Abstract
Objective: This study was conducted to investigate the outcome of percutaneous balloon kyphoplasty (KP) for the treatment of osteoporotic vertebral compression fracture(OVCF) in patients with rheumatoid arthritis (RA) and analyze the influence of erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), injected cement volume and duration of taking glucocorticoid on the outcome of KP procedure. Methods: A total of 39 RA patients (63 vertebral bodies) and 38 patients (50 vertebral bodies) without RA received KP management for OVCF. Changes in vertebral compression rate, local kyphotic angle, conditions of bone cement leakage, visual analogue scale (VAS) and Oswestry disability index (ODI) scores were evaluated for radiological and clinical outcomes of KP procedure. In addition, 39 OVCF patients with RA were divided into different groups according to the value of ESR, CRP, injected cement volume and duration of taking glucocorticoid to evaluate their influence on the outcomes of KP procedure.Results: The KP procedure significantly improved the compression rate, local kyphotic angle, VAS and ODI scores in both RA group and control group. The compression rate increased 11.56±3.8% in RA group which is significantly larger than the control group(p<0.05). The change of local kyphotic angle in RA group was 3.77±1.9, which is also larger than that in control group(p<0.05). Whereas, the changes of VAS and ODI scores were not significantly different between the two groups. Besides, radiological and clinical outcomes were not significantly different among the groups of different ESR, CRP, injected cement volume and duration of taking glucocorticoid no matter before or 1 year after the KP procedure, but 44% RA patients who take glucocorticoid for over 10 years had cement leakage after the KP procedure which is significantly higher than the group of RA patients with less than 10 years glucocorticoid use(p<0.05). In addition, 7 intradiscal cement leakage occurred in patients take glucocorticoid over 10 years where as no intradiscal leakage showed up in its control group(p<0.01).Conclusion: KP procedure was effective for OVCF patients with or without RA, for restoring vertebral body height, reducing local kyphotic angle, relieving pain and recovering spinal function. Compared to the control group, RA patients received more improvement in compression rate and local kyphotic angle after the operation. Intradiscal leakage occurred more in patients who take glucocorticoid for over 10 years.
Radiological and clinical outcomes of balloon kyphoplasty for osteoporotic vertebral compression fracture in patients with rheumatoid arthritis
