A comparative study of high-viscosity cement percutaneous vertebroplasty vs. low-viscosity cement percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures

Abstract

The clinical effects of two different methods-high-viscosity cement percutaneous vertebroplasty (PVP) and low-viscosity cement percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCFs) were investigated. From June 2010 to August 2013, 98 cases of OVCFs were included in our study. Forty-six patients underwent high-viscosity PVP and 52 patients underwent low-viscosity PKP. The occurrence of cement leakage was observed. Pain relief and functional activity were evaluated using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), respectively. Restoration of the vertebral body height and angle of kyphosis were assessed by comparing preoperative and postoperative measurements of the anterior heights, middle heights and the kyphotic angle of the fractured vertebra. Nine out of the 54 vertebra bodies and 11 out of the 60 vertebra bodies were observed to have cement leakage in the high-viscosity PVP and low-viscosity PKP groups, respectively. The rate of cement leakage, correction of anterior vertebral height and kyphotic angles showed no significant differences between the two groups (P>0.05). Low-viscosity PKP had significant advantage in terms of the restoration of middle vertebral height as compared with the high-viscosity PVP (P<0.05). Both groups showed significant improvements in pain relief and functional capacity status after surgery (P<0.05). It was concluded that high-viscosity PVP and low-viscosity PKP have similar clinical effects in terms of the rate of cement leakage, restoration of the anterior vertebral body height, changes of kyphotic angles, functional activity, and pain relief. Low-viscosity PKP is better than high-viscosity PVP in restoring the height of the middle vertebra.

Comparison of high- and low-viscosity cement in the treatment of vertebral compression fractures

“…Two RCTs (1 meeting abstract and 1 full text) [ 16 , 22 ] and 5 cohort studies (3 prospective and 2 retrospective) [ 17 , 18 , 20 , 21 , 23 ] with a total of 490 patients and 712 vertebral bodies were included in this meta-analysis. Relevant information on these studies is presented in Table 1 .…”

“…In the 5 cohort studies, NOS was used to assess the quality of literature, and studies that achieved 6 or more stars were considered high quality. Among these studies, 3 articles attained 7 stars, [ 18 , 20 , 23 ] and the others attained 6 stars. [ 17 , 21 ] Therefore, these articles were judged as high-quality studies because the information in these articles met the NOS criteria.…”

“…Information regarding follow-up for the VAS and ODI was provided in 5 [ 17 , 18 , 20 , 21 , 23 ] and 4 [ 18 , 20 , 21 , 23 ] studies, respectively. We defined 1 to 3 months as short term and 6 to 12 months as long term based on the data presented in the studies.…”

“…[ 17 ] However, some researchers held a different view that there was no significant difference in the cement leakage rate between HVC and LVC. [ 18 , 19 ] In addition, the results of numerous studies based on the locations of cement leakage, such as leakage into the paravertebral area, the venous system, the disc space, and the intraspinal space, also differed. A prospective cohort study reported that no differences were found in the intraspinal space, paravertebral area or peripheral vein, except for the disc space.…”

Preparation and characterization of injectable PMMA‐strontium‐substituted bioactive glass bone cement composites

“…This might be a useful observation for the VP procedures since low-viscosity cements are better than high-viscosity mixtures for restoring the height of vertebrae. 44 Furthermore, as long as the cement cures, it goes through the viscoelastic phase and tan d decreases progressively. A rapid decrease in the slope indicates a predominantly elastic behavior.…”