Incidence and risk factors of facet joint violation following percutaneous kyphoplasty for osteoporotic vertebral compression fractures

Abstract

Background Percutaneous kyphoplasty (PKP) has been widely used to osteoporotic vertebral compression fractures (OVCFs). No previous investigations have reported the incidence and risk factors of facet joint violation (FJV) caused by PKP. Purpose To determine the incidence and risk factors of FJV following PKP in patients with OVCFs. Material and Methods We reviewed a total of 153 patients who underwent bilateral PKP. Postoperative computed tomography (CT) scans were assessed to determine the degree of FJV owing to invasion by a puncture trocar. Clinical outcomes, including visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) scores, were collected from all patients. Clinical and radiological data were analyzed to identify the risk factors for FJV. Results FJV caused by PKP affected 18.9% of patients and 9.6% of facet joints; approximately 3.9% and 5.7% of facet joints were considered to have grade 1 and grade 2 violations, respectively. There were significant differences between the FJV and non-FJV groups in VAS and ODI scores after surgery. Significant differences were found with respect to the facet joint angle (FJA), the pedicle diameter (PD), and the distance from the entry point to the facet joint space (DEF). Multiple logistic regression analysis indicated that an FJA > 55°, a PD < 5 mm, and a DEF < 5 mm were independent risk factors for FJV. Conclusion The placement of a puncture trocar can cause FJV in patients with OVCFs and impact clinical outcomes after PKP. Special attention should be given to patients with an FJA > 55°, a PD < 5 mm, and a DEF < 5 mm.