O-arm-Assisted Balloon Kyphoplasty for the Treatment of Vertebral Compression Fractures: A Retrospective Study.

INTRODUCTION

Vertebral compression fractures (VCFs) are a common manifestation of osteoporosis and are getting more common as the world's population ages. Over the years, balloon kyphoplasty (BK) has established itself as a popular treatment modality for osteoporotic VCFs. O-arm-guided navigation is one of the innovative techniques that improve safety and precision during spine surgeries. This study aims to evaluate the accuracy and safety of O-arm-assisted BK (O-BK) in the management of VCFs.

MATERIAL AND

METHODS

This retrospective, single-center analysis includes patients who underwent O-BK at our institution between 2018 and 2023. The main imaging modality was the O-arm O2 Surgical Imaging System (Medtronic, Dublin, Ireland). The inclusion criteria consisted of patients with acute, painful traumatic or osteoporotic VCFs involving a maximum of three lumbar or thoracic levels and presenting with localized back pain without accompanying radicular symptoms. Patients with concomitant degenerative spinal diseases relevant to their symptoms or with unstable fractures were excluded from the study. The main objectives were to evaluate operation duration, radiation exposure, and the rate of cement leakage.

RESULTS

A total of 74 patients with 102 vertebral levels were treated. The mean age of patients was 75.4 years, with the majority being females (71.6%, 53/74). Osteoporotic fractures were the primary diagnosis in 78.4% (58/74) of patients. The mean operation time was 63.01 minutes. The mean fluoroscopy time was 36.7 seconds. The overall mean effective dose was 9.22 mSv. Cement leakages occurred in 33.3% (34/102) of treated levels, with an intraspinal leakage rate of 3.9% (4/102). No patient experienced symptomatic leakages.

CONCLUSIONS

O-BK appears to be a safe and accurate minimally invasive procedure for treating VCFs, especially those associated with osteoporosis. In addition to the controlled radiation dose, the procedure's safety is demonstrated by the low incidence of intraspinal cement leakages and the absence of neurological deficits. O-arm technology's enhanced imaging and navigation precision, which enables accurate and secure treatments, is a significant advantage.