Acute versus chronic vertebral compression fractures treated with kyphoplasty: early results*1

Crandall, Dennis G.; Slaughter, Douglas; Hankins, P.J.; Moore, Claire; Jerman, Jonathan D.

doi:10.1016/j.spinee.2004.01.003

Cited by 129 publications

(82 citation statements)

References 29 publications

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“…The data suggest kyphoplasty leads to more rapid return of independent functional mobility at a low risk of complications compared with nonoperative care. In contrast to recent reports questioning the efficacy of vertebral augmentation [4,34], our results support the use of kyphoplasty and confirm the results of other reports [16,24,27,35,40,56,58] that kyphoplasty may accelerate the restoration of patient functional mobility. The improvement in hospital discharge parameters may offset the initially higher cost of treatment and lead to a reduction in the use of medical resources after hospital discharge.…”

Section: Discussionsupporting

confidence: 88%

“…The authors concluded kyphoplasty is more effective than medical management of VCF. Despite these recent reports questioning the benefit of vertebral augmentation, the best evidence to date appears to support the use of kyphoplasty for treatment of symptomatic VCF [16,24,27,35,40,56,58]. No large-scale, nationwide studies have been performed to confirm the effect.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous augmentation of vertebral fractures by vertebroplasty [2,14,42] or kyphoplasty [25,35,37,40] has been used as a minimally invasive method of stabilizing such fractures and thereby reducing the associated pain of fracture motion in patients who have failed nonoperative care, including spinal bracing, activity modification, or narcotic analgesic medications. Many reports to date suggest that at both short-and long-term followup, well-selected patients can expect pain relief that limits narcotic requirements and enhances function in up to 90% of cases treated with kyphoplasty [16,24,27,35,40,56,58]. Recent randomized, controlled studies have suggested vertebral augmentation procedures are no more efficacious than sham placebo procedures [4,34].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of 5766 Vertebral Compression Fractures Treated With or Without Kyphoplasty

Zampini

White

McGuire

2010

Clinical Orthopaedics &Amp; Related Research

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Background The majority of the 700,000 osteoporotic vertebral compression fractures (VCFs) that occur annually in the United States affect women. The total treatment costs exceed $17 billion and approximate the total costs of breast cancer ($13 billion) and heart disease ($19 billion). Balloon-assisted percutaneous vertebral augmentation with bone cement (kyphoplasty) reportedly reduces VCF-related pain and accelerates return of independent functional mobility. Kyphoplasty may decrease overall cost of VCF treatment costs by reducing use of posttreatment medical resources. Questions/purposes We evaluated complications, mortality, posthospital disposition, and treatment costs of kyphoplasty compared with nonoperative treatment using the Nationwide Inpatient Sample database.Methods We identified 5766 VCFs (71% female) in patients 65 years of age or older with nonneoplastic VCF as the primary diagnosis in nonroutine hospital admissions; 15.3% underwent kyphoplasty. Demographic data, medical comorbidities, and fracture treatment type were recorded. Outcomes, including complications, mortality, posthospital disposition, and treatment costs, were compared for each treatment type. Results Women were more likely to be treated with kyphoplasty than were men. Patients undergoing kyphoplasty had comorbidity indices equivalent to those treated nonoperatively. Kyphoplasty was associated with a greater likelihood of routine discharge to home (38.4% versus 21.0% for nonoperative treatment), a lower rate of discharge to skilled nursing (26.1% versus 34.8%) or other facilities (35.7% versus 47.1%), a complication rate equivalent to nonoperative treatment (1.7% versus 1.0%), and a lower rate of in-hospital mortality (0.3% versus 1.6%). Kyphoplasty was associated with higher cost of hospitalization (mean $37,231 versus $20,112).

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of 5766 Vertebral Compression Fractures Treated With or Without Kyphoplasty

Zampini

White

McGuire

2010

Clinical Orthopaedics &Amp; Related Research

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“…The heterogeneity among studies observed in this latter case seems to be related to the duration of the follow-up period (P=0.06) in the meta-regression analysis. Likewise, the results of individual studies show that BK produces significant improvement in variables that indirectly measure pain symptoms, such as the need for opiates [10], the number of days during which pain interferes with daily life activities [15], and the number of days of bedrest because of pain [15] (Table 5). …”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

et al. 2006

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“…There is controversy regarding the optimal time of intervention, with some authorities recommending early intervention [61,71] and others suggesting that late augmentation does not compromise outcome [25,72]. The majority of VP studies that yielded significant pain relief (greater than a 4 point drop) had a mean fracture age less than 7 weeks (see Fig.…”

Section: Optimal Intervention Timementioning

confidence: 99%

Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies

et al. 2012

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Purpose To determine if differences in safety or efficacy exist between balloon kyphoplasty (BKP), vertebroplasty (VP) and non-surgical management (NSM) for the treatment of osteoporotic vertebral compression fractures (VCFs). Methods As of February 1, 2011, a PubMed search (key words: kyphoplasty, vertebroplasty) resulted in 1,587 articles out of which 27 met basic selection criteria (prospective multiple-arm studies with cohorts of C20 patients).This systematic review adheres to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.Results Pain reduction in both BKP (-5.07/10 points, P \ 0.01) and VP (-4.55/10, P \ 0.01) was superior to that for NSM (-2.17/10), while no difference was found between BKP/VP (P = 0.35). Subsequent fractures occurred more frequently in the NSM group (22 %) compared with VP (11 %, P = 0.04) and BKP (11 %, P = 0.01). BKP resulted in greater kyphosis reduction than VP (4.88 vs. 1.7°, P \ 0.01). Quality of life (QOL) improvement showed superiority of BKP over VP (P = 0.04), along with a trend for disability improvement (P = 0.08). Cement extravasation was less frequent in the BKP (P = 0.01). Surgical intervention within the first 7 weeks yielded greater pain reduction than VCFs treated later. Conclusions BKP/VP provided greater pain relief and fewer subsequent fractures than NSM in osteoporotic VCFs. BKP is marginally favored over VP in disability improvement, and significantly favored in QOL improvement. BKP had a lower risk of cement extravasation and resulted in greater kyphosis correction. Despite this analysis being restricted to Level I and II studies, significant heterogeneity suggests that the current literature is delivering inconsistent messages and further trials are needed to delineate confounding variables.

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Acute versus chronic vertebral compression fractures treated with kyphoplasty: early results*1

Cited by 129 publications

References 29 publications

Comparison of 5766 Vertebral Compression Fractures Treated With or Without Kyphoplasty

Comparison of 5766 Vertebral Compression Fractures Treated With or Without Kyphoplasty

Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies

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