Comparison of Clinical Outcomes and Radiographic Measurements in 4 Different Treatment Modalities for Osteoporotic Compression Fractures

Ee, Gerard; Jiang, Lei; Guo, Chang; Yeo, William; Tan, Seang Beng; Tow, Phak Boon Benjamin; Chen, Li Tat John; Yue, Wai-Mun

doi:10.1097/bsd.0b013e31828f940c

Cited by 19 publications

(18 citation statements)

References 13 publications

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“…17 , 26 – 56 ( Figure 1 ). They included 4 RCTs, 27 , 31 , 41 , 53 14 prospective cohort studiess, 17 , 32 , 33 , 36 , 39 , 40 , 41 – 49 , 54 and 14 retrospective cohort studies 26 , 28 – 30 , 34 , 35 , 37 , 38 , 42 , 50 – 52 , 55 , 56 ( Figures 2 and 3 ). There were a total of 3274 patients; 1653 patients underwent the KP surgery and 1621 underwent VP surgery.…”

Section: Resultsmentioning

confidence: 99%

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

Liang¹,

Chen

Jiang

et al. 2016

Annals of Saudi Medicine

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BACKGROUNDBoth kyphoplasty (KP) and vertebroplasty (VP) are effective for patients with osteoporotic vertebral compression fracture (OVCF), but which approach might be more effective remains unclear, so we decided to update earlier systematic reviews.OBJECTIVEReview and analyze studies published as of August 2015 that compared clinical outcomes and complications of KP versus VP.DESIGNSystematic review and meta-analysis.SEARCH METHODPublished reports up to August 2015 were found in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL).SELECTION CRITERIARandomized controlled trials (RCTs) and prospective and retrospective cohort studies comparing KP and VP in patients with OVCF.DATA COLLECTION AND ANALYSISTwo authors independently assessed the studies and extracted data.RESULTSThirty-two studies involving 3274 patients fulfilled the inclusion criteria. There were significant differences between the two groups in short- and long-term postoperative changes in measures of pain intensity and dysfunction (P<.01), in anterior and middle height (P<.01), kyphotic angle (P<.01), and time to injury, but not in posterior height (P=.178). There were no significant differences in the rate of postoperative fractures including adjacent and total fractures, but cement leakage to the intraspinal space was greater in the VP group (P=.035). KP surgery took longer and required a greater volume of injected cement.CONCLUSIONSKR resulted in better pain relief, improvements in Oswestry dysfunction and radiographic outcomes with less cement leakage, but further RCTs are needed to verify this conclusion.LIMITATIONSOnly four RCTs with a certain of risk of bias. Most studies were observational.

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Section: Resultsmentioning

confidence: 99%

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

Liang¹,

Chen

Jiang

et al. 2016

Annals of Saudi Medicine

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“…Currently, there are three kinds of treatments for VCFs are used in clinics:[ 3 – 6 ] traditional conservative treatment, traditional surgical treatment, minimally invasive treatment. Compared to the other two treatments, minimally invasive treatments have been increasingly used and will be the mainstream methods for the treatment of VCFs in the future due to its smaller incision, shorter treatment time, less blood loss, less pain, shorter recovery time, and shorter hospitalization [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…As a modified form of PVP, PKP is similar to PVP except that commercial inflatable bone tamp or Sky-bone expander is percutaneously inserted into the fractured vertebral body, and then is inflated, deflated, and withdrawn to create a cavity and to restore the fractured vertebral body height prior to bone cement injection. [ 8 , 9 ] PVP and PKP have been widely applied for the treatment of VCFs. However, the benefits and shortcomings of these two techniques are still debated such as height restoration and bone cement leakage [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy Studies of Vertebroplasty, Kyphoplasty, and Mesh-Container-Plasty for the Treatment of Vertebral Compression Fractures: Preliminary Report

Chen

Li²,

Wang

et al. 2016

PLoS ONE

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To evaluate the clinical safety and efficacies of percutaneous vertebroplasty (PVP), percutaneous kyphoplasty (PKP), and percutaneous mesh-container-plasty (PMCP) for the treatment of vertebral compression fractures (VCFs), a retrospective study of 90 patients with VCFs who had been treated by PVP (n = 30), PKP (n = 30), and PMCP (n = 30) was conducted. The clinical efficacies of these three treatments were evaluated by comparing their PMMA cement leakages, cement patterns, height restoration percentages, wedge angles, visual analogue scales (VAS), and oswestry disability index (ODI) at the pre- and post-operative time points. 6.67%, 3.33%, and 0% of patients had PMMA leakage in PVP, PKP, and PMCP groups, respectively. Three (solid, trabecular, and mixed patterns), two (solid and mixed patterns), and one (mixed patterns) types of cement patterns were observed in PVP, PKP, and PMCP groups, respectively. PKP and PMCP treatments had better height restoration ability than PVP treatment. PVP, PKP, and PMCP treatments had significant and similar ability in pain relief and functional recovery ability for the treatment of VCFs. These results indicate minimally invasive techniques were effective methods for the treatment of VCFs. Moreover, these initial outcomes suggest PMCP treatment may be better than both PVP treatment and PKP treatment.

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“…Large meta-analysis studies of conservative versus interventional treatment do not show statistically significant differences although elderly patients can be mobilized faster after KP or VA [ 1 ]. Follow-up data shows a better restoration of vertebral height and a reduction of the angle of mild kyphotic deformity if these procedures are performed within the initial two to six weeks compared to when it is performed 16 or more weeks after the onset [ 23 - 25 ]. However, especially after balloon kyphoplasty, longer-term follow-up studies have shown loss of the initial height reduction in up to 25%-30% of cases although this is noted on post-procedure radiologic studies, often without any recurrence of clinical pain [ 26 - 28 ].…”

Section: Discussionmentioning

confidence: 99%

Radiologic Evaluation of Chronic Vertebral Compression Fractures and Role of Vertebral Augmentation

Hatgis

Palea²,

Ghomri

et al. 2018

Cureus

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The literature has classified chronic vertebral compression fractures (VCF) as those still "symptomatic" four or more months after onset. Pain is regarded as the predominant chronic symptom; however, radiologic changes are important in evaluating fracture progression. This review examines a series of patients with chronic fractures and both persistence of spinal pain combined with radiologic changes, such as worsening collapse, spinal angulation, the development of vertebral edema and clefts, as well as the development of new fractures at adjacent spinal levels. In patients with clear progressive radiologic changes in addition to pain, vertebral augmentation on an average of 9.3 months after injury was effective in reducing the pain and stabilizing these more chronic osteoporotic fractures. A comparison of the pre- and post-procedure visual analog scale score (VAS) indicated an average of 66% reduction in pain. There are several reasons for the development of chronic symptomatic fractures. Most commonly, interventional treatment is delayed in a patient already diagnosed with VCF after a long period of conservative treatment, yet pain persists, or the initial clinical and radiologic evaluation misses the fracture, leading to a delay in diagnosis and treatment. In this report, management in these patients and the role of late vertebral augmentation for chronic symptomatic fractures is clarified based on the findings of various radiologic changes seen on both initial and follow-up radiologic studies.

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Comparison of Clinical Outcomes and Radiographic Measurements in 4 Different Treatment Modalities for Osteoporotic Compression Fractures

Cited by 19 publications

References 13 publications

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis

Safety and Efficacy Studies of Vertebroplasty, Kyphoplasty, and Mesh-Container-Plasty for the Treatment of Vertebral Compression Fractures: Preliminary Report

Radiologic Evaluation of Chronic Vertebral Compression Fractures and Role of Vertebral Augmentation

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