¹Edwards R, ²Edwards R, ²James S, ¹James S
¹Elite Orthopedics, Melbourne, FL, USA; ²Florida OrthoCare, Palm Beach Gardens, FL, USA

Study Design
A case report of three patients.

Objective
We present three cases in which vertebral compression fractures were treated with minimally invasive balloon kyphoplasty and propose the treatment as a viable alternative in adolescents and young adults.

Summary of Background Data
Vertebral fractures are often painful injuries that traditionally plague the osteoporotic and elderly populations. The mainstay of treatment today ventures down either the conservative bracing and medical management pathway or the minimally invasive balloon kyphoplasty approach. To date, few studies of balloon kyphoplasty in adolescents have been reported.

Methods
The study was a single cohort observational study examining outcome and radiographic measurements in three adolescent patients before and after balloon kyphoplasty for the treatment of non-osteoporotic traumatic thoracolumbar compression fractures. The patients ranged from ages fifteen to seventeen. The indications for the study included painful primary non-osteoporotic thoracolumbar compression fractures that were correlated with magnetic resonance imaging findings of signal changes consistent with compressions fractures. The patients were treated with an injection of polymethyl-methacrylate (PMMA) or calcium hydroxyapatite BVF via balloon kyphoplasty. The results were clinically assessed by Visual Analogue Score (VAS), Roland Morris Disability Questionnaire (RMDQ), and vertebral body height restoration/stability on imaging.

Results
The mean preoperative VAS was 9.0 (range of 0 to 10). Percutaneous balloon kyphoplasty was performed with no associated complications (infection, embolic events, or neurological events). The functional status of the patients was immediately improved and dependence on analgesic medication decreased in all three patients. All three patients improved on the VAS pain score by at least five points. An average RMDQ score of 0.66 (out of 24) was obtained when assessing back function during 1+ years post-kyphoplasty follow-ups.

Conclusion
Balloon kyphoplasty may be an excellent minimally invasive alternative to the medical management of adolescents and young adults with vertebral compression fractures. The ability to return to normal working activities and social life at an earlier date is a promoting factor in its use.