Efficacy of Balloon Kyphoplasty in Compression Fractures of the Thoracolumbar Spine


  • Waqas Noor Chughtai
  • Muhammad Adeel Razzaque
  • Tanveer Ahmad
  • Muhammad Tahir
  • Shakeel Ahmad
  • Shahzeb Nasir




Balloon Kyphoplasty, Vertebral Compression Fractures, bone cement


Objective:  To study the Efficacy of Balloon Kyphoplasty in compression fractures of the thoracolumbar spine.

Material and Methods:  This study was conducted on 95 patients with thoracolumbar wedge fractures from 2017 to 2022. Complete neurological examination and CT and MRI scans of the spine of all patients were done. All patients have been treated with a balloon kyphoplasty procedure. Data was collected on VAS score, SF-36 score, kyphotic angle and percentage of vertebral body destruction both preoperatively and post-operatively. Statistical analysis was done by using paired sample t-test.

Results:  The mean age was 57 years. Males were 58.9% and females 41.0%. Osteoporosis was the cause of fracture in 90.5% and trauma in 9.4% of patients. VAS improved from 7.42 ± 1.24 to post-procedure 3.24 ± 1.51, P < 0.0001. SF-36 improved from 35.31 ± 17.4 to post-procedure 49.23 ± 19.2, P < 0.0001. Kyphosis angle restoration from 18.42 ± 7.41 to post-procedure 10.61 ± 6.32, P value < 0.0001. Percentage loss of vertebral height from 32.91% to postoperatively 17.64% (SD-17.2 and P < 0.0001). 10.5% of patients developed cement leakage and there is no leakage in 89.4%. The adjacent level fracture occurred in 4 patients.

Conclusion:  Balloon Kyphoplasty is an effective procedure for thoracolumbar wedge fractures. It improves pain, activities of daily living, kyphosis angle improvement, and restoration of vertebral height.


Theodorou DJ, et al. Percutaneous balloon kyphoplasty for the correction of spinal deformity in painful vertebral body compression fractures. J Clin Imaging, 2002; 26: 1-5.

Chandra RV, Maingard J, Asadi H, Slater LA, Mazwi TL, Marcia S, Barr J, Hirsch JA. Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Fractures: What Are the Latest Data? AJNR Am J Neuroradiol. 2018; 39 (5): 798-806.

Kallmes DF, Comstock BA, Heagerty PJ, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures. N Engl J Med. 2009; 361: 569-579.

Filippiadis DK, Marcia S, Masala S, Deschamps F, Kelekis A. Percutaneous Vertebroplasty and Kyphoplasty: Current Status, New Developments and Old Controversies. Cardiovasc Intervent Radiol. 2017; 40 (12): 1815-1823.

Boss S, Srivastava V, Anitescu M. Vertebroplasty and Kyphoplasty. Phys Med Rehabil Clin N Am. 2022; 33 (2): 425-453.

Shapiro S, Abel T, Purvines S. Surgical removal of epidural and intradural polymethylmethacrylate extravasation complicating percutaneous vertebroplasty for an osteoporotic lumbar compression fracture: Case report. J Neurosurg. 2003; 98: 90-92.

Ledlie JT, Renfro M. Balloon kyphoplasty: one-year outcomes in vertebral body height restoration, chronic pain, and activity levels. J Neurosurg. 2003; 98: 36-42.

Wang B, Zhao CP, Song LX, Zhu L. Balloon kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fracture: a meta-analysis and systematic review. J Orthop Surg Res. 2018; 13 (1): 264.

Anselmetti GC, Zoarski G, Manca A, et al. Percutaneous vertebroplasty and bone cement leakage: clinical experience with a new high-viscosity bone cement and delivery system for vertebral augmentation in benign and malignant compression fractures. Cardiovasc Intervent Radiol. 2008; 31: 937-947.

Eck JC, Nachtigall D, Humphreys SC, et al. Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature. Spine J. 2008; 8: 488-497.

Lieberman IH, Dudeney S, Reinhardt MK, et al. Initial outcome and efficacy of “kyphoplasty” in the treatment of painful osteoporotic vertebral compression fractures. Spine, 2001; 26: 1631-1638.

Taylor RS, Taylor RJ, Fritzell P. Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine, 2006; 31: 2747-2755.

Zhang H, Xu C, Zhang T, Gao Z, Zhang T. Does Percutaneous Vertebroplasty or Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures Increase the Incidence of New Vertebral Fractures? A Meta-Analysis. Pain Physician, 2017; 20 (1): E13-E28.

Pitton MB, Morgen N, Herber S, et al. Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures. Eur Radiol. 2008; 18: 608-615.

Mukhdomi T, Whitten I, Kendall MC. Kyphoplasty: The Importance of Post-Operative Surveillance. R I Med J. (2013). 2020; 103 (8): 44-45.

Phillips FM, Ho E, Campbell-Hupp M, et al. Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Spine, 2003; 28: 2260-2267.

Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. N Engl J Med. 2009; 361: 557-568.

Li HM, Zhang RJ, Gao H, Jia CY, Zhang JX, Dong FL, Shen CL. New vertebral fractures after osteoporotic vertebral compression fracture between balloon kyphoplasty and nonsurgical treatment PRISMA. Medicine (Baltimore), 2018; 97 (40): e12666.

Garfin SR, Buckley RA, Ledlie J. Balloon kyphoplasty for symptomatic vertebral body compression fractures results in rapid, significant, and sustained improvements in back pain, function, and quality of life for elderly patients. Spine, 2006; 31: 2213-2220.

Coumans JV, Reinhardt MK, Lieberman IH. Kyphoplasty for vertebral compression fractures: 1-year clinical outcomes from a prospective study. J Neurosurg. 2003; 99 (1 Suppl): 44-50.

Wang H, Sribastav SS, Ye F, Yang C, Wang J, Liu H, Zheng Z. Comparison of Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Single Level Vertebral Compression Fractures: A Meta-analysis of the Literature. Pain Physician, 2015; 18 (3): 209-22.






Original Articles