ObjectiveTo investigate the safety and practicability of small balloon percutaneous kyphoplasty (PKP) in the treatment of osteoporotic mid-upper thoracic vertebral fractures and spinal metastases-related mid-upper thoracic vertebral fractures. MethodsThe clinical data of 34 patients (a total of 38 vertebral bodies) with osteoporotic mid-upper thoracic vertebral fractures or spinal metastases-related mid-upper thoracic vertebral fractures treated by PKP were retrospectively analyzed. The bone cement amount, leakage and diffusion were recorded, and the vertebral height, VAS score, and Oswestry disability index (ODI) score were compared before operation, 1 day after operation, and 7 days after operation. ResultsAll patients successfully completed the unilateral small balloon PKP. A postoperative review showed 2 cases of bone cement intervertebral space leakage and 1 case of perivertebral leakage, but with no clinical symptoms occurred. Bone cement diffused completely in 29 patients, averagely in 3, and poorly in 2. One patient with metastases had another pathologic fracture of the sacral 1 vertebra during follow-up. The average amount of bone cement injected into each vertebral body was 2.8-4.2 mL. The VAS scores and ODI scores 1 day and 7 days after operation were lower than those before operation, the vertebral heights were higher than that before operation, and the VAS score 7 days after operation was lower than that 1 day after operation, with statistically significant differences (all P＜0.05). ConclusionSmall balloon PKP in the treatment of osteoporotic mid-upper thoracic vertebral fractures and spinal metastases-related mid-upper thoracic vertebral fractures has high safety, with sufficient diffusion of bone cement and satisfactory clinical effect, which is worthy of clinical application.

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