NVCF. 36 patients were investigated. Compared with pre-operative value of initial and secondary BKP, patients in both groups gained statistical significant improvements for VAS and ODI after initial and secondary BKP, respectively (P < 0.05), and this improvement maintained at final follow-up. No statistical difference in VAS was found between the 2 groups after initial BKP and prior to the secondary BKP (P > 0.05), but patients in remote NVCF group achieved better VAS score than patients in adjacent NVCF group after the secondary BKP and at the final follow-up (P < 0.05). No statistical differences were detected in ODI between the 2 groups prior to the initial BKP, one day after initial BKP, prior to the secondary BKP and 1 day after the secondary BKP (P > 0.05), but the ODI scores were higher in adjacent NVCF group than in remote NVCF at last follow-up (P < 0.05). Kyphotic angle and vertebral heights were significantly restored and maintained after secondary BKP within groups, respectively. Secondary BKP is an effective procedure for treating NVCF after initial BKP. Patients with new fracture in remote level gain slightly better pain relief than those in the adjacent level.